Canine cardiology: From the basics to what's new

Presented by Danny Joffe, DVM, Dipl. ABVP (canine/feline specialty)

Continuing education questionnaire

CE credit: 1

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Questions

1. With respect to heart murmurs in dogs, which of the following is correct? *

Murmurs are the result of turbulent blood flow in the heart that can be due to physiological, congenital, or acquired causes.

The most common cause of an acquired murmur in middle-aged to older dog is atrioventricular insufficiency.

Based on a grading out of six, grade 1+2 murmurs are difficult to hear , grade 3+4 readily and consistently audible, grade 4 also has a palpable thrill, and 6 is audible without a stethoscope.

All of the above

2. When staging heart disease, which of the following is false? *

Heart disease staging is irrelevant as it progresses in an unpredictable way from dog to dog

Using a common staging system is helpful because it allows for easy case discussion between veterinarians and guides therapeutic decisions and allows for the provision of a prognosis

As a general rule, staging can be readily accomplished by acquiring patient signalmen and history, a complete physical examination, and doing chest radiographs

Stage B2 represents an asymptomatic dog with evidence of cardiac remodeling, indicating heart disease has progressed closer to overt heart failure

3. With respect to diagnostics used during heart disease staging, which of the following is false? *

NT-proBNP is an effective stand-alone test that provides definitive guidance as to heart disease staging and therapy

The definitive diagnostic test for determining the occurrence of CHF is demonstrating pulmonary edema on a chest radiograph

VHS is an objective and validated measure of cardiac size and once it becomes enlarged in a dog with asymptomatic heart disease, is consistent with Stage B2

For dogs with suspect MVD, echocardiography is a useful adjunctive diagnostic test, indicated when history, signalment, GPE and thoracic radiography fail to identify the cause of a murmur or cardiac enlargement

4. When developing a treatment plan for a newly-diagnosed dog in Stage C, published data definitively supports Vetmedin as first-line foundational treatment. *

True

False

5. Owner involvement is a key component to managing heart disease in dogs. With respect to resting respiratory rate (RRR), which of the following is true? *

Monitoring resting respiratory rate is an easy to perform, sensitive test that provides useful information as to a dogs cardiopulmonary status that the owner can do at home

Closely monitoring RRR can be useful in predicting the impending occurrence of pulmonary edema/CHF

Changes in RR can help guide heart failure management

All of the above

6. When deciding the right time to initiate treatment and the therapeutic(s) to be used, which of the following statements is false? *

When a dog has moved to overt CHF (Sage C), pharmaceutical intervention is critical and generally based on the use of a diuretic, Vetmedin, and an ACEi

Data published to date indicate that when Vetmedin is used as a first line treatment for CHF due to either DCM or MVD, survival and quality of life is dramatically improved over the use of only a diuretic and ACEi

Of the many studies published on a variety of therapeutic interventions to date, Vetmedin has demonstrated convincing evidence of delaying the progression of dogs from asymptomatic to CHF

The onset of a murmur should dictate therapeutic intervention