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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 heart 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''' 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.

{{Learning
|flashcards = [[Rabbit Medicine and Surgery Q&A 15]]
}}

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

Bourne, D. (2011) '''Congestive Heart Failure in Rabbits''' ''[http://www.wildlifeinformation.org Wildlife Information Twycross Zoo]''

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