Flashcards in 14. Pre-existing Disease Deck (19):
Most common heart conditions in dogs and cats?
*Mitral regurg in dogs
*HCM in cats
Advanced heart failure (stage D) contraindicates anesthesia
why do we care?
myocardial oxygen consuption
- we don't want to increase it / Don't want severe tachycardia
Mitral regurgitation main goal?
What type of problem is it?
reduce the regurgitant flow
Volume load problem
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)
How to use fluids in mitral regurgitation
- 3-5 ml/kg/hr; don't bolus
- reduce sodium load, these patients retain sodium
How to treat hypotension in mitral regurg patients?
CRI dopamine/dobutamine (dopamine also vasodilates)
meds for mitral regurg
premed: Ace if needed, opioids
1. Propofol or Alfaxalone (vasodilation but dec. contractility) Do a combo with benzo.
3. Etomidate (gagging, myoclonus)
4. benzo and opioid in depressed patient
maintain - iso
avoid ___ and ____ in post-op mitral valve regurg patients
HCM - thickened ________.
L ventrical and septum
goal in treating hCM pt
increase diastolic filling
prevent ______ in HCM
anterior systolic motion, vasodilation
- maintain preload
- increase afterload
- myocardial depression is acceptable
drugs contraindicated in hcm
ketamine (inc. contractility and HR) Ace, atropine
induction in hcm
- propofol with benzo
- benzo and opiod in depressed animals
hypotension in hcm
not dobutamine bc. inc contractility
use phenylephrine for vasocontriction
DCM and pulmonic stenosis are both ____ ____ problems
pressure loading (vs. other two were volume loading)
- reduce preload
- avoid vasoconstriction
- increase contractility (dobutamine)