8/21 - Canine Cardiomyopathy Continued

Dilated

What type of cardiomyopathy can be primary or secondary and is most common in large and giant breed dogs? It is characterized by poor contractility, weakness, syncope, and arrhythmias. It is the second most common cardiac disease in dogs and involves loss of contractility. Heart murmurs (systolic and diastolic), galloping rhythms, biventricular CHF, TBE, and sudden death can occur. CO will decrease while BP will increase, sympathetic activation will occur, and atrial fibrillation and VPCs are common.

R

What waves on an ECG can be come irregularly tall in cases of DCM? This irregularity is called electrical alternans.

Congestive

Which type of primary DCM occurs in Great Danes?

Electrical

Which type of primary DCM occurs in boxers and dobermans?

Secondary

Which category of DCM cases includes those caused by nutritional problems with boutique diets, such as brachycephalic breeds?

Primary

Which category of DCM cases are also called idiopathic and are caused by mutations, mostly unknown in most breeds? Dobermans have pyruvate dehydrogenase kinase 4 mutations, boxers have striatin mutations, great danes have x-linked dominant mutations, and portuguese water spaniels have autosomal recessive mutations.

Taurine

DCM in cats is a secondary condition caused by nutritional deficiency in what amino acid?

A

Which stage of DCM is a dog at risk but with no abnormalities?

B1

Which stage of DCM includes arrhythmias related to DCM such as atrial fibrillation and VPCs?

B2

Which stage of DCM includes echocardiogram evidence of DCM and electrical abnormalities?

C

Which stage of DCM includes past or current clinical signs of CHF secondary to DCM?

D

Which stage of DCM includes end stage DCM refractory to standard treatment?

Yes

Can a b-blocker be given to DCM patients if there is a serious arrythmia? Drugs include carvedilol and sotalol.

Pimobendan

Which drug is most important to give a DCM patient and is a phosphodiesterase III inhibitor? It is an inodilator and increases contractility of the heart by increasing Ca sensitivity. It is a peripheral vasodilator and helps prolong survival in cases of DCM, DVD, and HCM.

Doberman

Sudden death can occur in 20-40% of which breed dogs with DCM? Prognosis is guarded-poor with all breeds with this condition. Often life expectancy is 6-12 months.

Pericardium

Diseases affecting what tissue around the heart can include effusion, congenital PPDH, and tamponade? Signs include unexplained cardiomegaly, R-CHF, and systemic illness.

Pericardiocentesis

What diagnostic procedure/test is the only diagnostic method for pericardial effusion? This is done to obtain fluid for analysis.

Effusion

Before diagnosing pericardial what condition, you should rule out neoplasia, infectious pericarditis, pericardial abscesses, effusive pericardial disease, constrictive pericardial disease, trauma, idiopathic pericardial effusion, CVD with atrial tear, and CHF?

Tamponade

What condition present in cases of pericardial effusion prevents use of furosemide and ACE inhibitors in treating it? It refers to compression on the coronary arteries, decreasing O2 flow to the myocardium. Giving these drugs would decrease BP, also decreasing O2.

ECG

What test should be run while you are doing a pericardiocentesis?

Left

On which side is pericardiocentesis done at the 6th intercostal space? It is less likely to pierce or lacerate the myocardium on this side.

Right

On which side is pericardiocentesis done at the 4th or 5th intercostal space, and has less chance of hitting a coronary artery?

Above

When doing a pericardiocentesis, should you place a local block directly above or below the costochondral junction where you are doing it? You should try to hit the pleura, intercostal muscle, and skin. You should support with your opposite hand and monitor the ECG for VPCs. After, you should monitor for clotting before removing the catheter to make sure you have not tapped the ventricle.

Transudate

What type of effusate can be present in pericardial effusion due to hernias, cysts, CHF, hypoproteinemia, and a heart base mass?

Exudate

What type of effusate can be present in pericardial effusion due to perforation or infection (FIP, nocardia, fungi)?

Hemorrhagic

What type of effusate can be present in pericardial effusion that is idiopathic or due to cardiac or heart base tumors, coagulopathies, trauma, and atrial tears?

Chemodectoma

What heart base tumor can cause hemorrhagic pericardial effusion and is most common in brachycephalic breeds?

Doxorubicin

What drug can cause acute and chronic damage, decrease CO, cause arrhythmias, and can cause myocyte damage? This occurs to too high of a cumulative dose and has similar presentation to DCM. Carvedilol can be given to minimize damage and should be administered slowly.

Myocarditis

Which infective heart condition can occur due to parvovirus, canine distemper virus, Bartonella, Lyme disease, Chagas disease, toxoplasma, neospora, babesia, and hepatozoanosis?

Trypanasoma

What genus of protozoa causes Chagas’ disease and is spread by Reduviid bugs? It can cause myocarditis, and can be acute (tachyarrhythmias, AV disturbances, sudden death), latent (antibodies against this and the heart muscle), or chronic (cardiomegaly - general or right).