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79 Cards in this Set
- Front
- Back
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Why does CHF occur in Feline HCM?
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LV thickens > decreased compliance
Volume builds up in the LA > Dilation Hypertrophy > MVD |
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4 differentials for LVE in a cat
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Systemic hypertension
Hyperthyroidism Aortic Stenosis Acromegaly |
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What type of failure does DCM lead to?
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Systolic. Can't pump with a flabby heart.
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How Tx idiopathic DCM cat in CHF?
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Lasix
Pimo Aspirin Taurine |
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What are the most important treatments for acute pulmonary edema with feline DCM/HCM?
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O2
Cage rest Lasix |
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Treatment for HCM
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Diltiazem
Altenolol +/- topical nitro |
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Txt of HCM w/ ThE
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plavix/aspirin
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TX of CHF for Mt HCM
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Lasix PO
Diltiazem or altenolol (diltiazem first) |
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Difference between Diltiazem and Altenolol for TX of CHF Mt. HCM
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DIltiazem - lowers HR, Dilates coronaries, relaxes myocardium
Altenolol - Lowers HR, NO dilation of coronaries, Antiarrhythmic; relieves outflow obstruction |
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8 major 2ndary causes of Canine CM
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Taurine
Carnitine Endocardial firbroelastosis Doxorubicin Tachycardia induced failure Parvo T Cruzi Neoplasia |
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How DX DCM?
Sig, CS, ECG, Rads, Echo, Labs |
Lg breed >2yo
CS: Coughing, dyspnea, orthopnea ECG: Most have Afib (boxers and dogies have VArr RG: Cardiomegaly (dobies not globoid) Pleural effusion, ascites Echo: dilation of At, Vt. Decreased systolic function Labs:pre-renal azo, Increased ALT AST |
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How TX primary DCM in CHF?
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Lasix
Cage rest Dig/Pimo Dobutamine/dopamine/Amrinone Nitro (or other vasodilators) Lidocaine |
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Long term TX of DCM
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Lasix
Pimo/dig Enalapril Mexilitine/sotalol Supplement Taurine for Goldens, Newfies, Cockers |
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Most improtant TX for acute Pulm edema from DCM?
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Vasodilators - Nitrol, Enalapril once taking drugs
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Doberman DCM minutiae?
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Autosomal dominant gene
Dobies sensitive to dig (1/2 dose) Poor PG |
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When/how to tx VPCs?
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When
Vtach >200 Synope + VPCs Couplets of VPCs >600 in 1 day Altenolol/sotalol |
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Cocker DCM details?
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Only small dog that gets DCM
Get Poor wall movement as opposed to MVDz Very prone to endocardiosis ov MV - MUST ECHO to differentiate |
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TX for Cocker DCM?
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Lasix
Dig/pimo Enalapril Taurine L-Carnitine |
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ARVC genetics?
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Autosomal Dominant (heritable)
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How TX ARVC
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Treat forever
Acute: Lidocaine LT: Mexilitine+altenolol Sotalol Mexilitine alone SVArr? Acute: Dig LT: Diltiazem or altenolol |
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How TX myocarditis?
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ABX ≥ 1mo
Rest for a month post infection |
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What causes systemic hypertension?
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CRF
Hyperthyroidism Neurogenic Pheochromocytoma Arterioschlerosis Cushings Diabetes Mellitus |
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How TX systemic Hypertension?
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Amlodipine + Enalapril (can use Am alone in cats)
Enalapril +Benzalapril B-blockers Diuretics DO NOT USE DILTIAZEM!!! |
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Arterioschlerosis vs. Atheroschlerosis
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Art - loss of elasticity and narrowing of lumen
Ath - narrowing d/t plaque deposits in the intima (fatty) |
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4 year old FS GSD vomiting and diarrhea q2d
Irregular HR |
Sinus arrest and Vt escape beats which may be increased d/t increased vagal tone. Try atropine to see if it goes away.
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What is Phypert and what causes it? What FX does it have on the heart?
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increased BP in Pulm vasculature d/t lack of resistance or thickened, stiff plum aa.
Pressure OL on RVt > RVE (dilation+hypertrophy) Resistance to RV filling Tricuspid regurg d/t RVE R CHF |
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What changes do HW cause in the lungs, Heart, etc?
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Lungs
AG from female uterus > PIE Coughing PHYPERT |
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How does PHYPERT develop with HWD?
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pulmonary endarteritis d/t activity of adults>thickening>decreased elasticity and increased pressure (may lead to fibrosis, Phypert, pneumonia, Cor pulmonale)
Immature > inflammatory response |
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Best test for HW?
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Modified Knott's
ELISA for female antigens - never TX based on ONE positive test |
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What drug to TX adult HW?
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Malarsomine dihydrochloride (immiticide)
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Tx of HW - recommended protocol
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1st - Preventative, doxy
2nd - Preventative 3rd - preventative, 1 dose immiticide 4th - Preventative, 2 dose immiticide 24 hrs apart |
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TX for ThE from HW TX
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Rest
Steroids ABX |
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Advantages of using split dose of immiticide?
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Decreased occurrence of ThE
Increased efficacy and safety Decreases insult to lungs from worms dying Can delay 2nd round if reaction Don't have to stage Decreases Wolbachia |
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Disadvantages of Split dose of immiticide?
