• young
• excercise intolerance
• machinery murmur
• pulmonary edema
• Toy poodle, Saluki, German Shepherd, Collie

Functional effects of PDA?  What is the prognosis?

• Cardiomegaly with LA/LV dilation
• Aortic aneurysm
• CHF
• Hydrothorax
• hepatomegaly
• (left to right shunt)

- Prognosis:  good with surgery

• RV hypertrophy
• anuerysm in PA
• CPC-L
• jet lesions
• hepatomegaly
• ascites
• modified transudate in abdomen

a.  Hole in between ventricles

b.  jet lesions in RV

c.  LV/RV hypertrophy

d.  endocardial fibroelastosis around hole

1.  IVSD

2.  Pulmonic Stenosis

3.  Overriding aorta

4.  RV hypertrophy

1. dyspnea
2. severe cyanosis
3. polycythemia due to hypoxia

Dorsally = ligamentum arteriosum

Left = PA

Right = aorta

Ventral = base of heart

- mostly GI signs - Megaesophagus

- weight loss - regurgitation after eating solid foods

1.  Vascular ring anomaly

2.  Myasthenia gravis

3.  Foreign body

4.  Idiopathic

- CNS Signs

a.  moderate depression

b.  aimless wandering

c.  bumping into things

d.  snapping at objects

e.  disorientation

Answer:  Bilirubin/Liver Enz.

Congenital = Normal

Acquired = Increased

Congenital

1. Bile acids = Inc.
2. UN = Dec.
3. Ammonia = Inc.
4. Amm. Biurate crystals = Present

Acquired (same)

1.  Bile Acids = Inc.

2.  UN = Dec.

3.  Ammonia = Inc.

4.  Ammon. Biurate crystals = present

1.  Thrombocytopenia

2.  Vasculitis

Dog = Hemangiosarcoma in the Right Atrium #1

- idiopathic RA tear #2

Horse = idiopathic aorta rupture at the semilunar valve

Cat = Cardiomyopathy trauma

1. Neoplasia
2. Copper deficiency
3. Hit By Car
4. HSA

1. Neoplasia
2. CHF
3. Liver (hypoalbuminemia)
4. Glomerulis (or kidney ex. amyloidosis)
5. GI (ex. lymphoma)

- decreased colloid oncotic pressure (hypoalb.)

- Increased hydrostatic pressure

1.  Neoplasia

2.  CHF

- Vasculitis

1.  Septicemia

2. TRP

3.  Glasser's disease

1. Lymphangitis
2. Ruptured thoracic duct

a.  Anorexia

b.  Dec. milk production

c.  Wt. loss

4.  Painful

5.  "grunt" reflex

6.  Muffled heart sounds - machinery murmur

1.  TRP

2.  LSA

3.  Endocarditis

4.  Cardiomyopathy (rare)

1. White muscle disease - #1 in young ruminant
2. Uremia - #1 in Old Dog and Cat
3.  Hypervitaminosis D
4. Hypercalcemia
5. Brain-Heart Syndrome
6. Johne's Disease

AV Valves glistening, nodular, white

Histo = fibrous tissue covered by endothelium

1.  Trauma (parasites, jug. catheter , anomaly, idiopathic)

2.  Clot

3.  Sepsis

- valves white/yellow/red, crumbly, dry, dull

- PIECES BREAK OFF EASILY- leads to thromboemboli

Dog:  Bartonella, Strep, Staph, Enterobacter

Cat:  Cardiomyopathy

Cattle:  C. pyogenes, Clostiridium, Strep, Staph

Horse:  Step, S. vulgaris

Pigs:  Erysipelothrix (tail doc, castration)

Sheep:  Step

Young all spp:  strep, anomalies

1.  Toxins (Monensin)

2.  Mineralization

3.  Nutritional (WMD, Mulberry Heart, hypercalcemia)

4.  Viral (coronavirus - rabbit; parvo -dog)

5.  Bacterial (endocarditis)

6. Ischemia (emboli)

1.      PDA

2.      Aortic Stenosis

3.      Pulmonic Stenosis

1.      AVSD

2.      AV Valve Dysplasia

3.      Endocardial Fibrosis

4.      PDA

5.      Aortic Stenosis

1.  IVSD (50%)

2.  Tetralogy of Fallot

3.  PDA

1.  primary thyroid adenoma - secondary cardiomyopathy - increased metabolic rate - incr. tissue demand for oxygen - incr. CO and T4 - incr. oxygen/protein synthesis by myocytes

