PH

Question 1

What are the differential diagnoses for a coughing dog?

Answer 1

Laryngeal disease
Tracheal disease
Hilar lymphadenopathy
LA enlargement
Heart base mass or parenchymal neoplasia
Airway disease/chronic bronchitis
Pneumonia
CHF
Heartworm disease

Question 2

What diagnostics may be helpful to further investigate the cause of a cough?

Answer 2

Thoracic radiographs
Thoracic POCUS
+/- blood gas
+/- echocardiogram

Question 3

What are causes of pulmonary hypertension?

Answer 3

Pulmonary arterial hypertension (idiopathic, congenital heart defects)
Left heart disease
Respiratory disease, hypoxia
Pulmonary thromboembolism
Parasitic disease (heartworm)

Question 4

How is pulmonary hypertension treated?

Answer 4

Sildenafil (PDE5 inhibitor, vasodilation of pulmonary arteries)
Oxygen
Sedation
+/- pimobendan (PDE3 inhibitor)

Question 5

How do we assess cardiac size on radiographs?

Answer 5

Vertebral Heart Score
* Normal (dog) = 8.5 - 10.7
Vertebra Left Atrial Score
* Normal (dogs) = 1.4 - 2.3

Question 6

What types of respiratory disease can cause pulmonary hypertension?

Answer 6

Chronic obstructive airway disorders (tracheal or mainstem bronchi collapse, bronchomalacia)
Primary pulmonary parenchymal disease (interstitial lung disease, infectious pneumonia, diffuse pulmonary neoplasia)
Obstructive sleep apnea
Chronic exposure to high altitude

Question 7

What diseases predispose patients to hypercoaguability?

Answer 7

DIC
Heartworm disease
Hyperadrenocorticism
IMHA
Neoplasia
PLE, PLN
Sepsis