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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
Why will pericardial effusions froth when drained?
Proteinacious, fibrinous
25
Prognosis for pericardial effusion in the horse?
- good providing tx is early and aggressive | - constrctive disease may occour in chronic cases (worse prog)
26
Which valves does baterial endocarditis affect and how is it caused?
any valves | - 2* to bacteraemia
27
Which animals is bacterial endocarditis most common?
- 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
Why is propt tx of bacterial endocarditis necessary?
- large proliferatice vegetative lesions develop which limit propsect of return to normal valve function
29
Clinical signs of bacterial endocarditis
- 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
Tx bacterial endocarditis
- Broad spec Abx based on culture sensititvty | - Tx of farm animals usually not viable economically
31
Prognosis of bacterial endocarditits?
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
What condition may occour 2* to lung dysfunction? Pathophysiology?
> 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
CLinical signs of cor pulmonale?
- subcut oedema (bottle jaw, brisket) - jugular venous distension and pulsations - dyspneoa and tachypnoea - tachycardia and cardiac murmur
34
Prognosis of cor pulmonale
usually hopeless due to underlying chronic irreparable lung pathology and fibrosis - exception: high altitude -> move cattle to lower pasture
35
What is EIPH?
Excercise induced pulmonary haemorrhage
36
Pathogenesis of EIPH?
- 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
Which circulatory vessels are affected by EIPH?
Pulmonary | not bronchial
38
Why are the caudo-dorsal lung lobes most commonly affected by EIPH?
- ^ blood flow - v intrinsic vascular resistance - displacment of diaphragm -> transient v alveolar pressure -> ^ transmural pressure -> rupture - ^ mechanical forces
39
Predisposing factors for EIPH?
- 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
Does EIPH affect performance?
Rarely!
41
Clinical signs of EIPH?
- no clinical signs - poor performance - sudden onset excercise limitation - swallowing after excercie - epistaxis - other signs of URT, LRT, cardiac disease (atrial fibrillation)
42
How can EIPH be diagnosed?
``` > 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
Management of EIPH?
> 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
Why may furosemide not be indicated for EIPH treatment?
- against FEI guidlines so cannot be competed on it
45
What does furosemide do? What other drugs may be indicated for use with EIPH?
> 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
Prognosis for EIPH?
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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