Lecture 12 9/13/24

Question 1

What is the clinical approach to stage A MVD patients?

Answer 1

-genetically predisposed
-screen often

Question 2

What is the clinical approach to stage B1/B2 MVD patients?

Answer 2

-subclinical patients
-perform chest rads. and echo if VHS > 10.5
-treatment with pimobendan

Question 3

What is a VLAS score?

Answer 3

vertebral left atrial size

Question 4

What is the clinical approach to stage C MVD patients?

Answer 4

-patients with current or historical signs due to pulmonary edema
-parenteral diuretic therapy used for urgent presentations
-furosemide, ACE-I, pimobendan, +- spironolactone for at home maintenance

Question 5

What is the clinical approach to stage D MVD patients?

Answer 5

-optimize ACE-I/pimobendan dose
-monitor renal function
-use triple diuretic therapy OR use torsemide in place of furosemide
-additional vasodilation therapy
-hospitalization for parenteral therapy

Question 6

What is the consequence of partial LA rupture/endocardial split?

Answer 6

acute pericardial perfusion development, which can be minor or lead to circulatory collapse

Question 7

What are the potential complications of MVD?

Answer 7

-chordal rupture
-partial LA rupture/endocardial split
-pulmonary hypertension

Question 8

What are the characteristics of infective endocarditis?

Answer 8

-uncommon
-agent is almost always bacterial, potential for fungal
-lesion is referred to as a vegetation

Question 9

Which factors are experimentally important in the pathogenesis of infective endocarditis?

Answer 9

-endocardial injury
-activation of clotting factors
-bacteremia and colonization of a non-infective thrombus

Question 10

What are the potential predispositions for infective endocarditis?

Answer 10

-congenital malformations that provide substrate for development; subvalvular aortic stenosis
-outdoor activity/tick exposure in some regions

Question 11

What are the most common anatomical sites of infection in infective endocarditis?

Answer 11

-aortic valve
-mitral valve

Question 12

What are the causative organisms of infective endocarditis?

Answer 12

-Streptococcus spp.
-Staphylococcus spp.
-Bartonella spp.

Question 13

What are the consequences of infective endocarditis?

Answer 13

-sepsis
-valve destruction resulting in valvular regurgitation
-myocardial dysfunction
-congestive heart failure
-embolism

Question 14

Which dog breeds often present with aortic valve infective endocarditis?

Answer 14

-boxer
-german shepherd
-golden retriever
-rottweiler
-newfoundland

Question 15

What are the clinical signs often seen in IE patients?

Answer 15

-lethargy
-inappetence
-lameness
-resp. distress

Question 16

What are the physical exam findings in patients with IE?

Answer 16

-most have evidence of CV disease such as murmur or arrhythmia
-potentially febrile

Question 17

How is IE diagnosed?

Answer 17

-leukocytosis on CBC/chem
-blood cultures
-echocardiography

Question 18

How is IE treated?

Answer 18

-empirical or culture-guided antibiotic therapy
-medical management of heart disease/HF
-anti-thrombotic therapy

Question 19

What is the prognosis of IE?

Answer 19

very poor, especially with aortic valve involvement