Vascular Disease

Question 1

What size should a blood pressure cuff be?

Answer 1

40% the width of the limb

Question 2

How can cuff size influence blood pressure readings?

Answer 2

Narrow cuff = falsely high blood pressure readings

Cuff too big = falsely low readings

Question 3

What is the normal blood pressure of a dog?

Answer 3

133/75

Question 4

What is the normal blood pressure of a cat?

Answer 4

125/80

Question 5

What are definitions of systemic hypertension?

Answer 5

Systolic BP over 160

Diastolic pressure over 100

Question 6

What disease can cause systemic hypertension?

Answer 6

CKD
Hyperthyroidism
Hyperadrenocorticism 
Hyperaldosteronism
Phaeochromocytoma
Diabetes mellitus
Acromegaly
Liver disease
Chronic anaemia in cats
Obesity 
Stress 
CNS disease

Question 7

What consequences does hypertension have on the body?

Answer 7

Ocular
- retinal, haemorrhages, hyphaemia, retinal detachment

CNS
- bed tempered, haemorrhages, strokes, seizures, dull and depressed

Renal
- failure, proteinuria

Cardiac
- left ventricular hypertrophy, murmurs due to LVOT and mitral regurgitation

Question 8

If you diagnose hypertension what should you check?

Answer 8

Retinas
Neurological exam
Renal - USG and UPC
Echo - LV hypertrophy, LVOT

Question 9

How does arterial thromboembolism present in dogs?

Answer 9

Cavaliers predisposed
Secondary to endocrinopathies not heart disease
- Cushing’s disease
- Hypothyroidism

Emboli in the distal aorta
Usually only affects one limb
Painful, pulse less and cold
Hindlimb weakness or pain

Question 10

What conditions cause pulmonary hypertension?

Answer 10

Ventricular septal defects
Atrial septal defects
PDA

Heartworm 
Mitral valve disease
Pulmonary thromboembolism 
Left sided CHF 
Primary severe respiratory conditions

Question 11

How can you diagnose pulmonary hypertension?

Answer 11

Loud, systolic tricuspid regurgitation murmur
Dilated pulmonary arteries
Dilated right atrium
Tricuspid and pulmonic valve regurgitation

Question 12

What disease predispose to pulmonary thromboembolism?

Answer 12

Pulmonary hypertension
Cushings disease
PLE
PLN
IMHA

Question 13

How can you diagnose PTE?

Answer 13

Blood gases - large alveolar to arterial oxygen gradient

D-dimmer and fibrin degradation products increased

Question 14

What presentation does dirofilaria immitus cause?

Answer 14

Pulmonary hypertension and secondary RV hypertrophy 
Weight loss
Fatigue
Cough
Dysponea

Question 15

How can you diagnose heart worm?

Answer 15

Direct blood smear - visualise microfilariae
Microfilaria concentration tests
Heartworm ELISA
Radiography - enlarged pulmonary arteries
Us - worms in right atrium and pulmonary a.

Question 16

How should treat heart worm?

Answer 16

Remove worms via the vena cava

Question 17

How can you prevent lungworm?

Answer 17

Selamectin (stronghold)
Milbemycin (Milbemax)
Moxidectin (with imidacloprid in advocate)

Adulticide - melarsamine
- recommended to give doxycycline prior to this to kill off woolbachia first

Question 18

What is the presentation of lungworm?

Answer 18

Dogs that eat slugs and snails

Chronic coughing
Dysponea and haemoptysis
Ill thrift, exercise intolerance
CHF

Question 19

What are the clinical presentations of lungworm based on the body system?

Answer 19

Respiratory signs - cough, pulmonary hypertension (tricuspid murmur), dysponea

Coagulopathy - major bleed after surgery, epistaxis, haemoptysis, haematemesis

Neurological - due to aberrant migration of parasites, intracranial bleed

Question 20

How can you diagnose lungworm?

Answer 20

Radiography - patchy Millay lung pattern (at the periphery)
Angio-SNAP test
Larvae in faeces - baermanns
Larvae in BAL sample