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Cardiopulmonary > Canine Cardiomyopathies and Myocarditis > Flashcards

Canine Cardiomyopathies and Myocarditis Flashcards

(65 cards)

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1
Q

What are the three main canine cardiomyopathies?

A

Dilated Cardiomyopathy
Arrhythmogenic Right Ventricular Cardiomyopathy
Atrial Standstill

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2
Q

What type of cardiomyopathy is common in Dobermans and other large breed dogs?

A

DCM

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3
Q

Which breed inherits ventricular arrhythmias (rare)?

A

German Shepherd

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4
Q

Which breeds are predisposed to juvenile DCM?

A

Portugese Water Dog

Great Dane

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5
Q

What are three infectious causes of myocarditis?

A

Chagas disease
Parvovirus
Lyme disease

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6
Q

What are the two most common nutritional deficiences leading to cardiomyopathy in dogs?

A

Taurine

Carnitine

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7
Q

What drug can cause toxic cardiomyopathy in dogs?

A

Doxyrubricin

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8
Q

What four metabolic states can commonly cause cardiomyopathy and systolic dysfunction?

A

Muscular dystropy
Hypothyroidism
Hyperthyroidism
Tachycardia

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9
Q

What is dilated cardiomyopathy (DCM)?

A

Primary heart muscle disease characterized by cardiac dilatation and systolic dysfunction of one or both ventricles

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10
Q

What are the five hypothesized causes of canine cardiomyopathy?

A 
Familial/genetic
Immune-mediated
Viral
Metabolic
Nutritional
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11
Q

T/F: Canine cardiomyopathy is better understood than human cardiomyopathy

A

False; we’ve only pinpointed a few genes

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12
Q

Small dogs are more likely to get ___ (DCM/CVD), while large dogs are more likely to get (DCM/CVD)

A

CVD

DCM

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13
Q

T/F: There are breed-specific types of DCM

A 
True
Doberman
Boxer
English Cocker Spaniel
American Cocker Spaniel
Irish Wolfhound
Portuguese Water Dog
Great Dane
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14
Q

Large breed, male, middle aged dogs are a typical candidate for ___

A

DCM

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15
Q

What is the pathogenesis of DCM?

A

Neurohormonal activation -> proliferation of cardiac myocytes and fibroblasts and sodium and water retention -> increased preload -> cardiac remodeling (hypertrophy, dilatation, fibrosis, sphericity) -> Abnormal systolic, diastolic functions and arrhythmias

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16
Q

What are the three occult signs of DCM?

A

Arrhythmias
Systolic dysfunction
Sudden death

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17
Q

What are the six clinical signs of DCM?

A 
Weakness
Exercise intolerance
Syncope
Weight loss
CHF
Sudden cardiac death
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18
Q

What five signs of DCM should one look for on a physical exam?

A 
Systolic murmur or S3 gallop (S3 is blood filling ventricle)
Arrhythmia (pulse deficit)
Weak arterial pulses
Left sided CHF
Biventricular CHF occasionally occurs
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19
Q

What is seen on ECG of a dog with DCM?

A

Often, nothing

May see tachyarrhythmia (VT, AF)

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20
Q

What is seen on radiographs of a dog with DCM?

A

Nothing until overt diation present

Rads can’t assess function

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21
Q

What is seen on an echocardiograph of a dog with DCM?

A

Can see LV systolic dysfunction
Mitral regurgitation
LA enlargement

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22
Q

What are biomarkers?

A

Substances that can give information about organ function or dysfunction

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23
Q

What is atrial natriuretic peptide (ANP) useful for?

A

It is increased in Dobermans with occult and overt DCM

Not sensitive in other breeds

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24
Q

What are brain natriuretic peptide and N-terminal pro-BNP useful for?

