When fluid accumulates in the body

The body is unable to pump enough blood to meet the body's needs (L or R)

Most cases become congestive as the ♥ worsens

A clinical syndrome-due to many diff. problems.

L sided-pulmonary edema

R sided-ascites, liver failure

L-coughing (moist, nocturnal), labored breathing, exercise intolerance

R-ascites, pleural effusion, hepatomegaly, jugular distension, stocking edema (legs thickened)

dilated cardiomyopathy in dogs

hypertrophic cardiomyopathy in cats

Common cardiovascular disease of dogs

Older, male, large and giant breeds

high incidence in Boxers

dilation of ♥ chamber dt weak, thin myocardium

results: ↓ cardiac output, etiology unknown

asymptomatic

arrhythmias

episodic weakness, exercise intolerance

syncope

CHF (R or L)

EKG-arrhythmias

radiology-N to cardiomegaly, pulomary edema

Echocardiogram-dilation of chambers, abnormal contractility

Holter monitor (EKG recording over 24+ hrs) get PVCs

• no cure
• keep patient comfortable
• diuretic for pulmonary edema
• digoxin to ↑ contractility
• enalapril for vasodilation
• antiarrhythmic drugs

pathology similar to dogs

most common cause is taurine deficiency

CS-middle aged or older, dyspnea, resp. distress, acute rear limb paralysis, thromboembolism, ♥ murmur

Diagnosis-Radiographs, lab work

L ventricular hypertrophy

↑ ventricular muscle mass-decreased size of lumen

etiology unknown

soft murmur-grd 2-3/6

gallop rhythm or other arrhythmia

acute ♥ failure

thromboembolism

dyspnea

sudden death

radiographs-♥ N to cardiomegaly

pleural effusion seen commonly

EKG- possible arrhythmias

Ultrasound-increased L ventricular wall thickness, dilated L atrium

diuretic

thoracocentesis

beta blockers

aspirin for thromboembolism

uncommon to rare in dogs

similar to feline hypertrophic cardiomyopathy

uncommon cause of clinical heart disease

malformations of the heart

malformations of the great vessels

genetic basis

breed predilections

good hx

special attention to breed, age, sex

physical exam w/ auscultation

failure to grow

dyspnea

weakness

syncope

seizures

sudden death

cyanosis

no symptoms

loud murmur

precordial thrill

lab work may be N

radiographs-♥ enlargement, pleural fluid

ultrasound-echo can provide an accurate dx

Most common cardiovascular disorder in dogs

chance ↑ w/ age

dogs over 16yrs old-75% affected

causes 95% of all cases of CHF in sm. breed dogs

Cheilitis

Secondary to trauma, fb, periodontal d, stomatitis, licking infected skin/wounds

malignant melanomas-dogs w/ heavily pigmented mouths

squamous cell carcinomas

Papillomas-viral etiology

Epulis,Epulides-occur in gingiva

Tx-sx, chemotherapy, rad. therapy

Indolent (rodent) ulcers-often on upper lip

idiopathic

red, well circumscribed lesion

ulcerated, raised edges mostly on lips, may extend up to nose

hx

physical exam

biopsy

erosions-penetrate only into mucosal layer

ulcers-penetrates past mucosa into connective tissue, mayb muscularis, may perforate

NSAIDs-flunixin meglumine, aspirin, phenylbutzone, piroxicam, carprofen, etodolac, etc.

Corticosteroids

Hepatic & renal insufficiency

Uremic toxins

Addison's disease

Fb

Helicobacter spp

Stress

vomiting most common

frank blood in stool

melena

pale mm

anemia

abd. pain

septicemia if perforated

weight loss

CBC-anemia

Hypoproteinemia-blood loss

Radiology-survey, barium, iodine if perforation suspected

Endoscopy w/ biopsy

Sx. exploration, biopsy

fluid therapy, blood transfusions

antiulcer drugs-H₂ blockers (cimitidine), omeprazole, protectants (sucralfate), prostaglandins

antibiotic therapy for Helicobacter spp

dilation-overdistension of the stomach w/ ingesta, gas, or fluid

volvulus-twisting of the stomach on its long axis (occludes the passage of gastric contents through the esophagus or duodenum)

age, breed, conformation

laxity of gastric ligaments

lg. volume of food/H₂0

postprandial exercise

failure of N vomiting or eructating reflex

acute, non-productive retching

hypersalivation

adb. pain, distension

↑ ♥ rate & resp. rate

weakness, collapse

depression

mm brick red-b/c of endotoxins

hx. and PE

arrhythmias-PVCs

radiographs-R lateral recumbancy

Goals: manage/prevent shock, decompression of stomach, fluid therapy, stabalize & prepare dog for sx.

Decompression-trocar-16/18 g needle inserted into area of most tympany

orogastric tube-may need to sedate

temporary gastrotomy tube

gastric lavage

EKG for at least 24 hrs.

lidocaine/procainamide prn for arrhythmias

blood pressure monitor

antibiotics pre & post-op

turn frequently

maintain body temp.

nutritional support

feed several smaller meals/day

limit exercise postprandial

even after sx. correction GDV may reoccur

avg. hospital stay is 3-7 d