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Cost
Total Arsenical dose is increased More exercise restriction |
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How long will ELISA remain + post -tx?
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3-6 mo
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How effective is Ivermectin at killing adults?
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Great, but SLOW. If you use it, you have to keep the dog quiet 2 years.
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What drugs kill microfilaria and what SE?
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Ivermectin
Anaphylactic shock Not approved safe in collies only preventative that kills adults Milbemycin Safe! not approved Sterilizes females. |
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Why TX microfilaria?
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Source of infection to other animals
Damage to kidneys |
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Post caval syndrome CS?
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Shocky
Bilirubinuria Hemoglobinuria Azotemia |
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How HWD different in dog/cat?
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Cats less susceptible
Lower # Slower development Shorter life (2 years) Lower microfilaria count |
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CS of HWD in cats?
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Dyspnea
Cough Vomiting |
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DDX for HWD in cats?
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Asthma
Bronchitis Lungworms Hairballs Cardiomyopathy Toxo Pleural effusions |
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What are causes of transudate or modified transudate pericardial effusions?
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hypoproteinemia
CHF Neoplasti lymphatic obstruction Heartbase tumor |
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What causes pericardial sac hemorrhage?
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Hemangiosarc
Trauma LAt rupture Ruptured aorta Clotting deficiency Iatrogenic |
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Most common primary tumors of the heart?
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Hemangiosarc (goldens and GSD)
Mesothelioma Fibrosarc Chondrosarc Adenocarcinoma |
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FX of significant pericardial effusions?
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Increased intrapericardial pressure
Increased resistance to coronary flow > myocardial necrosis Impeded filling of At/Vt Decreases CO and BP |
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Which side of heart most affected by CHF?
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Right. Get CHF
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DDX for a dog with ascites?
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DCM
Pericardial dz HWD Neoplasia |
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ECG changes associated with pericardial effusions?
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Electrical alternans (DDX - Alternating BBB, SVT
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What radiographic changes are seen in a dog with Pericardial effusion?
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Globoid heart
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What test can be used to DX Pericardial effusion?
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Echo - Should reveal tamponade (compression of R side)
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How TX dog w/pericardial effusion?
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Tap it. Enter on L/R chest @ 5th ICS
Remove it. Chemo (HSA) ABX Steroids DO NOT GIVE PIMO OR DIG!!! |
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Where does bacterial endocarditis occur most frequently? Dog/Horse/Cow
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Dog M>A>T>P
Horse A>M Cow T only |
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BEitis is what?
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infection of the heart valve
Colonize and ulcerate leaflets>form vegeatations> Shortens, deforms valve>leaky valve |
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Define arterioschlerosis
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Thickened arteries
Common to have mineralization/fibrosis of caudal abdominal aorta in dogs. |
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What is a jet lesion, and where does it occur?
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endocardial schlerosis d/t mechanical irritation of regurg
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Why do MR hearts go into failure?
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Decreased CO>low O2>ischemic myocardium>arrhythmias.
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Which breeds most commonly affected by endocardiosis?
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Small breeds
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What are the CVHD classes?
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A - at risk
B1 - asymptomatic/no remodeling B2 - Asymptomatic/Murmur and LHE C - L ChF EVER D - refractory CHF |
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How to treat class B2?
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ACEI (-prils)
Low salt ±BB |
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How TX dog with endocardiosis >LHF?
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Lasix
Cage rest Pimo Tap it. Acute: Nitroprusside CRI Nitrol ointment ACEI Chronic: Lasix Enalapril Pimo Tx arr (BB once out of failure) Low sodium Spironolactone for RHF |
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How to tx afib
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Dig
BB CCB (diltiazem) Cough suppressants Bronchodilators |
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Why do dogs with endocardiosis > acute arrhythmias?
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decreased coronary bloodflow>hypoxia of myocardium>arrhythmia
TX with Dig/Pimo, (BB once out of HF) |
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What age dog is most likely to have BE?
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mature, but not old Large breeds.
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DDX for HCM cats
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Hyperthyroidism
Systemic Hypertension SAS Acromegaly |
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HCM cats with heritable components
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Maine Coon - A3
Ragdoll - A8 |
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Etiology of HCM
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dysfunction in contractile protein>increased wall stress>LV wall thickens>decreased chamber filling in systole
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DDX for L base murmur?
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Aortic - BE, ASten
Pulmonic - Psten, TofF, ASD, VSD (referred) |
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ASten causes what problem?
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Pressure OL LV
Concentric Hypertrophy Increase in diastolic pressure in LV LA>LHF |
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SAS murmur?
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Systolic at L Base radiating to the R base and up the carotids
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How TX SAS?
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Altenolol
Exercise Restriction Balloon dilation |
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Systolic murmur over mitral area DDX
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Psten
Tof F ASD VSD (radiates) |
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PSten is inherited how?
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Auto recessive
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What dogs get PSten
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bulldogs
Terriers Chihuahuas (small breeds) lab Mastiff Newfie boxer |
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TofF defects
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Overriding Aorta
RV Hypertrophy PSten VSD |
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TofF CS
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Cyanosis - blue baby
Seizures d/t polycythemia |
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How TX ASD?
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Tx HF
Ductal occluder |
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How TX VSD
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TX HF
Ductal occluder |
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How confirm a VSD
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Echo - visualize defect and enlargement
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