Small animal nursing overview:
Common case presentations
Cardiac

For my own personal use only:
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kccspaniel
A heart murmur in an at-risk breed can be an early indicator of heart Dz
  • Heart disease is advanced by the time patients present for cough, exercise intolerance so better to pick up on more subtle signs earlier.
  • Always stabilize patients prior to pursuing diagnostics.

Cardiac

  • Common signs
    • Heart murmur, arrhythmia
    • Can be asymptomatic 
      • Look for indicators of early cardiac Dz on physical exam (see part 4)
    • Advanced cardiac Dz:
      • Cough
      • Lethargy/weakness
      • Exercise intolerance
      • Collapse
      • Tachypnea —> dyspnea
palpate pulse
Palpate the femoral pulse in the region of the proximal, medial thigh
  • Common diseases
    • Myxomatous mitral valve degeneration
      • Most common canine cardiac Dz
      • Middle-aged to older small to medium dogs
      • + heart murmur
      • Can progress to left-sided CHF w/ pulmonary edema
    • Dilated cardiomyopathy (DCM)
      • Large/giant breeds
      • +/- heart murmur
      • +/- arrhythmia
      • Often not Dx until CHF (left- or right-sided) w/ pulmonary edema, pleural effusion, ascites
    • Hypertrophic cardiomyopathy (HCM)
      • Most common feline heart Dz
      • +/- gallop sound
      • +/- heart murmur
      • +/- arterial thromboembolism (ATE)
      • +/- left-sided CHF  resulting in pleural effusion, pulmonary edema
    • CHF: Medical emergency
      • O2 supplementation
      • Diuretic therapy 
      • +/- other cardiac medications

 

  • Common diagnostic testing
    • Thoracic radiographs 
      • Evaluate heart size and shape
      • Dogs w/ MMVD: Left atrial enlargement before CHF
      • Dogs w/ DCM: Global cardiomegaly
      • See signs of CHF
        • Dogs: Pulmonary edema
        • Cats: Pulmonary edema/pleural effusion
    • Electrocardiogram (ECG)
    • Systemic blood pressure
    • Echocardiogram: Gold-standard Dx
MMVD
MMVD at necropsy (arrow) (LV = left ventricle, LA = left atrium)
VHS
Vets use the vertebral heart score, shown here, to objectively measure heart size

Images courtesy of Courtney Mihaka (CKCS dog), Kalumet (MMVD), Mstr Sgt. John Nimmo, Sr (taking pulse), VERDE28 (vertebral heart score).

Canine