Veterinary Clinical Medicine-I (General and Systemic)

ENDOCARDITIS

Endocarditis

• Dogs
  • Dogs mostly aortic valves of male German Shepherd and large breeds about 5 years old. Soft diastolic murmur heard on left heart base. Arterial pulses bounding. Streptococcus, Staphylococcus, E.coli, Klebsiella. Usually due to dental disease, pyoderma, prostatitis. Left heart enlgmt. Prognosis is unfavourable.
  • Discospondylitis is a common sequela. Irregular lytic vertebrae.
• Horses
  • Mostly mitral valve. Systolic murmur over left cardiac apex. Streptococcus, actinobacillus equlli. Left heart enlargement noticed.
• Cattle
  •  Tricuspid valve. Right heart enlargement.
• Cats 
  • Rare

Clinical signs

• Chronic fluctuant fever, heart murmur, shifting leg lameness, Malaise and weight loss, signs of systemic embolization.

Diagnosis

• Echocardiogram., neutrophilic leukocytosis. Radiography show alveolar pattern & ECG shows tall R waves(LV enlargement) & wide P waves (LA enlargement) in LSHF. Positive blood/joint culture with demonstration of heart involvement.

Treatment

• High dose broad spectrum antibiotics.
• Treat for heart failure
• Supportive care with prophylactic antibiotics.

Endocardiosis – degenerative valve disease is most common cardiac disease in animals.

• Dogs
  • Left AV (mitral) valve. Small breed - old dogs are affected 
• Cats
  • Left AV (mitral)valve. Uncommon in occurence.
  • In all cases, it leads to mitral regurgitation and pulmonary edema. Dilates LA, leads to APCs, Atrial fibrillation, sustained tachycardia. May cause LA rupture. RAAS is activated.
  • Clinical signs includes – exercise intolerance, tachypnea followed by cough and dyspnea. Prominent murmur and a precordial thrill.
• Horses
  • Left AV (mitral) valve and aortic valves(grade 2-6 murmur at left 4^th i/c space).
  • Horses are usually asymptomatic.