Congestive Heart Failure - Rabbit

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Introduction

Congestive heart failure can occur in the rabbit as a result of heart disease, and is characterised by volume overload which can lead to signs of left-sided failure (pulmonary oedema and pleural effusion) and/or signs of right-sided failure (abdominal effusion, hepatomegaly and splenomegaly).

Heart diseases implicated include:

cardiomyopathy
valvular insufficiency
infectious causes
arrhythmia
congenital disease

Clinical Signs

The first signs of heart disease will be a decrease in activity, weight loss, changes in eating habits and breathing difficulties.

Signs of congestive heart failure may include

dyspnoea: open-mouth breathing, panting, wheezy chest sounds
tachycardia
ascites
peripheral oedema
cyanotic mucous membranes and arrhythmias

Diagnosis

If valvular insufficiency is present, a focal murmur may be heard on thoracic auscultation.

Radiography is the best way to diagnose CHF. It may reveal an enlarged heart, pulmonary oedema, pleural effusion. If right-sided failure is present there may be pericardial effusion, ascites, peripheral oedema, hepatomegaly.

ECG may reveal arrhythmias or tachycardia.

Echocardiography is important to diagnose the cause of the congestive heart failure, and may reveal valvular insufficiency or cardiomyopathy.

Blood pressure measurement is used to diagnose any output failure.

Treatment

If the rabbit presents in acute failure, treatment should include:

Oxygen: in an oxygen tent or via a facemask, minimising stress.
Diuretics: frusemide intramuscularly
Glyceryl trinitrate ointment to cause vasodilation
Thoracocentesis if pleural effusion is suspected: drain chest bilaterally placing a butterfly catheter ventrally through the chest wall. Multiple sites should be aspirated.

Prognosis is poor with acute congestive heart failure as rabbits usually present in the later stages of the condition and do not deal well with stressful situations.


Chronic treatment for CHF may include:

Diuretic: frusemide orally
ACE-inhibitors: enalapril or benazepril
Positive inotrope: digoxin

Regular monitoring of electrolytes and biochemistry is important during the course of treatment. Monitoring the rabbit's weight and eating habits is essential to ensure gut function remains adequate.

With chronic congestive heart failure, medical management may allow survival for months before decompensation occurs.


Congestive Heart Failure - Rabbit Learning Resources
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References

Girling, S. (2009) Rabbit Medicine and Surgery for Veterinary Nurses Wiley-Blackwell

Bourne, D. (2011) Congestive Heart Failure in Rabbits Wildlife Information Twycross Zoo




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