2.  good prognosis with thyroid disease

3.  Cardiomegaly without pale foci; Left-sided hypertrophy; NO thrombi

1. Congenital anomaly

2.  Endocardiosis

3.  Endocarditis

4.  Pericardial disease

5.  Idiopathic (hypertrophy or dilatory)

6.  Heartworms

1.  Cardiomegaly, ventricular/IVS hypertrophy;  Histo:  hypertrophy; disorganized mm cells, fibrosis

2.  Atrial or saddle thrombus; Renal infacts; Pulmonary congestion/edema; Cardiac tammonade; Atrial mural endocarditis

1.  Pulmonic stenosis

2.  Right AV endocardiosis

3.  Patent foramen ovale

4.  Cor. pulmonale

5.  High altitude

1.  Idiopathic HCM

2.  Hyperthyroidism

1.  CHF; pulmonary edema

2.  poor

(canine cardiomyopathy is dilatory not hypertrophic)

LEFT = aortic stenosis, PDA, L. AV insufficiency, endocarditis, cardiomyopthy, myocarditis, neoplasia

RIGHT = pulmonic stenosis, PDA, R. AV insufficiency, endocarditis (cow), cardiomyopathy, myocarditis, HWs, pericarditis, neoplasia

Dog - ascites

Cat/Cow - hydrothorax

Horse/cattle - dependent edema, SQ edema, jugular pulse

• Clin path:  normal to pre-renal azotemia
• Left:  Pulmonary edema, hemosiderosis, heart failure cells, dyspnea/orthopnea, ex. intolerance, RAAS
• Right:  CPC-L, cardiac edema to kidneys, jugular pulse, hepato/splenomegaly, ex. intolerance

Often bacterial emboli from endocarditis

1.  Bacteremia:  any, Clostiridum, Listeria, RMSF

2.  Viral:  parvo, K9 distemper (rare), FMD, BT

3.  Parasitic:  Trypanosoma (Chagas), Toxoplasma, Leishmania (rare), Prototheca (rare), Sarcocystis (cow/sheep)

4.  Plant:  granulomatous Vetch (midwest)

Pathology:  PALE AREAS of Myocardium

Histo:  purulent - granulomatous depending on cause, duration

Dog:  LNN

Cow; lnn, abomasum, uterus, ocular, CNS

1. Poor

2.  lungs, regional lnn

(HSA is commonly located in spleen, RA, and SQ in dogs)

1.  LSA on thymus (dog/cat)

2.  Heart base tumor

3.  Thymoma

4.  Mesothelioma

1.  Immune - mediated (TIIIH)

2.  Verminous

3.  Viral

4.  Bacterial

5.  Toxic (uremia, mercury)

1.  Equine rhinopneumonitis Equine herpes virus I; EVA - Equine viral abortion

2.  EVA = Equine viral arteritis, Toga virus

3.  FIP

4.  Canine adenovirus

1.  Equine herpes virus

DDx:  protozoal myelitis

Horse:  1. S. vulgaris

2.  Equine herpesvirus I

3.  Equine viral arteritis (EVA) = rare

Dogs:  1.  Heartworms

2.  K9 adenovirus

3.  RMSF

4.  S. lupi

Cat:  1. FIP

2. FIV

Pig: 1. E. Coli

2. Edema disease

Calves:  1.  Haemophilus - TEM

Cows:  1.  MCF

2.  BVD

1.  Equine:  S. vulgaris

2.  Cat:  CM

3.  Dog:  glomerular amyloidosis

4.  Any:  Endocarditis, sepsis

1.  Heartworm: #1 in Dog

2.  HCM:  #1 in Cat

3.  R. AV endocarditis

4.  Renal amyloidosis (#2 in dog/cat)

5.  Cushings

1.  Grain overload (frothy bloat)

2.  Cattle; pulmonary embolus can erode through vessels - causes exsanguination aka bleed out

1.  Trauma:  rupture or hole in thoracic duct

2.  LSA

3.  CHF

4.  Idiopathic

-Prognosis:  Poor;  Treat LSA or surgery for hole

1.  Dyspnea; Fluid triglyceride is greater than 300 ug/dL

2.  White or tomato soup color fluid; cloudy

• Early:  lymphocyte rich
• Late:  neutrophil rich
• Histology:  will see mostly lymphocytes.  May see neutrophils or MP (esp. if older fluid); can't distinguish from pseudochylothorax

- Always do cytology for lymphoma