Common Cardiovascular Diseases of Production Animals (PDF)

COMMON CARDIOVASCULAR DISEASES OF PRODUCTION ANIMALS HAYLEY HICKLING BVETMED PGCERT VET ED FHEA MRCVS LEARNING OBJECTIVES At the end of this session you should be able to: Construct a differential diagnosis list based on history & clinical presentations associated with card...

COMMON CARDIOVASCULAR DISEASES OF PRODUCTION ANIMALS HAYLEY HICKLING BVETMED PGCERT VET ED FHEA MRCVS LEARNING OBJECTIVES At the end of this session you should be able to: Construct a differential diagnosis list based on history & clinical presentations associated with cardiac diseases of common production species and chose appropriate diagnosis Determine appropriate medical and surgical interventions in the management and treatment of cardiac diseases of production species Determine appropriate prognosis, based on individual animal and a herd Determine prevention control measures appropriate for cardiac diseases in production species THOROUGH CASE WORK UP History History Signalment Clinical Signs Clinical Signs Physical Exam findings (Diagnostics) HISTORY Age Management Duration of disease Progression of disease Recent treatments Current management Feeding Housing Stage in lifecycle Lactation, pregnancy Changes in current management CLINICAL SIGNS Acute v’s Chronic Signs of heart failure: Oedema- submandibular/brisket Pale MM Increased HR Muffled heart Non-specific: Reduced production Milk yield Reduced growth rates Lethargy Inappetence Acute disease: Sudden death P H Y S I C A L E X A M I N AT I O N General Demeanour Temperature BCS Assessment of other body systems Cardiovascular system MM colour, CRT Cardiac auscultation- rate, rhythm, murmurs or muffling Jugular fill, distension and pulsation Respiratory system Resp rate, effort and pattern Auscultation  Left sided Heart Failure Right Sided Heart Failure Increased atrial pressure Volume overload, failure of from regurgitation venous return leading to secondary to ventricle not increased venous pressure pumping around body. Oedema, ascites, pleural Pulmonary hypertension effusion, tachycardia Pulmonary oedema, Causes: endocarditis causing tachycardia, prolonged valve regurgitation, jugular filling, weak pulses, congenital defects cool extremities Endocarditis causing valvular regurgitation Diastolic failure Restricts ventricular filling Congestive heart failure R ventricle more affected as thinner Changes in heart muscle due to walled increased pressures Overall reduced cardiac output and R Decompensation of the heart resulting in HF signs fluid build up in the body MAIN CAUSES Infectious Congenital Other Traumatic VSD Reticuloperiotonitis PDA Endocarditis Erysipelas Degenerative Secondary Strep Suis Clostridial myositis White Muscle Disease (blacks) Cor Pulmonale https://bvajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/v etr.701 CARDIAC A U S C U LTAT I O N Arrhythmias Often secondary to other causes Tachyarrhythmia Pain, infection Heart failure/compensation for reduced contractility Anaemia Electrolyte disturbances- hypomagnesaemia/hypocalcaemia Bradyarrhythmia Electrolyte disturbances – hyperkalaemia White muscle disease Intoxication- rhododendron  M U R M U R LO C A L I S AT I O N Left side: 3rd ICS= Pulmonic 4th ICS=Aortic 5Th ICS=Mitral Right side: 4th ICS= Tricuspid Tip: Punctum Maximum over ICS 5. To listen to cranial heart need to push behind the elbow DIFFERENTIALS FOR MURMURS Systolic, Diastolic or Continuous? Systolic Mitral/tricuspid regurgitation caused by endocarditis VSD Continuous Anaemia PDA Muffled heart sounds Pericarditis/pericardial effusion 11 ADDITIONAL DIAGNOSTICS Withers Pinch Identifies cranial abdominal pain Glutavac Cow side test Measure of fibrinogen/inflammation Nonspecific Help with prognosis Ultrasound Rectal linear scanner could be used Pericardial effusion Small ruminants DIFFERENTIAL DIAGNOSES Infectious Congenital Other Traumatic VSD Reticuloperiotonitis PDA Endocarditis Erysipelas Degenerative Secondary Strep Suis Clostridial myositis White Muscle Disease (blacks) Cor Pulmonale  Ingestion of sharp objects Penetration into pericardium T R A U M AT I C Septic peritonitis RETICULO- Fluid accumulation Cardiac tamponade PERITONITIS Reduced diastolic fill Right HF 14 T R A U M AT I C R E T I C U L O P E R I T O N I T I S CLINICAL SIGNS Cardiovascular signs +/- Pyrexia Muffled heart sounds Splashing/tinkling ‘Washing machine’ Right sided heart failure Jugular distension, Submandibular oedema Brisket oedema Pleural effusion Gastrointestinal signs Rumen hypomobility Cranial abdominal pain/lower thoracic pain Withers pinch/bar test Elbow abduction https://www.nadis.org.uk/disease-a-z/cattle/traumatic-reticulitis-wire/ Traumatic Reticuloperitonitis Treatment, Prevention, Prognosis Treatment Antibiotics, NSAIDs, Magnet Efficacy of magnets vary in studies 50-90% and depends greatly on position of FB Radical? Surgical pericardiocentesis Cull? Prognosis Varied but several studies show up to 80% in hospital settings Likely lower on farm V E G E TAT I V E E N D O C A R D I T I S Bacterial infection of heart valves Secondary to bacteraemia Cattle – Trueperella/strep from mastitis/metritis etc Pig bacteraemia caused by Erysipelas/Strep suis History of previous/concurrent infections important https://www.pig333.com/pathology-atlas/valvular- endocarditis_244 VEGETIVE ENDOCARDITIS Overgrowth on valve causes valvular incompetency → regurgitation Affecting mitral or tricuspid valves Missed or underdiagnosed Seen at slaughter Clinical signs Pyrexia, recurrent, waxing/waning Non-specific weight loss/reduced production Systolic murmur Treatment Long term broad spectrum antibiotics Prognosis Grave- average lifespan after diagnosis 6months  PULMONARY THROMBOEMBOLISM Abscess rupture Broncho- pneumonia Chronic Hepatic Localised spread Thrombo-embolic Disease Abscess spread Ruminal acidosis, Spread into Vena Cava Pulmonary Haematological passing liver via Spread to Artery Abscess spread from erosion pulmonary other organs artery Arterial rupture Epistaxis Acute Death PULMONARY THROMBOEMBOLISM COR PULMONALE Right sided heart hypertrophy Right sided heart failure Pulmonary hypertension Uncommon- dairy cattle- holstein>? Secondary to chronic respiratory disease/ pneumonia/chronic lungworm Brisket oedema DDx traumatic reticuloperitonitis Increased Overloading of Right sided Chronic hypoxaemia pulmonary RV heart failure artery pressure WHITE MUSCLE DISEASE Selenium and Vitamin E deficiency Both important in preventing cell damage Results in muscle damage Necrosis Cardiac, skeletal and diaphragmatic muscle Most common in beef cattle and sheep/goats Rapid growth in young (1-4 months old) Soil deficiency/Poor feed quality Herd/flock problem WHITE MUSCLE DISEASE Clinical signs Skeletal = Weakness, stiffness Treatment and recumbency Selenium and Vit E injection – Cardiac = Murmurs/ irregular repeat doses required tachycardia Supportive treatment Diaphragmatic = dyspnoea Prognosis SUDDEN DEATH Variable Diagnosis Prevention Clinical signs Supplementation boluses Haematology Se and Vit E = historic status Plasma GPx-1 levels = current status Post Mortem QUESTIONS?