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CRS2 > Vascular and Pericardial Disease in LA > Flashcards

Vascular and Pericardial Disease in LA Flashcards

1
Q

Most common causes of pericardial disease in different large animal species?

A
  • Traumatic / Septic
    • most common from in cattle
  • Idiopathic
    • most common from in horses
  • Bacterial
    • most common form in pigs
  • Neoplastic
    • uncommon in large animals
  • Viral
    • uncommon in large animals
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2
Q

How does traumatic pericarditis occur?

A
  • A manifestation of hardware disease (traumatic reticuloperitonitis)
  • ingested wires migrate through the wall of the reticulum, into the peritoneal cavity and through the diaphragm into the pericardial sac
  • accumulation of septic fluid and gas within the pericardial sac
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3
Q

Traumatic pericarditis clinical signs?

A
  • Early signs: non-specific
    • fever, anorexia, depression
    • stand with elbows abducted, or with forequarters elevated
    • reluctant to move
    • positive grunt test
  • Later signs: right-sided heart failure
    • venous congestion, peripheral oedema
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4
Q

Cardiovascular exam findings with traumatic pericarditis?

A
  • Tachycardia
  • Muffled heart sounds
  • Splashing “washing machine” murmurs
  • Venous distension
  • Weak pulses
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5
Q

Treatment of traumatic pericarditis?

A
  • the vast majority of affected cattle are culled
  • surgical procedures to strip out the pericardium and remove septic debris have been described
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6
Q

Causes of pericarditis in horses?

A
  • the majority of cases are idiopathic
    • equine viral arteritis, equine influenza
    • Strep. Pneumoniae (E.Coli, Actinobacillus
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7
Q

Clinical signs of pericarditis in horses?

A
  • Venous distension
  • Ventral oedema
  • Muffled heart sounds
  • Pericardial friction rubs (triphasic sounds in time with heart)
  • Pleural effusion
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8
Q

Diagnosis of pericarditis in the horse?

A
  • Echocardiography
    • fluid and fibrin in pericardial sac
    • compression of cardiac chambers
  • Electrocardiography
    • small complexes
  • Cytology of pericardial fluid
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9
Q

Treatment of pericarditis in the horse?

A
  • Pericardial drainage and lavage are indicated if the right atrium is collapsing (i.e. cardiac tamponade is present)
  • Indwelling drain and twice daily lavage with antibiotic containing fluids greatly improves prognosis
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10
Q

Prognosis of pericarditis in the horse?

A
  • good provided treatment is early and aggressive
  • constrictive disease may occur in chronic cases
  • Can return to full performance
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11
Q

Causes of pericarditis in the pig?

A

Haemophilus parasuis, Strep. Suis

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12
Q

Signs of pericarditis in the pig?

A
  • Non-specific signs - fever, depression
  • Also fibrinous serositis and effusion in CNS, pleural, peritoneum, and synovia
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13
Q

Clinical signs of septic jugular thrombosis?

A
  • hot
  • painful
  • discharging tracts (chronic)
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14
Q

Clinical signs of non-septic jugular thrombosis?

A
  • thickening “cording” of the vein
  • reduction in patency
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15
Q

What causes jugular thrombosis?

A
  • Most (all) cases of jugular thrombosis are associated with intravenous catheterisation or injection
  • Predisposing factors
    • Systemic inflammatory response syndrome
    • Multi-organ dysfunction Syndrome
    • irritant drugs
    • poor catheter placement
    • poor catheter use
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16
Q

What does the venous occlusion from jugular thrombosis cause?

A
  • Swelling in the supraorbital area
  • Cheek and lips
  • Tongue
    • Leading to dysphagia
  • Upper airway obstruction
    • Nasal airflow test
  • Proximal venous distension
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17
Q

What is ultrasonography used for with jugular thrombosis?

A

used to:

  • Assess extent of thrombus
  • Identify sepsis (cavitation)
  • Assess patency of vein
  • Distinguish perivenous swelling from thrombosis
  • Select site for aspiration
18
Q

Treatment of jugular thrombosis?

A
  • Broad spectrum antibiotics
  • Anti-inflammatories
    • Systemic (aspirin, other NSAIDs)
    • Topical (DMSO, hot packs)
  • Heparin
  • Vasodilators (Gyleryltrinitrate)
  • Raise head
19
Q

Complications of jugular thrombosis?

A
  • Embolic disease
    • Bacterial endocarditis
    • Septic Pneumonia
  • Long-term poor performance due to:
    • Recurrent laryngeal neuropathy
    • Upper airway oedema during exercise
20
Q

What is systemic inflammatory response system (SIRS)?

