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Cardiovascular > Large Animal CV Disease > Flashcards

Large Animal CV Disease Flashcards

0
Q

Most common cause of pericarditis in horses?

A

Idiopathic

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1
Q

What is the most common cause of pericarditis in cattle?

A

Septic

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2
Q

WHat are the 5 potential causes of pericardial disease?

A

> Septic (traumatic or embolic causes, most common in cattle)
Idiopathic (spontaneous and non-septic, eg. effusions, most common in horses)
1* bacterial pericarditis (pigs)
neoplastic (uncommon LA)
Viral (uncommon LA)

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3
Q

What is a sequalae to traumatic reticulo-peritonitis in cattle, but is now uncommon? what is this also known as?

A
  • traumatic peritonitis

- known as hardware or wire disease

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4
Q

How does traumatic pericarditis appear on opening of the pericardium?

A

“bread and butter” cheesey fibrous exudate, adhesions and gas

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5
Q

What may also be found with traumatic pericarditis in cattle?

A
  • reticular abscesses
  • liver abscesses
  • peritonitis
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6
Q

What may be a cause of hardware disease nowadays?

A

Chinese lanterns

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7
Q

Early signs of traumatic peritonitis?

A
  • fever
  • anorexia
  • depression
  • cranial abdo/reticular/thoracic pain
    > elbows adducted, reluctant to move, grunting on movement
    > positive WIlliams test (listen for grunt while ruminating) Bar and Pinch test for thoracic pain
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8
Q

Late signs of traumatic pericarditis?

A
  • right sided (constrictive) heart failure

- venous congestion, peripheral oedema

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9
Q

CLinical signs of traumatic pericarditis on CV exam?

A
  • tachycardia
  • muffled heart sounds
  • splashing washing machine murmer (sometimes)
  • venous distension
  • raised jug pulses and milk vein
  • weak peripheral pulses
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10
Q

Diagnosing traumatic peritonitis, best methods? What is usually done

A
  • radiography, US, pericardiocentesis under US guidance (only high value animals)
  • usually culled
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11
Q

Tx of traumatic pericarditis?

A
  • rumenotomy for wire removal
  • marsupialise pericardial sac to debride and lavage
  • magnet for prevention ( NOT multiple magnets! will repel!)
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12
Q

Which notifiable neoplastic disease in cattle may cause haemorrhagic pericardial effusion? Pathogensis?

A
  • Lymphosarcoma due to bovine leukeamia virus (BLV) = leukosis virus
  • Lymphoma masses in spine, RA wall (-> jugular distension), pericardium (-> haemorrhagic effusion, RCHF, neoplastic cells on cytology)
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13
Q

Which countries is BLV present?

A

US and Canada

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14
Q

What organism causes pericarditis in pigs? What is this disease commonly called?

A

> Haemophihlus parasuis
- Glassers disease
may also be caused by strep suis

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15
Q

CLinical signs of pericarditis in pigs?

A
  • fever
  • depression
  • fibrinous polyserostiis (joints)
  • CNS effusions
  • pleural, peritoneal and synovial effusions
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16
Q

What are the majority of pericardial effusions in horses casued by? What are a minority caused by?

A
  • majority idiopathic
  • minority pericarditis due to
    > EVA, influenza
    > strep pnumoniae, E. Coli, Actinobacillus equuii
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17
Q

Appearance of pericardium in horses with pericarditis?

A
  • bread and butter fibrinous effusion too
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18
Q

Drug tx of pericardial effusion in horses?

A

penicillin - potentially alter if something other than E. COli found as cause

19
Q

What oes cytology show in horses with pericardial effusion?

A

Unremarkable

20
Q

Clinical signs of pericardial effusion in horses

A
  • venous distension and ventral oesema
  • muffled heart sounds
  • pericardial friction rubs -> squeaking (rarely heard)
  • pleural effusion (dyspnoea, dullness on percussion, small lung field on auscultation)
21
Q

Diagnosing pericardial effusions in horses, best methods?

A 
> echo
- fluid +- fibrin in pericardial sac
- compression of cardiac chambers
> electrocardiography 
- small complexes
- main differential = obestiy 
> cytology of pericardial fluid (though risky!)
22
Q

What colour would a fibrinous effusion be on ultrasound?

A
  • effusion black

- fibrin white

23
Q

Tx pericardial effusion in horses?

A
  • repeated pericardial drainage and lavage +- Abx

- esp in RA collapsing (cardiac tamponade)

24
Q

Why will pericardial effusions froth when drained?

A

Proteinacious, fibrinous

25
Q

Prognosis for pericardial effusion in the horse?

A
  • good providing tx is early and aggressive

- constrctive disease may occour in chronic cases (worse prog)

26
Q

Which valves does baterial endocarditis affect and how is it caused?

A

any valves

- 2* to bacteraemia

27
Q

Which animals is bacterial endocarditis most common?

