What

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Whats your purpose?

• It may be that your sole purpose in life is
  simply to serve as a warning to others. ?
• -Anonymous

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DISEASES OF THE CARDIOVASCULAR SYSTEM

• Cardiomyopathies
• CHF
• Valvular disease
• Cogenital malformation
• Infectious

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CONGENITAL DEFECTS PULMONIC STENOSIS
Beagles, bulldogs (both French and English),
boxers, Bull Mastiffs, Miniature Schnauzers,
Chihuahuas and various terrier breeds are
predisposed to pulmonic stenosis. CAUSE
____________________________ inheritance gt 1 year
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PULMONIC STENOSIS
________most common congenital heart disease in
dogs
In pulmonic stenosis, the right ventricular
outflow tract is narrowed, either at the valve
itself, just below it, or just after it.
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PULMONIC STENOSIS
The most common form of pulmonic stenosis
involves a deformed pulmonary valve such that the
valve leaflets are too thick, the opening is too
narrow, or the valve cusps are fused.
The heart must pump extra hard to get blood
through This unusually narrow, stiff valve.
The right ventricle becomes _________________
from all this extra work. The right atrium, May
become dilated and hypertrophied.
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CONGENITAL DEFECTS PULMONIC STENOSIS
NORMAL CANINE CHEST RADS
THIS DOG HAS PULMONIC STENOSIS THE HEART LOOKS
PREGNANT IN THE FRONT DUE TO ______________
VENTRICULAR ENLARGEMENT
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CONGENITAL DEFECTS PULMONIC STENOSIS

• CLINICAL SIGNS
• Syncope
• Tiring on exercise
• _____________ -sided congested heart failure
• Left 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 (prominent jugular pulse)

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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 not very
beneficial in these cases. Beta-blockers may be
used to relax the heart muscle and possibly
dilate the stenosis.
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CLIENT EDUCATION

• Do not breeding
• Mild - moderate pulmonic stenosis better
  prognosis
• Moderate - severe pulmonic stenosis
  __________________ prognosis

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CONGENITAL DEFECTS SUBAORTIC STENOSIS
Newfoundland, Boxer, Golden Retriever, and Bull
Terrier are most commonly affected
LESION DEVELOPS IN THE FIRST 4-8 WEEKS OF LIFE
thickening Endocardial tissue
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CONGENITAL DEFECTS SUBAORTIC STENOSIS

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

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CONGENITAL DEFECTS SUBAORTIC STENOSIS
THE HARD WORK RESULTS IN LEFT_____________________
_____________ , LEFT ATRIAL ENLARGEMENT, AORTIC
DILATION _______________________
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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

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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 PROPRANOLOL
  (BETA-BLOCKER WILL DO THIS)

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CONGENITAL DEFECTS SUBAORTIC STENOSIS

• CLIENT INFO
• Should not be used for breeding
• Acute, left-sided congestive heart failure is
  possible
• Sudden death is not uncommon

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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
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CONGENITAL DEFECTS TETRALOGY OF FALLOT
Keeshonds are the most commonly affected breed,
but bulldogs and cats have increased incidence
as well. Cause polygenic inheritance
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CONGENITAL DEFECTS TETRALOGY OF FALLOT

• THERE ARE 4 MAIN ANATOMICAL ABNORMALITIES IN THIS
  DISEASE!
• Pulmonic stenosis
• ______________________________
• Ventricular septal defect
• Overriding aorta

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Right to left shunt pulmonary and systemic
circulations
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Overiding aorta Blood from RV into aorta mixed
blood, not fully oxygenated blood. Body
stimulates more RBC production to stimulate
oxygen carrying capacity
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CONGENITAL DEFECTS TETRALOGY OF FALLOT

• CLINICAL SIGNS and DIAGNOSIS
• Affected puppies are smaller 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

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CONGENITAL DEFECTS TETRALOGY OF FALLOT

• TREATMENT
• Phlebotomy to keep PCV below __________ (replace
  with crystalloids)
• Surgery
• Create a lefttoright shunt by doing systemic
  artery to pulmonary artery anastamosis
• Complete correction requires cardiopulmonary
  bypass which is uncommon in animals

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CONGENITAL DEFECTS TETRALOGY OF FALLOT

• CLIENT INFO
• These dogs should not be ___________
• Congestive heart failure rarely develops
• Affected animals need regular phlebotomy
• Limit stress and exercise
• Caution when using sedatives/ tranquilizers

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CONGENITAL DEFECTS PERSISTENT RIGHT 4TH AORTIC
ARCH
Great Danes, German Shepherds, Irish Setters are
most commonly affected
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CONGENITAL DEFECTS PERSISTENT RIGHT 4TH AORTIC
ARCH
Constrict the esophagus , food cannot get pass
and ________________will be formed.
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CONGENITAL DEFECTS PERSISTENT RIGHT 4TH AORTIC
ARCH
Main cause of megaesophagus in puppies dyspnea
and weight loss.
Clinical signs include regurgitation due to
megaesophagus, aspiration pneumonia, dyspnea,
weight loss
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PERSISTENT RIGHT 4TH AORTIC ARCH

• Dx Barium swallow study
• Tx Surgery (like PDA) megaesophagus
  maintenance Abs for secondary infections
• Client informations
• Do not breed
• Sx is needed
• After sx some megaesophagus hence no boluses of
  food

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Cases

• Four-month-old female toy poodle weighing 2.2 kg
  ("Cindy")
• Six-month-old female spayed Domestic Shorthair
  cat ("Nimbus")

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References

• Alleice Summers, Common Diseases of Companion
  Animals
• http//veterinarynews.dvm360.com/dvm/article/artic
  leDetail.jsp?id156665
• VIN Robert Prosek DVM, MS, DACVIM-Cardiology,
  DECVIM-CA
• Echocardiography in the Dog, Cat and Horse Dr.
  Francesco Porciello, 2009
• http//www.vin.com/WebLink.plx?URLhttp//www.vmth
  .ucdavis.edu/cardio/cases/