Dilated Cardiomyopathy - Feline Cardiomyopathies - Revision history

Bara at 17:57, 17 October 2013

2013-10-17T17:57:28Z

Lwilkie: /* References */

2012-12-02T22:33:38Z

References

Lwilkie: /* Two dimensional (2D) and M-mode */

2012-12-02T22:27:29Z

Two dimensional (2D) and M-mode

Lwilkie: /* References */

2012-12-02T22:20:27Z

References

Lwilkie: /* Overview */

2012-12-02T22:17:00Z

Overview

Lwilkie at 22:08, 2 December 2012

2012-12-02T22:08:39Z

Lwilkie: /* Treatment */

2012-12-02T22:06:33Z

Treatment

Lwilkie: /* Serum Taurine Levels */

2012-12-02T22:01:51Z

Serum Taurine Levels

Lwilkie: /* Pathophysiology */

2012-12-02T21:59:29Z

Pathophysiology

Lwilkie: /* Prognosis */

2012-12-02T21:48:22Z

Prognosis

← Older revision		Revision as of 17:57, 17 October 2013
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	*Ferasin L. Feline myocardial disease. 1: Classification, pathophysiology and clinical presentation. J Feline Med Surg 2009;11:3-13.		*Ferasin L. Feline myocardial disease. 1: Classification, pathophysiology and clinical presentation. J Feline Med Surg 2009;11:3-13.
	*Pion, P.D, Kittleson MD et al. Myocardial failure in cats associated with low plasma taurine:a reversible cardiomyopathy. Science 1987; 237:764-68.		*Pion, P.D, Kittleson MD et al. Myocardial failure in cats associated with low plasma taurine:a reversible cardiomyopathy. Science 1987; 237:764-68.
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		+	[[Category:Cardiology Section]]

← Older revision		Revision as of 22:33, 2 December 2012
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	==References==		==References==
		+	*Ferasin L. Feline myocardial disease. 1: Classification, pathophysiology and clinical presentation. J Feline Med Surg 2009;11:3-13.
	*Pion, P.D, Kittleson MD et al. Myocardial failure in cats associated with low plasma taurine:a reversible cardiomyopathy. Science 1987; 237:764-68.		*Pion, P.D, Kittleson MD et al. Myocardial failure in cats associated with low plasma taurine:a reversible cardiomyopathy. Science 1987; 237:764-68.

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 ===Echocardiography===
 ====Two dimensional (2D) and M-mode====
-* Increased end diastolic LV diameter
+DCM is defined as primary myocardial failure, which can be diagnosed by a reduced fractional shortening and increased LV end-systolic diameter.  Eccentric hypertrophy, which occurs as a result of volume overload, results in an increased end-diastolic diameter. Left atrial (LA) dilation occurs secondary to elevated LV filling pressures. Global systolic dysfunction resulting in dilation of all-four cardiac chambers is frequently observed in cases of DCM. Mild atrioventricular valve (mitral, tricuspid) insufficiency is common.  This occurs secondary to dilation of the valve annulus and distortion of the papillary muscles, such that the valve no longer seals closed within the dilated heart during systole. Spontaneous echocontrast and thrombi within the dilated atria are common findings. Mild pericardial effusion is also frequently identified.
 ===Taurine Levels===
 Although taurine deficiency is now a rare cause of DCM, it is worth ruling out due to its potentially reversible nature. Taurine levels are measured in plasma or whole blood.

← Older revision		Revision as of 22:20, 2 December 2012
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	==References==		==References==
		+	*Pion, P.D, Kittleson MD et al. Myocardial failure in cats associated with low plasma taurine:a reversible cardiomyopathy. Science 1987; 237:764-68.

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 {{unfinished}}
 ==Overview==
-Dilated cardiomyopathy (DCM) is now an uncommon feline cardiomyopathy, representing ~10% of cardiomyopathies. Previously, DCM was associated with taurine deficiency.  However, the discovery of this in 1987 led to supplementation of commercial feline diets with adequate taurine.  The rare cases of taurine deficiency observed since then are generally the consequence of vegetarian, vegan or canine diets to cats. It is difficult to differentiate true DCM, which is a primary systolic failure of the myocardium, from other forms of cardiac pathology which may result in a 'DCM phenotype'. Examples include the end stage of undiagnosed valvular diases (mitral dysplasia), ischaemic myocardial disease (HCM) or sustained tachycardia (tachycardia-induced cardiomyopathy).
+Dilated cardiomyopathy (DCM) is now an uncommon feline cardiomyopathy, representing ~10% of cardiomyopathies. Previously, DCM was associated with taurine deficiency.  However, the discovery of this in 1987 led to supplementation of commercial feline diets with adequate taurine.  The rare cases of taurine deficiency observed since then are generally the consequence of vegetarian, vegan or canine diets to cats. It is difficult to differentiate idiopathic DCM, which is a primary systolic failure of the myocardium, from other forms of cardiac pathology which may result in a 'DCM phenotype'. Examples include the end stage of undiagnosed valvular diases (mitral dysplasia), ischaemic myocardial disease (HCM) or sustained tachycardia (tachycardia-induced cardiomyopathy). Idiopathic DCM is a diagnosis of exclusion of other causes of secondary myocardial failure.
 ==Pathophysiology==

← Older revision		Revision as of 22:08, 2 December 2012
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	==Prognosis==		==Prognosis==
	Prognosis for cats with idiopathic DCM is grave. One case series of 11 cats with DCM reported a median survival time of just 11 days. Prognosis for DCM associated with taurine deficiency is generally good with appropriate therapy.		Prognosis for cats with idiopathic DCM is grave. One case series of 11 cats with DCM reported a median survival time of just 11 days. Prognosis for DCM associated with taurine deficiency is generally good with appropriate therapy.
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		+	==References==

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 ==Treatment==
 Treatment should aim to control clinical signs of congestive heart failure (CHF) and aim to prevent arterial thromboembolism (ATE).  In addition to this, consideration should be given to '''positive inotropic therapy'''. Treatment with positive inotropes, such as Pimobendan is indicated for severe systolic dysfunction and heart failure.
 ==Prognosis==
 Prognosis for cats with idiopathic DCM is grave. One case series of 11 cats with DCM reported a median survival time of just 11 days. Prognosis for DCM associated with taurine deficiency is generally good with appropriate therapy.

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 Spontaneous echocontrast and thrombi within the dilated atria are common findings. Mild pericardial effusion is also commonly identified.
-===Serum Taurine Levels===
+===Taurine Levels===
 ==Differential Diagnoses==

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 ==Pathophysiology==
 Reduced myocardial contractility, predominantly involving the left ventricle (LV), will result in reduced stroke volume and increased ventricular filling pressure.
 ==Clinical Signs==
 ===Signalment===

← Older revision		Revision as of 21:48, 2 December 2012
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	==Prognosis==		==Prognosis==
		+	Prognosis for cats with idiopathic DCM is grave. One case series of 11 cats with DCM reported a median survival time of just 11 days. Prognosis for DCM associated with taurine deficiency is generally good with appropriate therapy.