A
  • ruminants of and other farm animals (infection showers to the heart)
    > metritis, liver abscess, traumatic reticulitis, metritis, mastitis, navel abscess, joint ill
  • horses less common but possible
    > site of sepsis often not identified, spetic jugular thrombophlebitis from IV catheters possible
28
Q

Why is propt tx of bacterial endocarditis necessary?

A
  • large proliferatice vegetative lesions develop which limit propsect of return to normal valve function
29
Q

Clinical signs of bacterial endocarditis

A
  • congestive heart failure with murmur(s)
  • fever, cardiac murmur, tachycardia, tachypnoea
    > lab results
  • hyperfibrinogenaemia, anaemia, leucocytosis
  • blood culture (3x repeated, ideally when pyrexic) [sterile procedure, do not use indwelling catheter]
30
Q

Tx bacterial endocarditis

A
  • Broad spec Abx based on culture sensititvty

- Tx of farm animals usually not viable economically

31
Q

Prognosis of bacterial endocarditits?

A

Guarded even after bacteriologic cure (can limit further spread but damage to valve leaflets already done)

  • in some horses return to performance is seen with some right sided lesions
  • septic emboli may spread to distant sites (lungs from R heart, kidneys and joints from L heart) -> recrudescence
32
Q

What condition may occour 2* to lung dysfunction? Pathophysiology?

A

> cor pulmonale

  • leads to hypertrophy, dilation and ultimate failure of RV
  • caused by chronic pulmonary disease, pulmonary vascular disease or high altitude (eg. cattel farmed in mountains) leading to vasoconstriction [also known as brisket or high altitiude disease]
  • alveolar hypoxia -> pulmonary vasoconstriction -> pulmonary hypertension -> right ventricular failure
33
Q

CLinical signs of cor pulmonale?

A
  • subcut oedema (bottle jaw, brisket)
  • jugular venous distension and pulsations
  • dyspneoa and tachypnoea
  • tachycardia and cardiac murmur
34
Q

Prognosis of cor pulmonale

A

usually hopeless due to underlying chronic irreparable lung pathology and fibrosis
- exception: high altitude -> move cattle to lower pasture

35
Q

What is EIPH?

A

Excercise induced pulmonary haemorrhage

36
Q

Pathogenesis of EIPH?

A
  • pulmonary haemorrhage during excercise
  • volume varies from local pulmonary, tracheal bleeding or epistaxis
  • seen in horses, dogs and human athletes
  • haemorrhage from PULMONARY (not bronchial) vessels
  • in horses haemorrhage usually from caudodorsal lung lobes
  • pulmonary capillaries break as inevitable weak point (thin walled)
  • even with these mega thin capillaries normal TBs become hypoxic and hypercapnic at excercise
    > haemorrhage causes local inflam, ^ regional resistnance and pressure and ^ risk of vessel rupture
    > viscous cycle!
37
Q

Which circulatory vessels are affected by EIPH?

A

Pulmonary

not bronchial

38
Q

Why are the caudo-dorsal lung lobes most commonly affected by EIPH?

A
  • ^ blood flow
  • v intrinsic vascular resistance
  • displacment of diaphragm -> transient v alveolar pressure -> ^ transmural pressure -> rupture
  • ^ mechanical forces
39
Q

Predisposing factors for EIPH?

A
  • young TBs
  • BUT ^ prevalence with age due to fibrotic vessels
  • conditions ^ pulmonary vascular resistance
    > lower resp tract disease (eg. RAO)
    > Upper resp tract disease (eg. RLN)
    > Cardiac disease: atrial fibrillation, mitral valve disease
40
Q

Does EIPH affect performance?

A

Rarely!

41
Q

Clinical signs of EIPH?

A
  • no clinical signs
  • poor performance
  • sudden onset excercise limitation
  • swallowing after excercie
  • epistaxis
  • other signs of URT, LRT, cardiac disease (atrial fibrillation)
42
Q

How can EIPH be diagnosed?

A 
> clinical evidence
- epistaxis only present in very limited cases 
> endoscopy
> bronchoalveolar lavage 
- RBCs, haemosiderophages
> radiograpy
- not specific
- localised regions of interstitial opactiy in caudodorsal lung lobes
43
Q

Management of EIPH?

A

> ID and treat underlying URT, LRT, cardiac disease
break haemorrhage-iflammation cycle
- modify training to reduce episodes
- dust free (as RAO Tx)
- furosemide (v pulmonary capillary pressure - contentious!)

44
Q

Why may furosemide not be indicated for EIPH treatment?

A
  • against FEI guidlines so cannot be competed on it
45
Q

What does furosemide do? What other drugs may be indicated for use with EIPH?

A

> diuretic
- v circulating volume
- weight loss (marginally)
vasodilator
- other vasodilators eg. NO, argenine, ACEI
- silver trialled as anti-inflam and anti-bacterial (not a “drug” so allowed by FEI)

46
Q

Prognosis for EIPH?

A

Good to fair
- if spontaneous and minimal impact on perfomrmance
- or if asscoaited with resp infection or predisposing factor that can be identified and treated
Poor
- idiopathic bleeders with performance limitation

Cardiovascular (11 decks)

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