Veterinary Cardiology: Heart vs. Lung Conditions

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Questions and Answers

What is the most likely cause of Cinder's syncopal episode?

Dehydration

Cardiac arrhythmia (correct)

Hypertension

Hypoglycemia

Which of the following diagnostic tests would be most helpful in confirming the suspected cause of Cinder's syncope?

Biochemistry panel

Thoracic radiographs

Electrocardiogram (ECG) (correct)

Complete blood count (CBC)

What is the significance of the Grade III/VI right systolic heart murmur?

It indicates a mild heart murmur, unlikely to cause clinical signs.

It suggests a serious heart condition requiring immediate attention.

It indicates a possible congenital heart defect. (correct)

It is a normal finding in young dogs.

Why is it important to know Cinder's medical history prior to adoption?

It can help to determine if the current symptoms are pre-existing or new onset. (B) Signup and view all the answers

What is the most likely reason for Cinder's tachypnea?

She is experiencing respiratory distress secondary to her heart condition. (D) Signup and view all the answers

What is the most common cause of pleural effusion in cats?

Congestive heart failure (A) Signup and view all the answers

What does the acronym 'NT-proBNP' stand for?

N-terminal pro-brain natriuretic peptide (C) Signup and view all the answers

What is the active form of BNP?

C-terminus (D) Signup and view all the answers

What are the possible causes of a false elevation in NT-proBNP?

Azotemia, Pulmonary Hypertension, Hyperthyroidism, Systemic Hypertension (A) Signup and view all the answers

Among the listed factors, which is NOT a cause of pleural effusion in cats?

Hypertension (D) Signup and view all the answers

Which of the following is NOT a sign of heart disease in cats?

Decreased lung sounds ventrally (A) Signup and view all the answers

What is the significance of the 'Gallop sound' heard during a physical exam?

It is a better indicator of heart disease than a heart murmur (C) Signup and view all the answers

What is the recommendation for further diagnostics if NT-proBNP is abnormal?

Thoracic radiographs and echocardiogram (D) Signup and view all the answers

What is the most likely reason the owner noticed Milo's abnormal breathing pattern worsening over time?

Milo was previously healthy, so the worsening breathing is likely due to an acute illness (C) Signup and view all the answers

Which of the following is NOT a common broad category for causes of increased respiratory rate in cats?

Hypertension (B) Signup and view all the answers

The text suggests that the veterinary team should consider which principle when determining the most appropriate diagnostic plan for Milo?

Choosing tests based on the individual pet's needs and the likelihood of a diagnosis (D) Signup and view all the answers

Study Notes

Presentation Overview

Topics covered: Heart vs. Lung conditions in animals (specifically, cats and dogs)
Presented by: Hillary Hammond (cardiology), Akaterina Davros (internal medicine), Amber Harris (SAIM)

Learning Objectives

Differentiate between cardiovascular and respiratory issues in emergency cases
Identify common causes of increased respiratory rates in cats and dogs
Develop tailored diagnostic plans for individual pets using diagnostic stewardship

Case Study 1: Milo

Patient: 12-year-old male Domestic Short Hair (DSH) cat
History: owner noticed an abnormal breathing pattern worsening over time, otherwise healthy
Physical Exam: Heart rate 240 bpm, regular; no murmur; gallop sound; fair and synchronous pulses; rapid, shallow breathing; decreased lung sounds ventrally, increased bronchovesicular sounds dorsally
Diagnostics: Abnormal BNP test; POCUS (Thorax showing heart abnormalities)
Conclusion: Heart condition (likely congestive heart failure) is the primary issue. Further diagnostics recommended include thoracic radiographs and echocardiogram.

Case Study 2: Cinder

Patient: 3-year-old female Chihuahua
History: Coughing; a syncopal (fainting) episode; adopted three weeks prior; developed exercise intolerance; coughing worsened; recent history of coughing and exercise intolerance; tachypneic after chasing squirrel.
Physical Exam: Temperature 100.7 F, pulse 210 bpm; respiratory rate 90 breaths/minute; quiet, alert, and responsive; Grade III/VI right systolic heart murmur; no arrhythmias; pink/moist mucous membranes; capillary refill time <2 seconds; femoral pulses bilaterally strong and synchronous; dyspnea/respiratory distress; occasional hacking cough; harsh lung sounds on auscultation.
Diagnostics: History, physical exam, thoracic X-rays, bloodwork (including a comprehensive 4Dx panel for infectious diseases), POCUS (Point of Care Ultrasound)
Conclusion: The case is to be examined to determine if heart or lung problem (heartworm?) is the primary issue.
Further diagnostics are being advised.

Case Study 3: Relish

Patient: 10-year-old female Rat Terrier mix
History: Presented with increased respiratory rate and worsening cough; owner reported relatively healthy pet until five days prior when the problem was noted; started coughing and panting; no history of travel or boarding; no recent regurgitation or vomiting; only change is frequent use of fireplace/cold weather; previously diagnosed GERD, previous episode of aspiration pneumonia (September 2023), chronic intermittent productive cough.
Physical Exam: Temperature 102.1 F; Pulse 140 bpm; Respiratory rate 48; normal respiratory effort; Body Condition Score (BCS) 7/9; Mild diffuse muscle wasting; Weight 16kg; Grade II/VI left apical systolic heart murmur; fine crackles throughout lung fields; dry, hacking cough; elicit on tracheal palpation
Diagnostics: History; physical exam, thoracic X-rays, advanced diagnostics
Conclusion: Potential cause (canine chronic bronchitis, likely) is to be examined
Potential treatment and follow-up plan: No more fireplace use; Short tapering course of anti-inflammatory oral steroids; +/- Transition to inhaled steroids for long-term management; Echocardiogram at the earliest convenience; Update in 1-2 weeks; re-wash if needed.

Key Concepts and Findings

NT-proBNP: A cardiac biomarker for myocardial stretch and stress used in diagnosing heart conditions. Elevated levels indicate potential heart issues.
Heart Murmurs: Heart murmurs are often not definitive for heart disease and other factors must be confirmed.
Respiratory Distress: Conditions that cause respiratory distress (e.g., heart failure, lung conditions) can present with different symptoms and require thorough diagnostic evaluation
Diagnostic Stewardship: Importance of evaluating symptoms and financial constraints to prioritize the most appropriate diagnostics.

Additional Notes

Financial Constraints: A concern raised in relation to several case presentations.
Cytology: The result of transtracheal wash is indicated to be low cellularity overall, but there is an increased percentage of neutrophils.
Endotracheal wash: Performed in case of Relish to examine the lungs, leading to a diagnosis of canine chronic bronchitis.

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Description

This quiz focuses on the differentiation between cardiovascular and respiratory issues in cats and dogs. Participants will explore case studies, including a 12-year-old cat presenting with abnormal breathing patterns. Review key diagnostic plans and develop an understanding of emergency cases in veterinary medicine.