Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 36 CE: CONGESTIVE HEART FAILURE IN CANINES 1. A 12-year-old, female, spayed Shih Tzu presents with a short history of exercise intolerance and increased respiratory rate and effort. She is a longstanding patient who has had a left apical murmur for 3 years, which has increased in volume. The optimal initial treatment plan for this dog is: a. Administer high-dose furosemide IV, then obtain a detailed echocardiogram. b. Sedate to obtain diagnostic thoracic radiographs before starting medical treatment. c. Place in an oxygen cage and administer furosemide SC. d. Place in an oxygen cage with inotropic support, such as dobutamine. e. Place in an oxygen cage with high-dose furosemide IM, and delay further investigations pending clinical improvement. 2. A 6-year-old Cavalier King Charles spaniel is examined for routine vaccinations, and a grade 4 left apical systolic murmur is detected. Thoracic radiographs show an elevated trachea and left atrial enlargement but no evidence of pulmonary edema. Echocardiography confirms degenerative mitral valve disease (DMVD) with thickened leaflets and left sided volume overload. Using the heart failure classification scheme, this dog would be classified as stage: a. A b. B1 c. B2 d. C e. D 3. Regarding the action of pimobendan in dogs, which of the following statements is true? a. Pimobendan should be given with food to increase its absorption. b. Pimobendan increases the sensitivity of troponin I to calcium, which causes an increase in contractility. c. Pimobendan increases the risk of sudden death by causing an increase in ventricular arrhythmias. d. Pimobendan causes vasoconstriction helping to maintain blood pressure in dogs with congestive heart failure. e. Pimobendan increases life expectancy in dogs with congestive heart failure. 4. Thoracic radiographs are obtained from a dog with acute congestive heart failure. What are the common findings: a. A hypervascular lung pattern b. An alveolar/interstitial pattern in the dorso caudal lung fields c. A generalized bronchial pattern d. An alveolar/interstitial pattern in the cranio ventral lung fields e. Patchy alveolar pattern 5. Which of the following statements regarding the diuretic, furosemide, is correct: a. It is called a loop diuretic as it works on the loop of Henle in the kidney. b. The dose can be tapered down and eventually stopped in cases of congestive heart failure. c. It can be replaced by the potassium sparing diuretic, spironolactone, in cases of congestive heart failure. d. It causes minimal electrolyte imbalances so it is not necessary to check these levels occasionally. e. It causes minimal effects on renal function with escalating doses. Congestive Heart Failure in Canines LEARNING OBJECTIVES After reading this article, readers should be able to recognize congestive heart failure (CHF) and have a logical approach to its treatment, categorize treatment priorities, administer them appropriately in the acute setting, and explain their use in the chronic situation. OVERVIEW This article provides an overview of the recognition of CHF and the treatment of both acute and chronic CHF, using logical choices based on evidence-based medicine. The article you have read has been submitted for RACE approval for 1 hour of continuing education credit and will be opened for enrollment when approval has been received. To receive credit, take the approved test online for free at vetfolio.com/journal-ce . Free registration on VetFolio.com is required. Questions and answers online may differ from those below. Tests are valid for 2 years from the date of approval. CONTINUING EDUCATION NOTE Questions online may differ from those here; answers are available once CE test is taken at vetfolio.com/journal-ce . Tests are valid for 2 years from date of approval.

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