What’s your purpose?

“It may be that your sole purpose in life is simply to serve as a warning to others.”

-Anonymous

DISEASES OF THE CARDIOVASCULAR SYSTEM:

CardiomyopathiesCHF

Valvular diseaseCogenital malformation

Infectious

CONGENITAL DEFECTS: PULMONIC STENOSIS

Chihuahuas, English Bulldogs, are commonly affected. CAUSE: ___________________> 1 year

PULMONIC STENOSIS

In pulmonic stenosis, the _______________________ is narrowed, either at the valve itself, just below it, or just after it.

PULMONIC STENOSISThe most common form of pulmonic stenosis involvesa deformed pulmonary valve such that the valve leaflets____________ , the ___________________ , or the valve cuspsare fused.

The heart must pump extra hard to get blood throughThis unusually narrow, stiff valve.

The __________________ becomes thickened from all this extra work. The right atrium May become dilated and hypertrophied.

CONGENITAL DEFECTS: PULMONIC STENOSIS

NORMAL CANINE CHEST RADS

THIS DOG HAS PULMONIC STENOSIS –THE HEART LOOKS “______________” IN THEFRONT DUE TO RIGHT VENTRICULARENLARGEMENT

CONGENITAL DEFECTS: PULMONIC STENOSIS

• CLINICAL SIGNS:– Syncope

– Tiring on exercise

– _______________ congested heart failure

– ________________ basilar (base) murmur (PAM)

– Right ventricular enlargement

– Radiographs: right ventricular enlargement, dilation of the pulmonary artery, pulmonary underperfusion

– Echo: right ventricular hypertrophy and enlargement, dilation of the main pulmonary artery ( __________________________________ )

PULMONIC STENOSIS: TREATMENT

A special balloon is inserted into the valve where it is inflated and the obstruction is broken down: _______________________________________

Unfortunately, medical management is notvery beneficial in these cases. __________________________ may be used to relax the heart muscle and possibly dilate the stenosis.

CLIENT EDUCATION

• Do not breeding

• Mild - moderate pulmonic stenosis: better __________________

• Moderate - severe pulmonic stenosis: poorer prognosis

CONGENITAL DEFECTS: SUBAORTIC STENOSIS

LESION DEVELOPS IN THE FIRST ______________ WEEKS OF LIFE: thickening Endocardial tissue

Newfoundland, Boxer, Golden Retriever, and Bull Terrier are most commonly affected

CONGENITAL DEFECTS: SUBAORTIC STENOSIS

• There is a scar-like narrowing just below the aortic valve. The heart must pump _________ to get blood through the narrowed area. The blood is pushed through in a turbulent fashion creating a heart murmur.

CONGENITAL DEFECTS: SUBAORTIC STENOSIS

THE HARD WORK RESULTS IN LEFT VENTRICULAR HYPERTROPHY, LEFT ATRIAL ENLARGEMENT, AORTIC DILATION: ____________________

CONGENITAL DEFECTS: SUBAORTIC STENOSIS:

• CLINICAL SIGNS:– Fatigue– Exercise intolerance (low cardiac output)– ______________________– Systolic murmur (soft – moderate) at the left

heart base– ECG: evidence of left ventricular enlargement - ↑

QRS height– Echo: left ventricular hypertrophy, subvalvular

fibrous ring, aortic dilation

CONGENITIAL DEFECTS: SUBAORTIC STENOSIS

• TREATMENT– Balloon catheter dilation – has been done with variable

and temporary results

– Medical management: THE GOAL IS TO SLOW THE HEART RATE AND DECREASE CONTRACTILITY; ________________ (BETA-BLOCKER WILL DO THIS)

CONGENITAL DEFECTS: SUBAORTIC STENOSIS

• CLIENT INFO:– Should not be used for breeding

– Acute, left-sided congestive heart failure is possible

– ___________________ is not uncommon

DCM HCM PDA Aortic stenosis Pulmonic stenosis

•1 – dogs•Enlarged Heart bronchile constriction•Dilated Flappy muscle•Nutritional: no taurin in cats

•1 – Cats•Saddle thrombus•Rarely in dogs (hereditary)•Noncompliant heart muscle

•Aorta – pulmonary a – lungs back L side

•Stenotic aortic valve causes LV hypertrophy•High pressure in aortic valve can lead to aortic dilatation

•Stenotic pulmonic valve•Pregnant heart

•L sided heart failure (HF)

•LV hypertrophy •RV hypertrophy•R sided HF

•Increased HR•Cough

•Increased HR•Weakness in hindlimbs, acute pain, rear cold feet

•Pulmonary edema

•Sudden death if aorta ruptures

•Digoxin: increased contractibility

•Beta blocker: Slow HR•Diuretic•Blood thinner•No cure

•Treat surgically or die

•No breeding •Balloon valvuloplasty

CONGENITAL DEFECTS: TETRALOGY OF FALLOT

______________ are the most commonly affected breed, but bulldogs and cats have increased incidence as well. Cause: polygenic inheritance

CONGENITAL DEFECTS: TETRALOGY OF FALLOT

• THERE ARE 4 MAIN ANATOMICAL ABNORMALITIES IN THIS DISEASE!– Pulmonic stenosis

– Right ventricular hypertrophy

– Ventricular septal defect

– Overriding aorta

________ to left shunt: pulmonary and systemic circulations

Overiding aorta: Blood from RV into aorta: mixed blood, not fully oxygenated blood. Body stimulates more RBC production to stimulate oxygen carrying capacity

CONGENITAL DEFECTS: TETRALOGY OF FALLOT

• CLINICAL SIGNS and DIAGNOSIS:– Affected puppies are _____________ than littermates– Exercise intolerance– Dyspnea, tachypnea– Syncope– Cyanosis– _________________________: occurs as a response to

the large amount of deoxygenated blood going to the systemic circulation

– Systolic murmur over the pulmonic area– ECHO: right ventricular hypertrophy, subaortic

ventricular septal defect, right outflow tract obstruction

CONGENITAL DEFECTS: TETRALOGY OF FALLOT

• TREATMENT:– ___________________: to keep PCV below 65%

(replace with crystalloids)

– Surgery:• Create a _______________________ shunt by doing

systemic artery to pulmonary artery anastamosis

• Complete correction requires cardiopulmonary bypass which is uncommon in animals

CONGENITAL DEFECTS: TETRALOGY OF FALLOT

• CLIENT INFO:– These dogs should not be bred

– Congestive heart failure _____________ develops

– Affected animals need regular phlebotomy

– Limit stress and exercise

– Caution when using sedatives/ tranquilizers

CONGENITAL DEFECTS: PERSISTENT RIGHT 4TH AORTIC ARCH

Great Danes, German Shepherds, Irish Settersare most commonly affected

CONGENITAL DEFECTS: PERSISTENT RIGHT 4TH AORTIC ARCH

Constrict the esophagus , food cannot get pass and_______________________ will be formed.

CONGENITAL DEFECTS: PERSISTENT RIGHT 4TH AORTIC ARCH

Clinical signs include regurgitation due to megaesophagus, ______________________, dyspnea, weight loss

Main cause of megaesophagus in puppies: dyspnea and weight loss.

PERSISTENT RIGHT 4TH AORTIC ARCH

• Dx: ______________________ study

• Tx: Surgery (like PDA); megaesophagus maintenance; Ab’s for secondary infections

• Client informations– Do not breed

– Sx is needed

– After sx some megaesophagus hence no boluses of food