Page 364 - Feline Cardiology

Chapter 24: Comorbidities 379

if not caused by other factors such as pain or anxiety, may Disorders in Small Animal Practice, 3rd ed., DiBartola SP, ed. St.
mark the onset of pulmonary edema or pleural effusion Louis, Saunders Elsevier, 2006, 490–518.
and warrant a repeated chest radiograph. Campbell FE, Kittleson MD. The effect of hydration status on the
The onset of a gallop heart sound during fluid therapy echocardiographic measurements of normal cats. J Vet Intern
Med 2007;21:1008–1015.
is also an important clue suggesting intravascular volume de Madron E. Central venous pressure menasurement. In: Clinical
overload. A true gallop sound is a low-frequency, thud- Veterinary Advisor, 2nd ed., Côté E, ed. St. Louis, Mosby Elsevier,
like sound that occurs in addition to the two normal 2011, 1227–1228.
sounds (see Chapter 1). If a new gallop heart sound has DiBartola SP, de Morais HA. Disorders of potassium: Hypokalemia
emerged when it was not present at the time of and hyperkalemia. In: Fluid, Electrolyte, and Acid-Base Disorders
in Small Animal Practice, 3rd ed., DiBartola SP, ed. St. Louis,
admission/before fluid therapy, then congestive heart Saunders Elsevier, 2006, 91–121.
failure can be considered to be imminent and the fluid Freeman LM, Brown DJ, Smith FWK, Rush JE. Magnesium status and
rate should be decreased; a single dose of furosemide, the effect of magnesium supplementation in feline hypertrophic
typically 1–3 mg/kg IV, may be given if mild dyspnea is cardiomyopathy. Can J Vet Res 1997;61:227–231.
also apparent. Disappearance of the gallop is expected German AJ, Cannon MJ, Dye C, Booth MJ, Pearson GR, Reay CA,
Gruffydd-Jones TJ. Oesophageal strictures in cats associated with
with normalization of intravascular volume and end- doxycycline therapy. J Feline Med Surg 2005;7:33–41.
diastolic left ventricular pressure. In this way, the pres- Ginès P, Arroyo V. Paracentesis in the management of cirrhotic ascites.
ence and disappearance of a gallop heart sound can act J Hepatol 1993;17 Suppl 2:S14–S18.
as a gauge of intraventricular pressures and therefore Gookin JL, Atkins CE. Evaluation of the effect of pleural effusion
imminence of congestive heart failure. Importantly, on central venous pressure in cats. J Vet Intern Med 1999;13:
561–563.
many other extra heart sounds that are not gallop sounds Gouni V, Chetboul V, Pouchelon JL, Carlos Sampedrano C, Maurey
occur in the cat (i.e., midsystolic click, split heart sound), C, Lefebvre HP. Azotemia in cats with feline hypertrophic cardio-
and the mere presence of an extra heart sound with each myopathy: Prevalence and relationships with echocardiographic
heartbeat does not automatically indicate congestive variables. J Vet Cardiol 2008;10:117–123.
heart failure. The practical utility of gallop sounds Hand MS, Thatcher CD, Remillard RL, Roudebush P. Small Animal
Clinical Nutrition, 4th ed., Mark Morris Institute, 2000.
during fluid administration lies in their new onset, and Lamont LA, Bulmer BJ, Grimm KA, Tranquilli WJ, Sisson DD.
their diagnosis requires recognizing the characteristic Cardiopulmonary evaluation of medetomidine hydrochloride in
low frequency (audible better with the stethoscope’s bell cats. Am J Vet Res 2001;62:1745–1762.
than the diaphragm) of the extra sound. MacGregor JM, Rush JE, Rozanski EA, Boothe DM, Belmonte AA,
Finally, the principle of cardiac pseudohypertrophy is Freeman LM. Comparison of pharmacodynamic variables fol-
recognized in cats, and cats that require fluid therapy lowing oral versus transdermal administration of atenolol to
healthy cats. Am J Vet Res 2008;69:39–44.
due to dehydration must not be diagnosed with cardiac Maran BA, Meurs KM, Lahmers S, Nelson OL. Identification of beta-1
hypertrophy prematurely. When 10 normal cats were adrenergic receptor polymorphisms in cats [abstract]. J Vet Intern
given furosemide at standard dosages, echocardiography Med 2010;24:694. Comorbidities
identified that the interventricular septum and left ven- Oyama MA, Sisson DD, Bulmer BJ, Constable PD. Echocardiographic
tricular free wall thicknesses increased significantly, estimation of mean left atrial pressure in a canine model of acute
mitral valve insufficiency. J Vet Intern Med 2004;18:667–672.
including a thickness >6 mm (a generally agreed-upon Padrid P. Inhalation medication administration. In: Clinical Veterinary
cutoff for left ventricular hypertrophy) in 4/10 cats Advisor, 2nd ed., Côté E. St. Louis, Mosby Elsevier, 2011,
(Campbell and Kittleson 2007). Therefore, when a 1289–1290.
patient is dehydrated, the diagnosis of left ventricular Padrid P. Chronic bronchitis and asthma in cats. In: Kirk’s Current
hypertrophy is questionable if an echocardiogram was Veterinary Therapy XIV, Bonagura JD, Twedt DC, eds. St. Louis,
Saunders Elsevier, 2008, 650–658.
performed prior to rehydration. This is particularly Petrollini E, Drobatz KJ. Jugular catheter placement and manage-
important if the pseudohypertrophy is interpreted as a ment. In: Clinical Veterinary Advisor, 2nd ed., Côté E, ed. St.Louis,
reason to administer fluids cautiously, or more slowly, Mosby Elsevier, 2011, 1293–1294.
when in fact the patient has a normal heart and may Ployngam T, Tobias AH, Smith SA, Torres SM, Ross SJ. Hemodynamic
require vigorous fluid resuscitation. effects of methylprednisolone acetate administration in cats. Am
J Vet Res 2006;67:583–587.
Polzin DJ. Chronic kidney disease. In: Textbook of Veterinary Internal
REFERENCES Medicine, 7th ed., Ettinger SJ, Feldman EC, eds. St. Louis, Saunders
Elsevier, 2010, 1990–2021.
Boldface font indicates key references. Purina Veterinary Diets: Purina Veterinary Product Guide, VET
Adin DB, Taylor AW, Hill RC, Scott KC, Martin FG. Intermittent bolus 0866H-0110;January 2010.
injection versus continuous infusion of furosemide in normal Reneiro C. Asthma, Cat. In: Clinical Veterinary Advisor, 2nd ed., Côté
adult Greyhound dogs. J Vet Intern Med 2003;17:632–636. E, ed. St. Louis, Mosby Elsevier, 2011, 94–97.
Bonagura JD, Lehmkuhl LB, de Morais HA. Fluid and diuretic Richter KP. Low-grade gastrointestinal lymphoma. Vet Clin North
therapy in heart failure. In: Fluid, Electrolyte, and Acid-Base Am Small Anim Pract 2003;33:1083–1098.