Veterinary Internal Medicine 12 In case of non-suppurative pericarditis, resorbtion of the fluid...
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Transcript of Veterinary Internal Medicine 12 In case of non-suppurative pericarditis, resorbtion of the fluid...
Dr. Khaled M. Al-Qudah
Veterinary Internal Medicine
Pericarditis; Endocarditis; Myocarditis
Dr. Khaled M. Al-Qudah
Audible friction rub in early
Muffling of the heart
sounds in advance stage
Inflammation of the pericardial sac,
• May be septic, nonseptic, neoplastic, or
• Common bacteria are Streptococcus and
gram negatives in horses, plus anaerobes
and Actinomycosis in cattle
• Horses with pleuropneumonia or EHV1
• Cattle with hardware
Pericardial disease causes diastolic cardiac
dysfunction with minimal alterations in systolic
Accumulation of fluid in pericardial sac and
thickened and inflamed pericardium cause
cardiac tamponade and restrictive pericarditis,
which restrict diastolic filling resulting in
1. Early stage of inflammation hyperemia and
deposition of fibrinous exudate
Friction rub when the pericardium and epicardium
rub together during cardiac movements.
2. As effusion develops the inflamed surfaces
are separated, and the friction rub is replaced
by muffling of the heart sounds.
3. The accumulation of the fluid will compress
the atria and
ventricles preventing their complete filling
4. Toxemia is present in case of suppurative
In case of non-suppurative pericarditis,
resorbtion of the fluid followed by adhesion
between the pericardium and the epicardium.
This kind of adhesion is not strong to impair
In suppurative pericarditis the adhesions are
more serious and may cause complete
attachment between the epicardium and the
pericardium, which restrict the cardiac
movement followed by C.H.F.
5. In the recovery stage:
• Fever, depression, anorexia
• Pleurodynia (intercostal muscular pain)
• Colic in horses
• Cardiac tamponade
Most specific signs:
1) Jugular distention, edema
2) Pleural effusion
3) Splashy or muffled heart sounds and/or
pericardial friction rubs
• May also have arrhythmias
Clinical signs and physical findings:
The animal avoid to move
Abduction of the elbows
Arching of the back
Shallow abdominal respiration
The animal lies down carefully
Most specific diagnostic test is an echocardiogram
demonstrating pericardial fluid and collapsed RA.
Aspirate of pericardial fluid for cytology and
Other nonspecific findings:
Laboratory evidence of infection or inflammation:
• Pericardial drainage and lavage is very
• Antimicrobial therapy based on cytology
• Anti-inflammatory and analgesic therapy
• Rumenotomy or pericardiotomy to remove
foreign body in cattle if present with
• Treat arrhythmias and cardiac failure if
DR. Khaled M. Al-Qudah
Inflammation of the endocardium may
interfere with the ejection of blood from
the heart by causing insufficiency or
stenosis of the valves.
Cattle [corynebacterium pyogenes
[clostridium chauvoci (Black leg)
[ myoplasma mycoides
Horses [streptococcus spp
[strongylus spp (larvae)
Focus of infection anywhere in the body that embolizes to the valves
1)Actinomyces and Streptococcus most
common in cattle
2) Pasturella, Actinobacillus, and Streptococcus most common in horses
Pre-existing valve lesions may predispose to bacterial colonization
M.O. colonize the heart valves and
Vegetative and ulcerative lesions
1. this will interfere with normal
blood passage through the cardiac orfices
Fragments of vegetative lesions may become
miliary pulmonary abscesses
kidneys and joint abscesses
Impaired valve function from bacterial
colonization can lead to heart failure
1) Signs depend on valve (s) affected
2) Aortic and mitral valves (LAV) more
common in horse
3) Tricuspid valve (RAV) more common in
Depend on valve (s) affected and severity
May be subclinical …Cattle !!
May cause heart failure
The clinical signs of right-sided C.H.F.
Jugular and mammary vein distention with palpable pulses.
Ventral and submandibular edema
Systolic murmur only 50% have detectable murmurs.
Often younger animals (< 5 years)
50% of cattle also have shifting leg
1. The history and physical examination.
2. Blood culture is the single most useful
procedure for the diagnosis of BE.
Three venous blood samples should be
collected aseptically during one or two hour
Necropsy photograph of the heart of the above calf.
Note the large vegetation on the TV (arrow)
Most specific would be visualization of abnormal
valves on an echocardiogram
Endocarditis Left AV valve
Endocarditis in a calf about 6 months old
Not highly successful
Antimicrobial therapy (4-6 wks) based on
The thickness of the lesions prevents
adequate penetration of the drugs.
It is hard to treat before the isolation of the
M.O. and the selection of the drug should be
based on the sensitivity.
In case of negative culture:
Penicillin with gentamicin
Potentiated sulfonamide for long period...
Fair to good if treated early before significant
Poor to grave if significant valve lesions
80% of horses with aortic or mitral valve
Dr. Khaled M. Al-Qudah
Inflammation of cardiac muscle caused by
2) Viral infection, EIA, EVA, FMD, AHS
3) Parasitic migration (Strongylosis, Neospora canium,
sarcocystis, cysticercosis infection)
4) Bacterial endocarditis (Clostridium chauvoei, Str