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Subject: Veterinary Medicine × Author: SATlSH KUMAR, K × End date: 2009 × Start date: 2000 × Type: Thesis × Thesis Type: Ph.D ×
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    ThesisItemOpen Access
    STUDIES ON CARDIAC DISEASES AND THERAPEUTIC MANAGEMENT OF CONGESTIVE HEART FAILURE IN DOGS
    (SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2009-01) SATlSH KUMAR, K; ALAHA SINGARI, N(MAJOR); TIRUMALA RAO, D.S; RAGHAVENDER, K.B.P.; ESWARA PRASAD, P; VYKUNTA RAO, V
    A RSTRACT: The present investigation was undertaken to study the occurrence of cardiac diseases, and the efficacy of different therapeutic regimens of congestive heart failure in dogs Dogs presented to \,'eterinary Hospital. Bhoiguda Teaching L'eterinary Clinical Complex. College of Veterinary science, Hyderabad from October 2006 to November 2008 i e , for a period of 26 months were considered for the study During this period 27,618 dogs were presented to the Hospital. ot' which 886 were suspected to ha~eca rdiac disease based on the clinical man~festat~crnasn d 4-71 Mere diagnosed with various cardiac diseases based on clinical examination, haematology. biochemistry. electrocardiography. radiography and echocardiography The owrall occurrence of cardiac disease in doss was 1 65 OO and the occurrence of the disease in the population exhibiting clinical manifestations was 48 b '0 The h~shesr prevalence was recorded in Labrador Retriever (13 26 ''0) folloued by Spitr German Shepherd, Doberman Pincher. Great Dane, Nondescript breed, Boxer, Cmlden Retriever. Rot\veiler and lowest in Dachshund ( 1 97 Oo) The age wise occurrence of cardlac d15eas in dogs was highest (61.13 O.0) in between 10 to I4 years of age and In\\est (5 It, in do@ with less than 5 years of a_re The scx wise occurrence of cardiac disease in dogs \\as bQ 10° o in males and 30 600,,0 in females The clinical manifestations recorded in the present investigation were exercise intolerance in 282 (65.47 %), dyspnoea at rest in 264 (61.25 %), anorexia in 249 (57 68 %), cough in 185 (42.85 Oh), going down in condition in 169 (39 14 Oh), pale mucosa in 11 5 (26.65 %), ascites in 49 (1 1.26 %), peripheral edema in 34 (7 80 Oh), cyanosis in 24 (5.64 Oh) and syncope in 10 (2.35 %) dogs and murmurs, gallop sounds and arrhythmias in all the dogs According to ISACHC regulations, out of 43 1 cases, 118 (27.3 %) dogs were found to be under class 11, 294 (68 2 Oh) dogs were under class 111 A and 19 (4 5 ?/o) animals were in class 111 B and 29 (6 68 ?/o) dogs belonged to phase 11, 58 (13.5 YOb) elonged to phase I11 and 344 (79.82 %) were under phase IV as per New York Heart Association recommendations The mean values of hemoglobin and total erythrocyte wunt was significantly low with an increase in TLC levels of all the CHF dogs on day 0 before therapy when compared with healthy dogs. The mean CKMB. LDH and Na levels were significantly elevated with a decrease in TP and serum albumin levels of all the CHF dogs before therapy The various ECG abnormalities detected in 384 dogs out of 431 dops with cardiac diseases \vere increased R amplitude m.ith ST slurring (8 6 Oh). Deep S na\.e (6 il OOJ. Increased P and R wave amplitudes (6 O OW), Deep Q and elevated R wave (6 0 40), abnormal confiyuration of P wave (5.72 9b). deep Q wave (2.21 O.b), wide P wave (4 94 Ob), low voltage CJRS complexes (1 95 O 0). \.entricular tachycardia (4 69 O 0). absence of P na\c (3 16 OO). elevated R Ma\ e. wide QRS. ST co\.ing (3 9 1 ). configurational change in P \\a\ e- \r ondering sinus pacemaker (-3 h5 OO), increased amplitude and width of P wave (3 -39 '0). ventricular premature complexes with atrial enlargement (3 39 96). elevated T wave (3 39 '0). fine atrial fibrillation (3 -39 OO). junctional premature conlplexes \\.ith 11 degree .A\' block (2 86 '0). ventricular premature complexes of riyht ventricle origin ( 2 86 OO). hrad\cardia \cith low voltage QRS complexes,. notched R wave (3 60 OO), ventricular bigeminy of left ventricle origin (2 60 O,O). deep T wave (7 60 96). sinus arrhythymia m.ith low R wave (2 34 '0). bundle branch block (7 34 O 0). reg~llar\ ,entricular premature complex -- after e\ erv second beat (-1 08 ?b) and \.cntricular depolarization from ectopic foci of hean. nler3ing uith riorrnal sinus rhythm - A complex arrhythmia ( 1 82 O 0) On radlopraphy. 