Feline Cardiac Dz I

What genes are affected w/ HCM?

Contractile proteins Sarcometric

What genes are affected w/ DCM?

Structural proteins - cytoskeletal

Name a few clinical signs of Cardiomyopathy in cats?

Murmur

Sudden death

Pulm edema/ plural effusion

Acites

Hypothermia

What is dx of choice for Cardiomyopathy in felines?

Echocardiogram

-2Dimentions or M mode

What is M-mode echocardiography?

A calculation over time of what the heart is doing - slices through the ventricle

What is typically going to be enlarged in a cat w/ cardiomyopathy?

L atria

What is HCM?

Thickening of non-dilated ventricle - diastolic dysfunction

What protein is going to be affected in HCM?

Cardiac myosin binding protein C

Which two breeds have dysfunctions in Cardiac myosin binding protein C ?

Ragdolls,

Maine coons

What two things should be ruled out when suspecting HCM?

Systemic hypertension and Hyperthyroidism - cause secondary L ventricular hypertrophy

What is the equivocal for LV wall thickness in HCM?

Above 6-5.5mm

Identify the condition?

HCM

Identify the condition?

HCM

What are signs of Hypertrophic obstructive cardiomyopathy (HOCM)

Systolic Anterior Motion of the mitral valve (SAM)

L ventricular outflow obstruction

Mitral regurge

What are two signs of SAM?

Central papillary displacement

Chordal laxity

What drug can be used for HOCM?

Atenolol - tries to reduce heart rate to reduce SAM/LVOT - no longterm survival benefit

Identify the condition?

HCM -Myocyte disarray

What nutritional deficit was associated with/ DCM in cats?

Taurine

What is DCM in cats?

L ventricular dilation and systolic dysfunction - cannot contract

What two measurements would dx DCM on Echocardiograms?

L Ventricular dilation above 18mm

LV end systolic dimension above 14mm

Identify the condition?

DCM

Identify the condition?

DCM

What will we see on necropsy of DCM?

L ventricular dilation

Flattened atrophied papillary muscles and trabeculae

Apical thinning

Identify the condition?

DCM - Attenuated wavy fibers

What is restrictive cardiomyopathy (RCM)?

Decreased compliance of the ventricles due to fibrosis of muscle tissue - cannot relax to fill

What will you see on echocardiogram for RCM?

LA/biatrial enlargement - normal LV

Systolic function is normal

EMF - bridging fibrosis

Thrombus

Identify the condition?

RCM

What is arrhythmogenic R ventricular Cardiomyopathy(ARVC)?

R ventricular dilation due to fibrofatty replacement of the myocardium

What arrhythmias can be seen w/ ARVC?

Supraventricular tachycardia

Ventricular tachycardia

ARVC is similar to what canine dz?

Boxer cardiomyopathy

What are echocardiogram signs of ARVC?

R atrial / R ventricular dilation

Tricuspid regurge

Abnormal septal involvement

Identify the condition?

ARVC

Identify the condition?

ARVC

Non-specific phenotype Cardiomyopathy is a dx of ___?

Exclusions

What is an insensitive diagnostic test for Cardiomyopathy in a cat?

Murmurs - auscultation

What degree of systemic hypertension will be more likely to cause secondary L ventricular hypertrophy?

BP above 200mmHg

In an animal w/ Systemic hypertension what body system should be evaluated?

CKD

What can push a cat w/ systemic hypertension induced L ventricular hypertrophy into CHF?

Volume overload

How is feline systemic hypertension tx?

Amlodipine +/- ACE inhibitors

How does hyperthyroidism directly affect cardiac remodeling of the L ventricle?

Expression of myosin heavy chain genes

How does hyperthyroidism Indirectly affect cardiac remodeling of the L ventricle?

SNS -> systemic hypertension w/ increase of HR

Hyperthyroid induced hypertrophy is a ___ condition?

Reversible

What should be assessed b4 treating hyperthyroidism in cats?

Azotemia - can be falsely normal w/ hyperthyroidism

How is Hyperthyroidism tx in cats?

Methimazole

Radioiodine I-131

What is the LA/Ao ratio used for?

Prognostic indicator w/ cats w/ CM to develop CHF

What are two things to consider when using biomarkers?

Instability of the sample
Renal influence - are we in CRF

When do felines develop thrombi?

L atrial enlargement - stasis blood flow

What is virchows triad?

1. Venous stasis (blood flow)
2. Hypercoagulability (Composition of blood)
3. Trauma to a vessel (alteration to endocardial surface)

What is spontaneous contrast going to suggest?

Pre-thrombotic environment

What does a thromboembolism do?

Aortic trifurcation/ obstruction to organs
Vasoconstriction via serotonin and thromboxane

What do low temperatures in a thromboembolism suggest?

Low cardiac output - poor predictor of survival

What drug did the FATCAT study recommend to increase longterm survival and decrease of thrombotic events in cats?

Clopridogrel

What is the MOA of Rivaroxaban?

Factor Xa inhibitor (Sim to heparin)
-reduced rate of Acute thromboembolism - especially combined with/ clopridogrel

What is the MOA of Felycin-CA1?

mTORC1 targeting rapamycin complex 1 that reduces cell growth and protein synthesis - designed to reduce wall thickness

As of now due to the RAPACAT trial what Stage of heart dz can Felycin-CA1 be used in?

Subclinical Stage B1/B2 of HCM

Pimobendan should not be used in a cat w/ ____ but should be in ____?

HCM - heart unable to relax - pimobendan has no effect
DCM - heart unable to contract and pimobendan helps

What might be a clinical sign of a thromboembolic event?

Pain/ loss of deep pain
Cyanotic nail bed