14. Pre-existing Disease Flashcards Preview

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Flashcards in 14. Pre-existing Disease Deck (19):
1

Most common heart conditions in dogs and cats?

*Mitral regurg in dogs
*HCM in cats
Also DCM

2

Advanced heart failure (stage D) contraindicates anesthesia
T/F?

True

3

MVO2?

why do we care?

myocardial oxygen consuption
- we don't want to increase it / Don't want severe tachycardia

4

Mitral regurgitation main goal?
What type of problem is it?

reduce the regurgitant flow
Volume load problem

5

How to change anesthetic plan for mitral regurg

- reduce preload
- peripheral vasodilation (avoid vasoconstricting drug)
- avoid depression of contractility
- prefer higher HR (less time in systole)

6

How to use fluids in mitral regurgitation

- 3-5 ml/kg/hr; don't bolus
- reduce sodium load, these patients retain sodium

7

How to treat hypotension in mitral regurg patients?

CRI dopamine/dobutamine (dopamine also vasodilates)

NOT fluids!

8

meds for mitral regurg

premed
induction
maintenance

premed: Ace if needed, opioids

induction:
1. Propofol or Alfaxalone (vasodilation but dec. contractility) Do a combo with benzo.
2. Ketamine
3. Etomidate (gagging, myoclonus)
4. benzo and opioid in depressed patient

maintain - iso

9

avoid ___ and ____ in post-op mitral valve regurg patients

hypoxemia, hypercapnia

10

HCM - thickened ________.

L ventrical and septum

11

goal in treating hCM pt

increase diastolic filling

12

prevent ______ in HCM

anterior systolic motion, vasodilation

13

preload?
afterload?
contractility?
in HCM

- maintain preload
- increase afterload
- myocardial depression is acceptable

14

drugs contraindicated in hcm

ketamine (inc. contractility and HR) Ace, atropine

15

induction in hcm

induction:
- propofol with benzo
- etomitate
- benzo and opiod in depressed animals

16

hypotension in hcm

not dobutamine bc. inc contractility

use phenylephrine for vasocontriction

17

DCM and pulmonic stenosis are both ____ ____ problems

pressure loading (vs. other two were volume loading)

18

DCM
preload?
afterload?
***contractility?

- reduce preload
- avoid vasoconstriction
- increase contractility (dobutamine)

19

main goal for dcm

maintain and support contractility (dobutamine)