Cardiomyopathies

Question 1

Canine Dilated Cardiomyopathy

Answer 1

Disease of older male, large and giant breed dogs

Question 2

What is the cause of Canine Dilated cardiomyopathy?

Answer 2

Unknown

Could be from other myopathies, bacteria, viruses, nutritional defects, or immune-mediated diseases

Question 3

What occurs in patients with Canine Dilated cardiomyopathy?

Answer 3

The cardiac muscle (myocardium) becomes weak and flabby.
All chambers of the heart become dilated
Low-output circulatory failure (weakness, syncope, exercise intolerance)

Question 4

What do dogs with canine dilated cardiomyopathy often develop?

Answer 4

atrial fibrillation

Question 5

What are the clinical signs of canine dilated cardiomyopathy?

Answer 5

Right and left-sided heart failure

Question 6

When auscultating the chest of a dog with canine dilated cardiomyopathy, what do you hear?

Answer 6

A murmur of mitral regurgitation heard on the left chest
+/- gallop rhythm
+/- tachyrhythm

Question 7

What do the radiographs of a dog with canine dilated cardiomyopathy look like?

Answer 7

Left ventricular enlargement

Enlargement of both atria

Question 8

What does the ECG of a dog with canine dilated cardiomyopathy look like?

Answer 8

Insensitive

May show widened QRS and P waves

Question 9

What does an echocardiogram of a dog with canine dilated cardiomyopathy look like?

Answer 9

Test of choice

Left and right atrial wall thickening and left ventricular dilation

Question 10

What are the laboratory tests that are run to help diagnose canine dilated cardiomyopathy?

Answer 10

Atrial Natriuretic Peptide (ANP)
Brain Natriuretic Peptide (BNP)
Pro-BNP
Troponin 1 (cTn1)

Question 11

How do you treat canine dilated cardiomyopathy?

Answer 11

Diuretics
ACE inhibitors
Digoxin
Pimobendan
\+/- betablockers

Question 12

What is the prognosis of dogs with canine dilated cardiomyopathy?

Answer 12

Progressive disease

Almost always fatal in 6 months to 2 years

Question 13

What is Feline Dilated Cardiomyopathy associated with

Answer 13

Taurine deficiency

Question 14

What are the clinical signs of feline dilated cardiomyopathy?

Answer 14

Older, mixed breed cats
Dyspnea
Inactivity
Anorexia
Acute lameness or paralysis of the hind limbs

Question 15

What will you see on the echocardiogram of a cat with feline dilated cardiomyopathy?

Answer 15

Dilated heart chambers

Question 16

What will the ECG of a cat with feline dilated cardiomyopathy (DCM) look like?

Answer 16

Increased QRS voltages
Wide P waves
Ventricular arrhythmia

Question 17

What is the treatment for a cat with DCM?

Answer 17

Oral taurine supplementation 
Diuretic
Oxygen
Digoxin
ACE inhibitor
Pimobendan

Question 18

What is the prognosis of cats with DCM?

Answer 18

If they survive the 1st 2 weeks and respond to taurine supplementation they have a good prognosis
Cats that do not respond have a poor long-term prognosis

Question 19

What is the most common cardiomyopathy in cats?

Answer 19

Feline Hypertrophic Cardiomyopathy (HCM)

Question 20

What percentage of cases does HCM make up?

Answer 20

50-70%

Question 21

What happens to the heart of cats affected with HCM?

Answer 21

The left ventricle becomes thickened and stiff

Mitral regurgitation and aortic embolization frequently occur

Question 22

What occurs in 16-18% of cats with HCM?

Answer 22

Thromboembolism

Question 23

When auscultating a cat with HCM, what do you hear?

Answer 23

Soft, systolic murmur

Gallop rhythms or other arrhythmia

Question 24

What do you see on the radiographs of a cat with HCM

Answer 24

Normal to slight left atrial enlargement

“Valentine” heart shape

Question 25

What do you see on the ECG of a cat with HCM?

Answer 25

Increased P-waves Increased QRS width Sinus tachycardia

Question 26

What do you see on an echocardiogram of a cat with HCM?

Answer 26

Increased left ventricular free wall thickness and dilated left atrium

Question 27

What are the laboratory tests used to diagnose HCM?

Answer 27

BNP pro-BNP cTn1

Question 28

What is the most accurate method of HCM diagnosis?

Answer 28

MRI

Question 29

How do you treat HCM?

Answer 29

ACE inhibitors +/- Propanolol Diltiazem Low-dose heparin or aspirin to prevent thromboembolism

Question 30

What occurs second to heart disease in cats?

Answer 30

Thrombus formation

Question 31

Why are cats predisposed to form thrombi?

Answer 31

High platelet reactivity Endothelial damage Sluggish blood flow

Question 32

Where do thrombi frequently lodge?

Answer 32

The trifurcation of the aorta

Question 33

What do cats with feline thromboembolism present with?

Answer 33

A decrease in circulation in the rear legs

Question 34

What are the clinical signs of feline thromboembolism

Answer 34

Acute onset of rear leg pain and paresis Clod, bluish food pads Lack of palpable pulses in the rear limbs

Question 35

What is the treatment for cats with feline thromboembolism?

Answer 35

Tissue plasminogen activator Heparin Low dose aspirin

Question 36

What does tissue plasminogen activator do?

Answer 36

Fibrinolysin to break down clots

Question 37

What does heparin do?

Answer 37

Inhibits the formation of stable clots

Question 38

What is the prognosis for feline thromboembolism?

Answer 38

Guarded to poor