Treatment of Cats with Acquired CV Disease Flashcards

1
Q

What four classes can cats with acquired CV disease be split into, for treatment purposes?

A

At risk, Asymptomatic, Post or Present heart failure, chronic refractor HF.

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2
Q

Is treatment of cats with acquired CV disease based on type of cardiomyopathy or stage of the disease?

A

Stage of disease, treat most cardiomyopathies the same way depending on the stage.

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3
Q

What cats may be considered at risk of cardiomyopathies? Do these cats need treatment? How can you test them?

A

Maine coones, ragdolls etc may be at an increased genetic risk of HCM. Mutation testing can be done on Maine Coones, may check NT-proBNP as an initial step. No treatment needed.

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4
Q

If a cat has a cardiomyopathy but is asymptomatic, do they need treatment?

A

Usually low risk factors in these cats. They usually do not require treatment. May give ACEi if LA dilated, Diltiazem, or a B-blocker for control of LVOTO but not good evidence for these drugs.

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5
Q

If a cat has a cardiomyopathy but is asymptomatic, what signs would you expect to be normal (i.e. what are the risk factors for these cats)?

A

No gallop, no arrhythmias, normal LA size, low NT-proBNP. If have any of these may consider treatment.

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6
Q

If a cat has a cardiomyopathy and presents with an acute, life threatening heart failure, what are your initial treatment steps? Would you give IV fluids?

A

Administer oxygen (oxygen cages), sedation (as dyspnoeic cats get very distressed), IV furosemide to effect, thoracocentesis if necessary (significant pleural effusions are more common than in dogs). AVOID I.V. Fluids!!!

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7
Q

If a cat has a cardiomyopathy and presents with mild-moderate heart failure, what treatments would you consider? Would you hospitalise these patients?

A

Usually treated as out patients. Furosemide is important (give initially to clear congestive signs then have to continue), ACEi also used to eliminate abnormal fluid retention.

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8
Q

Would you give a cat with cardiomyopathy and presents with mild-moderate heart failure drugs to decrease HR?

A

May give atenolol or diltiazem which help to improve relaxation. However, it is controversial, as they are also negative inotropes which may worse CHF.

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9
Q

If a cat has a cardiomyopathy and recurrent chronic refractory heart failure after being given furosemide and an ACEi, what treatments would you consider?

A

Increase the dose of furosemide. If this doesn’t work, consider adding other diuretics e.g. Spironolactone, Thiazides. For cats with systolic dysfunction, may give Pimobendan, BUT NEVER TO CATS WITH LVOTO.

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10
Q

What are the risk factors for a cat with a cardiomyopathy developing an aortic thromboembolism (ATE)?

A

Any cat with a cardiomyopathy is at risk of an aortic thromboembolism, especially when LA is dilated and poorly contractile.

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11
Q

What can be done to try prevent a cat with a cardiomyopathy developing an aortic thromboembolism (ATE)?

A

Aspirin, low molecular weight heparin, WARFARIN IS NOT RECOMMENDED.

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12
Q

What is the treatment protocol in managing acute aortic thromboembolism?

A

Analgesia (methadone, fentanyl CRI), manage acid-base abnormalities, heparin (stop thrombus extension). Pulses should return within 72 hours.

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13
Q

What is the prognosis for a cat with acute aortic thromboembolism?

A

Grave prognosis <45%

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