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what types of meds are used for chronic CHF therapy?
- diuretics (furosemide, spirinolactone)
- ACE inhibitors
- vasodilators (hydralazine, Amlodipine)
- + inotropes (pimobendan, digoxin)
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what is MOA for digoxin?
- inhibits Na/K ATPase and incr. Ca+
- (can incr. arrhythmias in atria; decr. them in ventricles)
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Are B-blockers helpful with DCM or HCM?
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HCM is idiopathic left ventricular hypertrophy and is genetic in which cat breeds?
- Maine coons
- rag dolls
- persians
- American SH
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what type of murmur is associated with HCM?
systolic murmur w/gallop rhythm heard best over sternum
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how does the mitral valve worsen HCM?
*systolic anterior motion* - increased pressure in ventricle pulls mitral leaflet into aortic outflow - obstruction - further incr. pressure in ventricle - worsens hypertrophy
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is HCM more commonly associated w/ atrial or ventricular fibrillation?
atrial fib (and TBE, sudden death)
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what meds are considered for tx of HCM?
- beta blockers/Diltiazem (slow rate for better filling)
- ACE inhibitors
- Aspirin/Clopidogrel (to prevent TBE)
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what age cat is affected by restrictive cardiomyopathy? what type of murmur? atrial or ventricular fibrillation?
- middle aged to older
- systolic murmur w/gallop rhythm heard on sternum
- ventricular arrythmias
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What breed of cat is affected by peritoneopericardial diaphragmatic hernias?
- DLH
- Persians
- Himalayans
- (weimeraners)
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what is the most common cause of heart failure in the dog?
valvular endocardiosis
-
which valve is most often affected by endocardiosis?
mitral (and tricuspid) - causes holosystolic plateau murmur
-
is valvular endocardiosis associated w/atrial or ventricular fibrillation?
atrial (enlarged atria also causes bronchial compression)
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endocardiosis is a degenerative valve disease affecting what size dogs at what age?
- small-mid sized older dogs
- (*except King Charles- young*)
-
what is myxomatous degeneration?
nodular thickening, deformity and weakening of valve with endocardiosis
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how can the progression of valvular endocardiosis be monitored at home?
have owners monitor resting respiration rate (earliest sign of PE)
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what valve is affected with bacterial endocarditis?
aortic and mitral
-
what is cause of bacterial endocarditis?
- concurrent or recent infections
- transient or persistent bacteremia (strep, staph, e.coli, bartonella)
-
what age and size dog is often affected by endocarditis? what kind of murmur?
young large breed w/newly diagnosed murmur (to and fro murmur)
-
what types of dogs are affected by DCM? what type of murmur?
- large/giant breed males (esp. Dobies)
- systolic (+/-) diastolic murmur that may have gallop rhythm
-
what nutritional deficiencies can cause DCM?
- taurine deficiency in cats
- L-carnitine deficiency in cocker spaniels
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are atrial or ventricular arrhythmias a common sequela of DCM?
atrial fib and VPCs
-
how is ECG affected by DCM?
tall R waves
-
what meds are considered for tx of DCM?
- ACE inhibitors to decr. afterload
- improve contractility (pimobendan, digoxin)
- (+/-Bblocker/Diltiazem to control arrhythmias)
-
what is MOA of pimobendan?
- phosphodiesterase 3 inhibitor
- ionodilator (incr. contractility by incr. Ca sensitivity)
- peripheral vasodilator
-
does pericardial disease affect R or L side first?
right side (thinner walls so compresses first)
-
what is most common type of fluid accumulation in dogs w/pericardial effusion?
hemorrhagic
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