A
  • A self-amplifying dysregulated systemic inflammatory response
  • Triggered by
    • Bacterial toxins
  • Previously referred to as endotoxaemia
21
Q

What is multi-organ dysfunction syndrome?

A
  • Altered organ function in an acutely ill animal such that haemostasis cannot be maintained without intervention
  • Classified as either primary or secondary
22
Q

What is primary multi-organ dysfunction syndrome?

A
  • resulting from well-defined insult where organ dysfunction occurs early and is a direct consequence of the insult itself
  • Eg burns and neoplasia
23
Q

What is secondary multi-organ dysfunction syndrome?

A
  • Organ failure not in direct response to the insult but as a consequence of a host response (SIRS)
24
Q

What is disseminated intravascular coagulation (DIC)?

A
  • Pathological activation of coagulation
  • Associated with
    • SIRS, SEPSIS, SEPTIC SHOCK
25
Q

Clinical signs of disseminated intravascular coagulation?

A
  • In large animals, DIC is usually manifested by thrombosis rather than spontaneous haemorrhage
    • petechial haemorrhages
    • bleeding at following trauma
      • Venipuncture
      • Surgical sites
      • Nasogastric intubation
26
Q

Diagnosis of disseminated intravascular coagulation?

A
  • 4 out of 5 abnormalities of
    • Thrombocytopaenia
    • Prolonged prothrombin time
    • Activated partial thromboplastin time
    • Fibrin degradation products
    • Antithrombin 3
27
Q

Standard procedure for intravenous injection?

A
  • Inject in the proximal one third of the neck
    • avoids the carotid artery
    • which is less superficial
  • Remove the needle from the syringe
    • 18 gauge, 1/5 inch needle
  • Push the needle right into the hub
28
Q

What is aortoiliac thrombosis?

A

Partial or complete occlusion of the terminal aorta, and external and internal iliac arteries by an organising thrombu

29
Q

Clinical signs of aortoiliac thrombosis?

A
  • Poor performance
  • Exercise-associated hindlimb lameness
  • Breeding failure in stallions
  • After exercise
    • Cold limb
    • Weak pulses
30
Q

Diagnosis of aortoiliac thrombosis?

A
  • palpate thrombus, turgid vessel on rectal examination
  • visualise the thrombus with transrectal ultrasonography
  • vascular phase scintigraphy
31
Q

Treatment of aortoiliac thrombosis?

A
  • Non-steroidal anti-inflammatory drugs
  • Aspirin
  • Fenbendazole
32
Q

Prognosis of aortoiliac thrombosis?

A

guarded

33
Q

When does caudal vena caval thrombosis develop?

A
  • Formation of thrombus in the caudal vena cava following extension of sepsis from a liver abscess
  • Young, beef cattle
34
Q

Clinical signs of caudal vena caval thrombosis?

A
  • Early signs vague, may appreciate distension in the superficial epigastric veins without jugular distension
  • Respiratory signs
  • Severe epistaxis
  • Reduction in rumen motility, hyperkeratosis, loss of mucosal integrity
35
Q

When does vascular rupture tend to occur?

A
  • Vascular rupture is the commonest form of sudden death during exercising horses, accounts for around 30% of cases
  • Any intra-abdominal or intra-thoracic vessel can rupture
    • aorta and pulmonary artery appear to be most common sites
  • Vascular rupture and haemoperitoneum is an important differential in horses that present with severe distress following strenuous exercise (particularly if colic-type pain is noted)
36
Q

When does rupture of the uterine vessels occur?

A
  • Occurs in periparturient broodmares, particularly immediately before or after foaling, but up to three weeks after
    • Colic
    • Mass palpable in the broad ligament, or may bleed directly into abdomen
37
Q

Management of rupture of uterine vessels?

A
  • Conservative
  • Support circulation
  • Analgesics
38
Q

What is Aorto-cardiac fistula?

A
  • Congenital or acquired absence defect of the aortic wall
  • Seen mainly in intact males
39
Q

Clinical signs of aorto-cardiac fistula?

A
  • Rupture occurs during exercise or breeding
    • Sudden death
    • Distress
    • Ventricular tachycardia
    • Loud continuous murmur
40
Q

Diagnosis of aorto-cardiac fistula?

A

Echocardiography

41
Q

Prognosis of aorto-cardiac fistula?

A

Hopeless

CRS2 (64 decks)

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