L79: large animal cardiac diseases

what is the normal heart rate of a cow?

40-80 bpm

A 2 week foal/calf presents with a respiratory rate of 80bpm. The client has treated the animal with multiple doses of antibiotics, but the animals condition continues to deteriorate and is now open mouth breathing. What specific question could you ask that would indicate a congenital heart issue?

has this been a problem since birth?

what things may indicate that this steer has cardiac disease?

1. brisket edema

2. jugular distension

3. reluctance to move

what are non-specific signs of heart disease in cattle?

1. exercise intolerance

2. weakness

3. ill thirft

4. pain

5. anorexia

6. prolonged recumbency

what are clinical signs of cardiac or respiratory issues in cattle?

1. cough

2. dyspnea

3. jugular pulse or distension

4. swollen abdomen

5. open mouth breathing

6. murmurs

7. arrhytmias

what are specific clinical signs of heart disease in cattle?

1. venous distension

2. murmurs or muffled heart sounds

3. arrhythmias

4. jugular pulse or distension

what is jugular distension an indicator of?

right sided heart failure

what causes venous distension/pulsations?

increased resistance to right ventricular filling

how do we want to evaluate venous distention?

with the head elevated

what specific conditions lead to venous distension?

1. right sided heart failure

2. tricuspid regurgitation

3. left sided heart failure with pulmonary hypertension

4. cor pulmonale

5. constrictive pericarditis

6. cardiomyopathy

7. heart base tumor or abscess

what deficiencies can lead to cardiomyopathy?

1. selenium deficiency

2. vitamin E deficiency

what clinical signs will you visually see in a cow with right heart failure?

1. jugular vein distension

2. brisket edema

3. tachypnea, dyspnea

4. can be found dead

where do you place your stethoscope for a cardiac auscultation in cow?

deep in the arm pit and listen on both sides

what are cardiac causes for tachycardia in large animals and horses?

1. congenital defects

2. endocarditis

3. pericarditis

4. TRP

what causes tachycardia in large animals?

1. reduced cardiac output due to cardiac or pulmonic issues

2. reduced output due to lack of circulating volume

3. reduced oxygen carrying capacity of blood

4. physiological

what are the cardiac diseases in ruminants?

1. arrhythmia

2. pericarditis

3. endocarditis

4. high mountain disease

5. cor pulmonale

what are the cardiac diseases in pigs?

1. mulberry heart disease

2. valvular endocarditis

what are the cardiac diseases in camelids?

1. congenital defects (VSD, PDA)

2. pericardittis

3. epicarditis

A 7 year old HFr beef cow, 50 days post calving, presents with a heart rate of 44 bpm, a

reduced rumen turnover and faecal output, and a ping in the left paralumbar fossa. No

fluid audible on succussion The cow is also distended on right ventral abdomen. She

walks without pain. What condition is the cow likely suffering from?

vagal indigestion

what is a “pabble” in cattle?

ventral sac of the rumen enlarges and extends into the right side pushing the abomasum to the right

what gives a better prognosis for PA murmurs in large animals?

1. anemia

2. excitement

3. fever

what gives a grave prognosis for PA murmurs in large animals?

1. pericarditis

2. lymphosarcoma

3. congenital defects

4. valve disease

what is the most common cause of pericarditis in large animals?

trauma → hardware disease

what are the causes of pericarditis in large animals?

1. trauma

2. hematongeous

3. extension from lungs or pleura

4. neoplasia (EBL)

what are the causes of endocarditis in large animals?

1. chronic bactermia

2. foot rot

3. abscesses

4. mastitis

5. metritis

6. TRP

what is the most common congenital cardiac defect seen in large animals?

ventricular septal defect (VSD)

what common congenital cardiac defects are seen in large animals?

1. VSD

2. PDA

3. ASD

what is cardiomyopathy in large animals?

subacute or chronic disease of ventricular myocardium

with cardiomyopathy there is no disease of what?

1. valves

2. vessels

3. lungs

what structure is often affected with endocarditis in cattle?

tricuspid valve

what is often the cause of endocarditis in cattle?

infection

what testing is done for endocarditis in cattle?

blood culture and potential echocardiography

what is the treatment for endocarditis in cattle?

• long-term (4-6+ weeks) bacteriocidal antimicrobials

• repeat blood culture 1-2 months after treatment stops

what is the prognosis of endocarditis in cattle?

guarded

what type of arrhythmias are more common in livestock?

secondary

what is a PA arrhythmia?

refers to Paroxysmal Atrial Fibrillation (pAF), an intermittent, irregular heart rhythm

what can PA arrhythmias be caused by?

1. vagal issues from forestomach issues

2. electrolytes and ketones

3. tumors

what is the normal heart rate of a horse?

28-44 bpm

what are the causes of tachycardia in horses?

