Acquired heart dz in cats Flashcards

1
Q

Which heart diseases occur most in cats?

A

Cardiomyopathies
congenital dz
arrhythmias

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2
Q

What are the traditional cardiomyopathy classifications?

A

hypertrophic
dilated
restrictive
arrhythmogenic RV
unclassified

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3
Q

What is HCM?

A

hypertrophic cardiomyopathy
increased LV wall thickness

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4
Q

What can cause HCM?

A

hypertension
reduced preload
neoplastic infiltration
transient myocardial thickening
acromegaly
hyperthyroidism

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5
Q

What is RCM?

A

restrictive cardiomyopathy
normal LV wall thickness, LA dilation

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6
Q

What is a condition that can cause RCM?

A

hyperthyroidism

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7
Q

What is DCM?

A

Dilated cardiomyopathy
chamber dilation, systolic dysfunction

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8
Q

What can cause DCM?

A

dietary taurine deficiency
tachycardia-mediated

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9
Q

What is ARVC?

A

arrythmogenic RV
RA and RV dilation

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10
Q

What is the prevalence of HCM in cats?

A

15%
increases with age
1 in 7 clinically silent

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11
Q

Why are the LV walls thick in HCM?

A

In humans its mostly genetic mutation

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12
Q

What are 3 consequences to the heart of LV hypertrophy?

A

LV doesn’t relax (bad filling)
Stiff ventricle
= diastolic dysfunction
Poor myocardial perfusion

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13
Q

What are 3 clinical effects of cardiomyopathies in cats?

A

Pulmonary oedema
Intra-cardiac thrombus (dilated chamber is ideal for formation)
Arrhythmias

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14
Q

Which cats are prone to cardiomyopathies?

A

maine coons/ragdolls
mutations of myosin binding protein C

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15
Q

What is Dynamic LVOT obstruction?

A

SAM: Systolic Anterior Motion of the mitral leaflet/valve

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16
Q

What is the signalment for HCM?

A

male predisposition
before 6m or over 12y
pedrigree cats (maine coon, ragdoll, british shorthair, bengal, sphinx, etc)

17
Q

What does a cat with a gallop heart tell us?

A

they have a higher risk
associated with a worse prognosis for their HCM

18
Q

What are diagnosis tools for HCM in cats?

A

Xray (heart shouldnt be wider than 2 rib spaces, pulmonary oedema)
BP
Rule out hyperthyroidism
Echocardiography (LA enlargement)
Biomarkers

19
Q

What does a cat with LA tell us?

A

HCM cats with bigger LA have a higher risk and worse survival rate

20
Q

What are biomarkers for HCM?

A

Cardiac troponin-I (part of contractile apparatus and leak out with damage)
NT-proBNP (high in cats with LA dilation/myocardium stretch)

21
Q

What are the stages of heart disease?

A

A: predisposed animal
B1 low risk: subclinical, have dz but no CS
B2 higher risk: subclinical, have dz but no clinical signs, high risk of developing
C: current/previous HCF/ATE
D: refractory HCF

22
Q

What are the treatment options for asymptomatic (B1/B2) heart dz?

A

Low risk cats (no CS, no gallop, no arrhythmia, normal LA size, low biomarkers) -> No tx with follow up

23
Q

What are the treatment options for dynamic LVOT obstruction (Stage B2)?

A

if angina (panting when playing)
atenolol (B-blocker)

24
Q

What is the effect of atenolol on survival in cats with HCM?

A

Doesn’t improve survival but does improve quality of life

25
Q

What are the 2 major risks with LA enlargement?

A

Risk of CHF
Risk of thromboembolism

26
Q

What can we give to reduce the risk of thromboembolism (Stage B2)?

A

Anti-thrombotic medication: Clopidogrel, aspirin

27
Q

Between Aspirin and Clopidogrel which anti-thrombotic medication helped survival rates (Stage B2)?

A

Clopidogrel
Standard to reduce risk of thromboembolism

28
Q

What do we do with an acutely decompensated cat who we suspect has CHF (stage C))?

A

Minimal handling to decrease stress
Improve oxygenation
Potentially sedate to reduce stress
Furosemide to effect (loop diuretic to try and clear pulmonary oedema)
Echocardiogram (B lines = artifact)
Monitor renal function and electrolytes

29
Q

What medications can we give to eliminate abnormal fluid retention (Stage C)?

A

Furosemide
ACE inhibitor? (no proven benefit)
Spironolactone

30
Q

What medications can we give to a cate with refractory CHF (Stage D)?

A

increased furosemide
spironolactone
replace furosemide with torasemide?
Pimobendan?

31
Q

What are the tx for asympotmatic, normal LA?

A

No tx
atenolol for LVOTO

32
Q

What are the tx for asymptomatic, big LA?

A

Clopidogrel

33
Q

What are the tx for CHF?

A

Furosemide
Clopidogrel
Spironolactone (if cat can tolerate more meds)
Ace inhibitor?

34
Q

What are the tx for poor systolic function?

A

Pimobendan