58 (38 88O0) dogs showed pulmonw benous congestion. 49 (32 hhOo) showed cardlomegaly. Ih ( 17 ;3 '0) an~n~aslhso med aurlculilr hulsr leti dtrlal enlargement and 17 ( 1 1 33O 0) dops revealed pleural and perlcardlal ctTuslon In the present study out of a total of 150 dogs subjected to echocardiography, dilated cardiomyopathy in 74 (49.33 %) dogs, mitral valve insufliciency in 88 (58.66 %), tricuspid valve insufliciency in 37 (24.66 %), pericardial efision in 28 (18.66 %), hypertrophic cardiomyopathy in 8 (5.33 %) and patent ductus aneriosus in 5 (3.33 %) dogs was revealed. The LVEdD, LVEsD, and EPSS dimensions were increased with a decrease in LVPWd, LVPWs. IVSd, IVSs, and contractility indices (EF and FS) of DCM associated CHF dogs. There was a significant turbulence on pulsed wave Doppler and mosaic panern appearance on color flow Doppler of the mitral valve in MVI associated CHI- dogs In the present study all the 43 1 dogs diagnosed for heart disease were negative for the presence of adult heanworm antigen in the blood Out of the total patients diagnosed for various cardiac diseases. 60 patients diagnosed to be ailing ivith Congestive Heart Failure (30 dogs with DCM and 30 u.ith lLlitral Valve Insutliciencv) based on hemato-biochemistry. ECG, radiogaphy and echocardiography were selected and subjected to different therapeutic regimens. The selected 60 patients were randomly di\ ided into 3 groups, Cir 1. II and 111 each having 20 (10 DC\I and 10 XfVi) dogs Dogs in group 1 were treattxi with benazapril. frusemide and digovin once dad!.. orall!- Dogs in group 11 were treated with ramipril, fmsemide and digoxin once daily, orally Dogs in group I11 were treated uith ramipril. frusemide and digoxin at the same dosage as given to the dogs of the group I1 and a neutraceuticle. L-C'arnitine for L>C\1 dogs and Coenzyme Q10 fix mitral \ al\ e insufficiency doss .All the dogs under treatment for 45 da!.s \\ere monitored and the eflicacy was assessed at tbrtniyht intewals based on improvement of' clinical signs. henlato-biochemistry. electrocardiography. radiography and echocardiography features. 1-here \\as a significant impro\ement in the haen~atobinchemical parameters of CHF dogs during therap!. Radiographicall?. no appreciable reduction in heart size uas obseried in any of the Cl1F dogs after 45 days of therapy except substantial reduction in the pulmonarv edenla and pleural effusion There was improvement and disappearance in the cardiac arrh17hnlias on electrocardiograph^ A significant ditkrerice in left \.entncle dinlensions (LVEdD. L\'LisD. l.\'PM'd. I \'PWs. I\.Sd. IVSs. and EPSSl and contractilit! indices (EF and FS) were noticed tn W'hl associated CHF dogs b! the end of the trial Whereas. nu spmific difference in severity and intensity of turbulence and mosaic pattern of cvlour jet flow at m~tral \,a!\ e was noticed in (1'1 IF dogs associated with J2\-1 All the CHF dogs of group 111 recovered by the end of therapeutic trial Whereas, 5 dogs in group 1 and 3 in grwp 11 showed signs of azotemia and died after five weeks in spite of reduction in the doses of digoxin and ACEi Based on the resolution of clinical signs, improvement in haemato biochemical parameters and echocardiographic features, it was found that a combination of ramipril, frusemide and digoxin along with neutriceutical supplementation of L-Carnitine and Coenzyme Q was superior to other two combinations as indicated by the faster disappearance of sips and early recovery with no adverse drug reactions both during and after therapy Hence. this therapeutic regimen is indicated in dogs with congestive heart failure associated w~th either dilated cardiomyopathy or mitral valve insufficiency.