Cardiomyopathy II- CardioRush

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Breed
What does the DCM syndrome in a specific patient mostly depend on?
LCHF or biventricular CHF, a fib, sudden death may occur
What are the characteristics of DCM in large breed dogs?
Survival 6 months or less if CHF, asymptomatic with arrhythmia may have prolonged survival
What is the prognosis of DCM in large breed dogs?
Pleural effusion, often chylothorax, CV abnormalities common, a fib common in CHF, can be slowly progressive (pimo may delay)
What are the characteristics of DCM in Irish Wolfhounds?
Middle age or older, a fib, decreased fractional shortening (even in normal dogs), taurine def on some diets, refractory CHF most common cause of death
What are the characteristics of DCM in Newfoundlands?
Ventricular arrhythmia, cardiac enlargement
What are the most common ways DCM is identified in Dobermans?
45-63%
What percentage of Dobermans have DCM in the US?
40-50% sudden death, ventriular arrhythmias or v fib, cardiogenic shock
What are the classic findings with Doberman DCM?
False (some have 1 mutation, others 2, others none)
True or false: Dobermans with DCM always have a genetic mutation that can be detected by a genetic test
1800
What is the cut off for NT proBNP above which heart disease is likely present and if dyspnic, CHF?
Significant heart disease unlikelyWhat do levels of NT proBNP below 900 likely mean in most breeds other than Dobermans?500-600What is the cutoff of NT proBNP for Dobermans in which occult DCM may be present?Usually middle age, equal male and female, low plasma taurine common, supplements can help in some dogsWhat are the characteristics of Cocker Spaniel DCM?ECG LVE pattern, APCs common, generalized cardiomegaly with pulmonary edemaWhat are the diagnostic findings in Cocker Spaniel DCM?PWDWhat is the only breed of dog that DCM affects juveniles?5 weeks to 3-4 monthsWhat age is affected in PWD DCM?Sudden death, peracute CHFWhat are the signs of DCM in PWDs?False (can have normal echo at 6 weeks and develop DCM by 6 months)True or false: some PWD with a normal echo at 6 weeks will not develop DCMArrhythmias infrequent, soft murmur or gallop, pulmonary edema, hepatomegalyWhat are the signs shown in PWD if they don't die suddenly from DCM?Arrhythmogenic right ventricular cardiomyopathyWhat type of CM occurs in Boxers?2Which of these ventricular arrhythmias is more common in Dobermans?1Which of these ventricular arrhythmias is more common in Boxers?RV diseased, myocytes die, replaced with fat and fibrosis, become electrically unstable, ventricular arrhythmias developWhat occurs in Boxer ARVCM?Upright QRSHow do we know these VPCs are originating from the RV?Sustained rapid (300-400bpm) v tach, VPC with upright QRS from RV (LBBB pattern in lead II), often wide QRS, P wave in sinus beatsWhat are the ECG findings in boxers with ARVCM?Ryanodine receptor striatin mutation leads to DCMWhat is the mutation that leads to ARVCM in Boxers?False (about 20% go on to develop classic DCM, the rest die suddenly before that)True or false: the majority of boxers with ARVCM will go on to show classic DCM characteristicsCHF, sometimes ventricular arrhythmiasWhat is the most likely cause of sudden death in Boxers with ARVCM?A fibWhat type of arrhythmias has a worse prognosis in Boxer ARVCM?SotalolWhat is the drug of choice for Boxer ARVCM for treating ventricular arrhythmias?Mexiletine and atenolo, mexiletine and sotalolWhat combination of drugs is often used to treat Boxer ARVCM other than sotalol?Holer monitor (>100 VPCs per 24 hours suspect)What is a useful way to search for asymptomatic Boxers with ARVCM?TrueTrue or false: the more unusual the diet the animal is on, the more likely taurine deficiency is an issue in DCMFalse (may be reversible if caught early enough and animal survives crisis)True or false: Diet associated DCM is never reversibleDilation of all 4 chambers, thinning of IVS, LV, RV walls, atrophy of papillary muscles, enlarged AV ring, LCHF or biventricularWhat are the pathologic changes associated with feline DCM?Mild endocardial and interstitial fibrosis, edema, mild mononuclear cell infiltrate, systolic dysfunction, neuroendocrine compensatory responsesWhat are some possible findings on histopath in feline DCM?Taurine deficiencyWhat used to be the main cause of DCM in cats?Heterogenous, possible cytoskeletal abnormalitiesWhat is now thought to be the cause of DCM in cats?No age or sex predis, Burmese, Siamese, Abyssinian more commonWhat is the signalment in feline DCM?Acute onset anorexia, lethargy (1-3 days), hiding, vomiting, dyspnea, collapse, lameness (ATE), cough uncommonWhat is the typical history associated with feline DCM?Soft 1-3/6 systolic murmur, mitral, tricuspid, or sternal location, S3 gallop, arrhythmias commonWhat are the common auscultatory findings associated with feline DCM?Normal or low temp, weak arterial pulses and apex beat, HR variable, dyspnic, RCHF signs, MM pallor, delayed CRT, weight loss, cool limbs, weaknessWhat are the PE findings in feline DCM?Generalized cardiomegaly, sometimes tracheal elevation, pleural effusion, perihilar interstitial pattern, sometimes veins and arteries enlarged, rarely ascitesWhat are the thoracic radiograph findings consistent with feline DCM?LVEWhat is the arrow pointing to?RAE and LAEWhat is the radiographic finding?Enlarged pulmonary veinWhat is the arrowing pointing to?Cardiomegaly, pleural effusion, interstitial lung patternWhat are the overall radiographic findings?Cardiomegaly, pleural effusion with fissure lines, LAEWhat are the main radiographic findings?P mitrale from LAE, LVE pattern, ventricular arrhythmias, APCs or a fib, AV blockWhat are the ECG findings associated with feline DCM?Same as dogsWhat are the echo findings characteristic of feline DCM?TrueTrue or false: getting taurine levels in cats that present with DCM is always a good ideaHypotensiveWhat is the BP in cats with DCM?False (very uncommon in horses, mainly seen in SA)True or false: DCM is a common disease in horsesRCHFHow does CHF manifest in DCM in horses?False (reported in ferrets, can get CHF)True or false: DCM is not reported in any exotic petsTrueTrue or false: cats can get ARVCM and it manifests are severe R heart enlargement and RCHF, with the prognosis being poor once diagnosed