1. reduced cardiac output due to cardiac or pulmonic issues

2. reduced output due to lack of circulating volume

3. reduced oxygen carrying capacity of blood

4. physiological

what can you test for if you think tachycardia in a horse is due to a cardiac or pulmonic issue?

1. troponin

2. electrolytes

3. trace elements

what can you test for if you think tachycardia in a horse is due to lack of circulating volume?

1. lactate

2. PCV/TP

what can you test for if you think tachycardia in a horse is due to reduced oxygen carrying capacity of blood?

1. PCV

2. blood smear

3. lactate

what is the typical presenting complaint for equine cardio issues?

exercise intolerance

what are the clinical signs of cardiac issues in equine?

1. lethargy

2. anorexia

3. weight loss

4. sudden death

what findings on clinical exam indicate equine cardiac disease or compromise?

1. jugular distension

2. tachycardia

3. chest edema

4. murmur

5. pale mucus membranes

the jugular pulse in a healthy horse should…

extend up to 1/3 of the way up the neck when the head is raised

what is the landmark for a positive jugular pulse?

1 hand above thoracic inlet

what is the primary indication for jugular distension in horses?

increased cardiovascular pressure and volume overload

what is the primary indication for jugular pulse in horses?

tricuspid regurgitation or heart failure

what is the physical appearance of jugular distension in horses?

vein is swollen or engorged

what is the physical appearance of jugular pulse in horses?

rhythmic wave or pulsation

where do you feel for the peripheral pulse when auscultating?

1. transverse facial vein

2. mandibular branch

what can a mismatch between a horses heart rate and peripheral pulse be a sign of?

1. peripheral arterial disease

2. blood clots

3. atrial fibrillation

what do you tell the owner of a horse that has a mismatch between heart rate and peripheral pulse?

no riding the horse

what is the normal blood pressure for a horse?

120/80

where can you take blood pressure for a horse?

1. tail cuff standing

2. distal limb

3. arterial

4. jugular catherization

what are heart specific diagnostics that can be done for blood pressure?

1. cardiac tropnonin I

2. myocardial CK

what is the following ECG in a horse?

2nd degree AV block

what is the following ECG in a horse?

normal

what is the following ECG in a horse?

3rd degree AV block

Which of the following would most likely indicate a 3rd degree AV block

on auscultation?

bradycardia with an irregular rhythm

what pattern do you see for a 2nd degree AV block in horses?

1. dropped beat

2. P wave without a QRS

3. can hear S4

what pattern do you see for an atrial fibrillation in horses?

1. baseline flutter

2. no P waves

what pattern do you see for a ventricular tachycardia in horses?

1. more than 4 VPCs

2. can be uniform or multiform

what cardiac drugs do we use in horses?

1. furosemide

2. quinidine

3. lidocaine

what do we use furosemide for in horses?

1. reduce edema

2. congestive heart failure

what do we use quinidine for in horses?

1. conversion of atrial fibrillation

2. ventricular tachycardia

what do we use lidocaine for in horses?

ventricular tachycardia

you perform a physical exam on a foal. upon ausculation, you hear a continous grade 3 murmur that is heard louder on the left side. what is your diagnosis?

PDA

what do you do if a foal younger than 7 days has a PDA?

recheck as it will likely close

what do you do if a foal older than 7 days has a PDA?

refer to specialist as it will not close

you perform a physical exam on a foal. upon ausculation, you hear a systolic right sided murmur. what is your diagnosis?

ventricular septal defect (VSD)

you perform a physical exam on a foal. upon ausculation, you hear a pansystolic grade 4 murmur. what is your diagnosis?

tetraology of fallot

what are the most common valves affected with valvular disease in horses?

mitral and aortic

what are the typical reasons for valvular disease in horses?

1. age related degenerative disease

2. bacterial endocarditis

You are listening to the heart in a horse on the left side. You hear a systolic murmur and determine it to be a mitral valve issue. What are your differential diagnoses?

1. mitral insufficiency

2. mitral endocarditis

You are listening to the heart in an older horse on the left side. You hear a diastolic murmur and determine it to be a semilunar valve issue. You listen again and determine it is a grade 3 murmur. What are your differential diagnoses?

1. endocarditis

2. aortic insufficiency

what are the bacterial causes of myocarditis in horses?

1. strep

2. stap

3. clostridium

what are the viral causes for myocarditis in horses?

1. EIA

2. influenza

3. EVA

what toxins can cause myocarditis in horses?

1. ionophores

2. gossypol

3. cassia

what are the clinical signs of myocarditis in horses?

1. fever

2. tachycardia

3. arrhythmias

4. +/ - murmur

what are the clinical signs of myocarditis with cardiac insufficiency in horses?

1. exercise intolerance

2. edema

3. weakness

4. respiratory signs

what is diagnostic of myocarditis in horses?

elevated troponin

what is the treatment for myocarditis in horses?

treat underlying disease and cardiac symptoms