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Rumi CVS 2

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sihirlifil's version from 2018-04-29 13:23

Myocardial Dz

Question Answer
Cardiomyopathy =Subacute/chronic dz of ventricular myocardium w/o disease of valves, vessels, or lungs
Etiologies of cardiomyopathy (4)Inherited (red Holsteins, polled Herefords)
Toxic (monensin, lasalocid, gossypol, Phalaris)
Deficiencies (Cu, Se), High Mo/sulfates
Neoplasia (LSA)
CS of heart problems(All are +/-!)
Fever or hx of fever
Tachycardia
Arrhytmias
Gallop rhythm or murmur
Exercise intolerance, reluct to move
CHF
How do we diagnose?Like endocarditis: suspect something wrong, in this case can’t find the problem
Necropsy +/- histopath
Try echo, ECG
Bloodwork (+/- abnorm, check trace minerals)
Cardiac Troponin I
Feed analysis
Hx?
Prognosis of cardiomyopathyPoor to fair/good, depending on underlying cause
Types of myocarditisBacterial: S. aureus, C. chauvoei, Mycobacterium
Viral: FMD
Parasitic: strongyles, toxoplasma, sarcocysts, Borrellia
Complications of myocarditisBacteremia, septicemia, pericarditis, endocarditis, etc
Myocarditis: CS(Variable, often undx/masked by 1ry dz)
1ry dz (mastitis, metritis…)
Tachycardia, arrhythmias
Signs of CHG
Myocarditis: TxUnderlying agent/cause
Control arrhythmias, CHF, shock
Diagnosis?
White muscle disease (Vit E deficiency)
Myocardial necrosis
Clostridium chauvoei: who at risk? why?Cattle >2y.o.
Immune system, behaviors bull calves…? (sonic)
C. chauvoei causes what?Blackleg in skeletal muscle
Visceral blackleg in heart! (Cardiac myonecrosis, suspect min. def Cu, Se, Vit E)
C. chauvoei: CS?
Notorious for killing within hours
Histophilus somni: CS?Multisystemic! Myocarditis & pneumonia, otitis, polyarthritis, TEME, septicemia
Bacteria adheres to endothelium --> Vasculitis & thromboemboli
Feedlot risks
These lesions consistent with which bact?
H. somni: vasculitis & thromboemboli
Dilated cardiomyopathy: what happens?Ventricular dilation, incr ventricular mass, decr systolic fxn
DCM: causes?Inherited (Red Holsteins, polled Herefords)
Acquired: Cu/Se/Vit E; Ionophores, gossypol, Cassia, Phalaris; LSA infiltration
DCM: CSTachycardia, gallop rhythm, arrhythmias
Murmur, muffled heart sounds
Tachypnea/dsypnes
Exercise intolerance/incr recumbency
Signs of heart failure
Death
Nutritional/Toxic cardiomyopathy: causes?High energy demands of myocardium make it very susceptible to toxicants that decrease O2 availability or carb metabolism --> myocardial necrosis
Ionophore tox
Plant e.g. Gossypol
Snake venom
Vit E/Se deficiency
What are ionophores? e.g.? how do they cause tox?Antibiotic compounds with (-)charge that can complex with cations & carry them across biological membranes
Interfere w/ K & Ca transport: Influx of Na into cell --> concurrent influx of Ca2+ --> cationic overload causes mitochondrial dmg, death of cell
E.g. Monensin, lasalocid, naracin, salinomycin, maduramycin
(Ionophores LD50)(Horse 2-3mg/kg, sheep 12mg/kg, pigs 17mg/kg, cattle 20-34mg/kg)
Salinomycin 0.6 mg/kg! Highly toxic!
Concerns with ionophore useAnimals that survive the acute exposure or have low dose chronic exposure may show CS of CHF, as well as poor weight gain & growth (anorexia, tachypnea, weakness, ataxia, D+, pulm edema, ascites)
Gossypol = ? CS?Yellow polyphenolic pigment in cotton, esp in seed. Cadiotoxin>>>repro & IV hemolysis
See sudden death or CHF (no tx)
Vit E/Se deficiency aka? in who? what happens?White muscle disease, nutritional myodegeneration
Young animals
Musc weakness (cardiac & skeletal) (need Se for antioxidant enzyme systems that protect from O2 dmg during norm cellular metab processes) --> death from cardiomyopathy
White musc dz: Dx?CK often >10,000-15,000
Whole blood Se, serum vit E, glutathione peroxidase lvls
Necropsy
White musc dz: Tx?BoSe, MuSe (but caution in high Se regions! can cause toxicity)
Vit E (PO, parenteral) (not enough vet E in Bo-Se)
What is Crotalus viridis? why do we care?Prairie rattlesnake! Venom contains proteolytic enzymes, cardiotoxi, bacteria
What happened to this guy?
Pissed off a snake
Snakebite: Tx(Depends on bite size, size of animal, when it was bitten)
Polyvalent antivenin (IV)
Antibx, IV fluids, tetanus antitoxin, pain management, (laser therapy?)
Snakebite: PrognosisFatalities rare with tx
Delayed cardiotoxic effects
Cor Pulmonale: aka? what happens?Brisket Disease, Pulmonary Hypertension
2ry form of heart disease: the effect of lung dysfunction on the heart. Pulmonary hypertension --> RV hypertrophy --> RV dilation --> RV failure
RH failure: CSBrisket edema (ventral, scrotal, submandibular)
Jugular vein distention
Tachypnea, tachycardia
What’s up with this guy? Brisket edema (CS of RH failure)
High Mountain Dz/High Altitude Dz: most common in? predispositions?Most common in cattle (mainly calves), usually at >5000 ft (starting to see at lower)
Predispositions: Genetic + breed, respiratory dz, Locoweed (Oxytropis spp.)
How does body condition affect pulmonary arterial pressure (PAP)?Excessive BCS increases PAP (Feedlot cattle grow bigger faster)
(PAP) Variation in response to hypoxia: who is hyper-reactive?Bovine, porcine
(PAP) Variation in response to hypoxia: who is moderate-reactive?Equine (humans)
(PAP) Variation in response to hypoxia: who is hypo-reactive?Ovine, caprine, camelid, canine
How is PAP affected by altitude?Increases (more hypoxic)
High Mountain Dz: TxLower altitude, treat 1ry lung dz, diuretics (+/- water restriction), digoxin
High Mountain Dz: Prevention?Genetic selection (bulls w/ lowest PAPs @ >5000ft)
Remove susceptible cattle
Prevent locoweed ingestion
Reduce incidence of 1ry pulmonary dz: vax for respiratory pathogens, management
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Pericardial Dz