A

NTproBNP increased in overt DCM

BNP sensitive screen for dogs with occult DCM

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25
What is troponin I (cTNI) useful for?
Increased in overt and occult DCM in Doberman
26
In American cocker spaniels, there is an association between low plasma ___ and DCM. How is this treated?
Taurine | Supplement taurine and L-carnitine
27
T/F: Female dalmations are more predisposed to DCM than males
False
28
What is the most commonly represented breed with DCM?
Doberman pinschers
29
T/F: Nearly 50% of Doberman pinschers will develop DCM in their lifetime
True
30
When/how do Doberman pinschers develop DCM? What are the two most likely outcomes?
Autosomal dominant inheritance (PDK4) Adult-onset (usually around 5yrs) Sudden death CHF
31
What is the main sign in the occult phase of DCM for Dobermans?
Progressive LV dysfunction
32
What does PDK4 do?
It plays a regulatory role in cardiac energy metabolism and fatty acid oxidation
33
T/F: Approximately 25% of Great Danes will develop DCM
True
34
T/F: DCM is an X linked dominant inheritance
False; X linked recessive
35
T/F: DCM is an autosomal recessive sex-linked allele inheritance in Irish Wolfhounds
True
36
T/F: Atrial fibrillation precedes DCM in many large breed dogs?
True (Great Danes, Irish Wolfhounds, Newfoundlands)
37
T/F: Univentricular CHF is most common in Irish Wolfhounds with DCM
False; Biventricular is most common
38
T/F: Newfoundlands often have DCM with no appreciable heart murmur
True
39
T/F: DCM is an autosomal recessive trait in Portuguese Water Dogs
True
40
What drugs can be used to treat occult DCM?
``` ACE inhibitors (Benazapril - Dobermans) Beta blockers (Carvedilol) - use cautiously with gradual increase, not for active CHF Pimobendan - the miracle drug ```
41
What drugs that provide inotropic support can be given for dogs with overt DCM? (3)
Dobutamine Pimobendan Digoxin
42
What drugs provide a neurohormonal blockade for dogs with overt DCM? (2)
ACE inhibitors | Spirinolactone
43
What drugs reduce preload in dogs with overt DCM? (1 and lifestyle change)
Furosemide | Low Na diet
44
What drugs reduce afterload in dogs with overt DCM? (2)
ACE inhibitors | Pimobendan
45
What drugs help control ventricular arrhythmia in dogs with overt DCM? (4)
Lidocaine Mexilitine Sotalol Amiodarone
46
What drugs help control supraventricular arrhythmias in dogs with overt DCM? (3)
Digoxin Diltiazem Amiodarone
47
What class I drugs (Na channel blockers) help treat ventricular arrhythmias?
Lidocaine (IV) Mexilitine (oral, can cause nausea) Procainamide (IV slowly)
48
What class III drugs (K channel blockers) help treat ventricular arrhythmias?
``` Sotalol Amiodarone (neutropenia, liver dysfunction) ```
49
What is arrhythmogenic right ventricular cardiomyopathy?
Fibrous fatty infiltrate of the right ventricular free wall Previously known as "boxer cardiomyopathy" Ventricular arrhythmias, syncope, and sudden death Ventricular systolic dysfunction and dilation also seen
50
How do boxers inherit ARVC?
Autosomal dominant trait | Deletion of gene encoding for striatin production
51
What signs characterize the classes of ARVC?
Class I: asymptomatic Class II: collapse and syncope Class III: left sided CHF (rare, usually right side first) All classes have RV arrhythmias
52
How is ARVC diagnosed?
``` Arrhythmia (not always) Biomarkers (cTNI - VPCs) Echocardiogram Holter monitor ECG - VPCs - singlet, runs, etc. ```
53
How is ARVC treated? (7)
``` Sotalol Mexilitine Amiodarone Fish oils Pimobendan ACE inhibitors Diuretics ```
54
What is atrial standstill?
Destruction and fibrous infiltration of the atrial myocardium results in an inability to transmit signal. See only nodal escape rhythm (Equally positive and negative QRS wave, large T)
55
What signs are associated with atrial standstill? (4)
Exercise intolerance Weakness Syncope R CHF
56
When are German Shepherds most at risk for inherited ventricular arrhythmias?
12 weeks to 18 months
57
What causes inherited ventricular arrhythmias in German Shepherds and how is it treated?
Abnormal sympathetic innervation of the ventricular myocardium Mexilitine - Sotalol combination
58
T/F: Plasma cTNI is often elevated with myocardial injury
True
59
What are three causes of protozoal myocarditis?
Leishmania Neospora caninum Toxoplasma gondii
60
What are two viral causes of myocarditis?
Parvovirus | West Nile
61
What are two parasitic causes of myocarditis?
Trypanosoma cruzi | Borrelia bergdorferi
62
T/F: Hypertrophic Cardiomyopathy is usually a primary disease in dogs
False; secondary
63
T/F: Hypothyroidism can cause systolic dysfunction and increased RV dimensions
False; LV
64
T/F: myocardial infarction is one of the most common cardiac issues in dogs
False; people!
65
Doxorubricin toxicity leads to what three cardiac changes?
Myocardial damage Systolic dysfunction DCM +/- CHF

Cardiopulmonary (12 decks)

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