Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

41 Cards in this Set

  • Front
  • Back

Valvular endocardiosis

Myxomatous degeneration of the heart valves, affecting mitral and tricuspid valves, leading to their incompetence

Breed and sex predisposition

CKC spaniel, poodles, males

Clinical signs

Systolic murmur over mitral and tricuspid valves.

Starts off as low grade left apical systolic murmur but grade increases, as does duration to become pan systolic

Mitral murmur moves over to right side of heart

Coughing due to large left atrium pressing on bronchi

Exercise intolerance

May present with incidental murmur or left sided or biventricular heart failure


Left atrial and ventricular enlargement

Severe mitral insufficiency

Right atrial and ventricular enlargement

Severe tricuspid insufficiency

Check pulmonary veins and lung fields for congestion or oedema

Generalised cardiomegaly


P waves - wide - left atrial enlargement or - wide and tall - left and right atrial enlargement

R waves - frequently tall and wide due to left ventricular enlargement

Tall R waves, wide QRS and deep Q wave indicative of biventricular enlargement

May be sinus tachycardia


Thickened valves may be visualised

Chamber enlargement

Doppler ultrasound


Depends on class of failure:

Frusemide, ACE inhibitors, pimobendan

Additional diuretics may be needed or digoxin for sinus tachycardia or atrial fibrillation


Guarded once heart failure develops

Cause of bacterial endocarditis

Systemic bacteraemia - septic emboli will seed off


Valvular incompetence or stenosis

Valve affected in cows compared to dogs and cats

tricuspid - emboli to lungs

D and c - emboli to joints and kidneys

source of bacteria for dogs

often periodontal disease

Presenting signs







Clinical findings

Pyrexia most common

Shifting lameness if septic arthritis

New murmur - systolic or diastolic


Non-specific findings


Non-specific findings

Myocardial emboli or myocarditis may cause arrhythmias


Vegetative lesions may be seen

Valvular lesions may lead to insufficiency/stenosis which will be apparent with Doppler

Diagnostic tests

Haematology for positive bacterial infection via culture

3 samples in 24 hours

May do urine sample and culture


Antibiotics for 4-6 weeks

Often parenteral followed by oral



Approach to patients with left-sided congestive heart failure

If stable - definitively diagnose and treat underlying cause

If critical - make stable by: oxygenation, cage rest, sedation if necessary, preload and after load reduction

then make definitive diagnosis

Approach to patients with right-sided congestive heart failure

If stable obtain definitve diagnosis

If large pleural effusion -> thoracocentesis

Abdominocentesis usually left only for diagnosis unless interfering with ventilation (because you will deprive animal of protein)

Once stable find definitive diagnosis and treat accordingly

Principles of long term treatment

Treat primary underlying cause

Preload and after load reduction

Positive inotrope

Improve diastolic filling

Correct rhythm - brady/tachyarrhythmias

Preload definition

Volume of blood filling ventricles at end of diastole

Afterload definition

Pressure left ventricle must overcome to circulate blood

Preload reduction methods

Loop diuretics

Thiazide diuretics

Potassium-sparing diuretics

ACE inhibitors


Loop diuretics

Frusemide - diruetic and natriuresis

May cause dehydration, pre-renal azotaemia, hypokalaemia and hyponatraemia and may stimulate RAAS

IV frusemide is vasodilatory so can be used to decrease preload in this way

Thiazide diuretics

Hydrochlorthiazide, chlorthiazide

Diuretic and natriuresis - sodium depletion if used with loop diuretic

Potassium-saring diuretic

Spironolactone - spares potassium, slow acting and cannot be used on its own but with ACE inhibitors and other diuretics

Venodilators (rhea)

Glyceryl trinitate -useful for cardiogenic pulmonary oedema - absorbed through skin - short term

Frusemide IV

ACE inhibitors (pril)

Enalapril, benazepril, imidipril, ramipril -

Hyperkalaemia is possible (careful with potassium sparing diuretics and potassium supplementation)

Enalapril - renal excretion so

Afterload reduction


ACE inhibitors



Hydralazine - mitral valve insufficiency,

May cause hypotension and reflex tachycardia

Large tablet hard to administer in small dogs and cats


Pimobendan - positive inotrope, vasodilator, no compensatory tachycardia

Treating systolic failure

Calcium sensitizer/inodilators

Cardiac glycosides

Beta agonist

Calcium sensitizer/inodilator

Pimobendan - beneficial for dilated cardiomyopathy and myxomatous valve disease

Cardiac glycoside


Weakly positive inotrope and used to control ventricular rate in ventricular fibrillation

Maintenance dose

Stop use if: anorexia, nausea, GI signs, arrhythmias

Decrease for obese dogs, fluid retention, dobermans, renal failure

Long half life in cats so use with caution

Beta agonist


IV, severe myocardial failure

Treating diastolic failure

Depends on underlying cause

Drain pericardial effusion

Improve ventricular relaxation

Slow heart rate and thus increase filling time

Decrease contractility and thus myocardial O2 consumption

Calcium channel antagonists

Diltiazem - lusitropic, negative inotrope and chronotrope

Beta blocker


Reduce heart rate so increase filling time and cardiac work

Negative inotrope