Question Answer
Pericarditis =Inflam of pericardium, resulting in accumulation of fluid/exudate btw visceral & parietal pericardium
Pericarditis: etiology (4)Trauma: Hardware dz
Hematogenous
Extension from lungs or pleura
Neoplasia
Pericarditis: CSNonspecific fever, anorexia, wt loss, lethargy
Peripheral edema, jugular distention/pulses, tachypnea, dyspnea
Ventral pain, abducted elbows, grunting
Muffled heart sounds, absent lung sounds ventrally
Washing machine murmur
Traumatic Reticulopericarditis/peritonitis (TRP) aka?Hardware disease (FB in reticulum)
This cow presents with fever, abdominal pain, anorexia. Tachypnic & dyspneic with muffled heart sounds. Suspect…? TRP
How does peritonitis result from a FB in the reticulum?FB in cranioventral reticulum --> mucosa traps sharp objects --> contractions promote penetration of the wall
Why does pregnancy/parturition increase likelihood of FB penetration in the reticulum?Compression of the uterus & straining during parturition (& mounting during estrus)
Special tests to do for TRP? results?Withers pinch: no ventral deflection = ‘positive’ = ABNORMAL (normally cow lowers her back)
Grunt test: knee or board across the xyphoid, grunt if TRP
** Diagnostics for pericarditisCBC/Chem/Fib (>1500mg/dL)
ECG, Echo
Metal detector
US (often hard to image, see if reticulum contracting or fused)
Rads (may show metal object, fluid/gas interface)
Pericardiocentesis
Laparotomy
If you want to take rads for TRP, keep in mind…May demonstrate location of wire causing the TRP, but absence doesn’t r/o!
What’s wrong here?
Pericardial effusion
What’s this ECG telling you?
General low amplitudes in all leads: electrical conductivity insulated from ECG electrodes (heart floating in pericardial sac)
** How can you get a definitive dx of suppurative pericarditis?Pericardiocentesis
Insert cannula into pericardial sac through left 6 ICS --> foul-smelling exudate
Risks assoc w/ pericardiocentesis?Can result in rupture of pericardium --> massive toxin release --> toxic shock syndrome if purulent substance present (often abscess/pus is contained within pericardial sac, not pleural space)
** Transudative pericarditis: Tx options?Pericardiocentesis
NSAIDs
(sent to slaughter)
** Exudative pericarditis: Tx options?Pericardiocentesis
Antibx
Pericardotomy
Digitalis + diuretics
(send to slaughter)
Pericarditis: prognosis?Poor for recovery because of constrictive fibrous pericarditis :/ consider econ value of cow (tx $$$)
Pericardotomy: how is it done?Local ANX
Resect 5th rib, expose pericardial sac
Remove fibrin, FB, etc
Flush abscessed pericardial sac to remove exudate
Allow to granulate closed
Prolonged antibx therapy (Oxytetracyline, penicillin, cephalosporins, florfenicol)
Diagnosis?

Pericarditis (w/ wire!)
Prevention of TRPProphylactic reticulum magnet
Electromagnet on feed mills
Hay balers that use twine
Plastic/nylon bristles on brooms & scratching posts
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Miscellaneous

Question Answer
Arrhythmias: think…E-lyte imbalances
Toxemia
Neoplasia
Arrhythmias: TxQuinidine/Digoxin NOT RECOMMENDED for ruminant! Tx underlying cause
Interpretation?
** Atrial fibrillation (A-fib)
Most common arrhythmia in cattle
** Most often cause of A-fibE-lyte imbalances from GI issues (Hypocalcemia, hypokalemia, hypochloremia, metabolic alkalosis)
Foot rot, pneumonia, endocarditis (toxemias)
Tx of A-fibCorrect e-lyte imbalances (IV fluids, electrolytes)
Treat cause of toxemia
Interpretation?
Premature atrial contractions (e-lyte imbalance, toxemia, myocardial dz)
Interpretation?
Ventricular premature contraction (myocardial dz, toxemia)
Tx premature contractionsOral & IV electrolytes (Ca, K, Cl)
Correct metabolic derangement (e.g. vagal indigestion, scours)
Glucose
Which cardiac tumors do rumis get?(rare) LSA, mesothelioma, fibrosarcoma, adenosarcoma, carcinomas…
Dx?
Lymphosarcoma
Most common cardiac tumor in cattleLSA (50-70% of cattle w/ LSA have heart lesions)
LSA: where in the heart usually?Right atrium (HAULS-R), pericardial effusion seen
LSA: TxTap fluid (short-term improvement)
Nothing… prognosis is poor, additional body systems affected :(
memorize

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