Canine pericarditis- inflammation outer shell heart (pericardium, cardiac sac). It can be acute or chronic; by origin - primary and secondary; by prevalence pathological process- focal and diffuse; according to the nature of the inflammatory exudate - serous, fibrinous, hemorrhagic, purulent. There are also dry (fibrinous) and effusion (exudative) pericarditis.

Etiology. Primary pericarditis occurs less frequently in dogs than secondary pericarditis, and is mainly aseptic in nature.
Its causes may be colds, drafts, allergies, blood diseases and hemorrhagic diathesis, malignant tumors, trauma, radiation exposure, autoimmune consequences, metabolic disorders - uremia, long-term treatment with glucocorticoids, hypovitaminosis C. Secondary pericarditis is a complication of a number of infectious (plague, parvovirus enteritis, hepatitis, leukemia, etc.), invasive and non-communicable diseases (pneumonia, pleurisy , bronchitis, myocarditis, etc.).
Very rarely, traumatic pericarditis is a consequence of mechanical damage to the chest and pericardium due to rib fractures, stab and gunshot wounds.

Symptoms pericarditis depend on the origin and stage of its development. Dry (fibrinous) pericarditis is accompanied by low-grade fever body and increased heart rate. The general condition of the dog is depressed. Appetite is reduced or absent. Dogs avoid sudden movements and often stand with their forelimbs spread to the sides, elbows sharply turned outward. As the disease progresses, the pulse becomes small and weakly filled. The heartbeat is increased.
Palpation of the cardiac region causes a pain reaction. Exudative (exudative) pericarditis is characterized by severe constant shortness of breath, forced dog posture - a sitting position with a forward bend. Body temperature is elevated at the beginning of the disease. Severe tachycardia appears. The pulse is small, weakly filled, sometimes thread-like, often arrhythmic. Heart sounds are weakened, dull, as if heard from afar, and are often arrhythmic. The liver enlarges and becomes painful. Arterial pressure decreased, and venous - increased. The speed of blood flow is reduced.
The disease is accompanied by gastritis, dysfunction of the liver, lungs, kidneys and other organs.
The course of pericarditis in dogs depends on the causes that caused it. Dry (fibrinous) pericarditis can often result in the patient’s recovery relatively quickly.
Exudative (exudative) pericarditis takes longer and is more severe. In some cases, when the myocardium and endocardium are affected, inflammation occurs quickly, within several days, and ends in the death of the dog.

Diagnosis. Dry pericarditis is determined by pain and friction noises in the cardiac region, increased cardiac impulse, tachycardia and other signs. Effusion pericarditis is characterized by displacement, weakening and diffuseness of the cardiac impulse, enlargement and merging of areas of relative cardiac dullness and absolute stupidity heart, weakening and dullness of tones, tachycardia, splashing noises, overflow and tension of the veins of the neck, edema.
Differential diagnosis. Venous pericarditis should be distinguished from hydrocele of the cardiac sac and effusion pleurisy. Dry pericarditis and the initial stage of effusion pericarditis must be differentiated from dry pleurisy, as well as from acute myocarditis and endocarditis.

Treatment of dogs. First of all, the owner of the animal should contact a veterinarian (call a veterinarian to the house), and not try to treat it on his own. Treatment should be comprehensive and aimed primarily at the underlying disease that caused pericarditis. First, complete rest and silence is prescribed to the sick dog. Limit the animal's exercise as much as possible. Food should be high in calories, fortified and contain a wide range of microelements. In the first days of therapy, it is recommended to slightly limit the supply of water.
In drug therapy, various diuretics are used to resolve exudate, and cardiac medications are used to maintain normal heart function. Good medicinal properties have glucose solutions that are administered parenterally several times a day. At the same time, the veterinarian prescribes antimicrobial and vitamin therapy. Allergic phenomena are eliminated by the use of antihistamines. The course and dose of the medication is determined by the veterinarian.

Bacterial pericardial infections in dogs and cats are very rare, and most often occur as a result of penetration of a foreign body. The infection is usually localized within the pericardial sac and causes fibrous pericarditis, fluid accumulation, and eventually leads to compressive pericarditis. This entails an increase in pericardial pressure, which begins to interfere with the filling of the ventricles (cardiac tamponade). Pericarditis in dogs and cats may also be the result of spread of the pathological process from the pleura, or violation of asepsis during pericardiocentesis. Viral infections that cause vascular lesions and serositis can also lead to the accumulation of significant amounts of pericardial fluid (eg, feline infectious peritonitis, canine herpesvirus type 1).

History/clinical signs

History may include anxiety, anorexia, weight loss, abdominal bloating due to right-sided congestive heart failure, and respiratory distress due to intravenous effusion. pleural cavity. Clinical examination may reveal fever, ascites (abdominal enlargement, fluid fluctuations), pronounced jugular venous pulsation, tachycardia, weak peripheral pulse and weakened cardiac impulse.

With careful auscultation of the heart, one may hear muffled tones with “thrusts,” possibly resulting from a rapid decrease in diastolic blood volume due to pericardial narrowing, as well as pericardial friction sounds, which occur when the rough and thickened visceral and parietal layers of the pericardium touch each other during cardiac contractions.

Microorganisms

In dogs, Nocardia asteroids and Actynomices spp. are most common, while in cats, Pasteurella is more common. Some fungi have also been isolated from pericardial effusions. Viral infections are very rare, although feline infectious peritonitis virus can cause pericarditis, which is of clinical importance.

Differential diagnosis

The table lists differential diagnoses for pericardial effusions. Other causes of fluid accumulation in the pericardial cavity include coagulopathies, uremia, and trauma; however, in these cases it usually predominates Clinical signs, not associated with cardiac disorders.

Differential diagnoses for pericardial effusion

Diagnostic plan

Clinical pathology

Clinical blood test for pericarditis in dogs and cats may show neutrophilic leukocytosis, possibly with a left shift. Increased liver enzyme activity may be observed in right-sided congestive heart failure, and increases in urea and creatinine concentrations may occur in prerenal heart failure. renal failure with increased urine density. Laboratory analysis free abdominal fluid shows signs of a modified transudate.

Radiography

A chest x-ray may show a rounded cardiac shadow without visible contours and prominent pericardial borders. In advanced cases of fibrosis, the heart shadow may be expanded to a lesser extent. Liquid in abdominal cavity resulting in right-sided congestive heart failure may obscure details.

Electrocardiography

An electrocardiogram (ECG) may reveal tachycardia (as a result of increased temperature and decreased cardiac output) and low PQRS wave voltage. Electrical alternans (differences in the height of the R wave as the heart oscillates) may also occur.

Ultrasound

Echocardiography can easily detect fluid accumulation in the pericardial cavity. During an echocardiographic study in such cases, it is important to focus not only on the work of the heart, but also on possible availability neoplastic masses. Detection of fibrous thickening of the pericardium may indicate a possible infection. Pericardiocentesis can be performed under the guidance of echocardiography, although this is not absolutely necessary. With cardiac tamponade, fluid may accumulate in the abdominal cavity, which is clearly visible on ultrasound.

Analysis of pericardial fluid To make a definitive diagnosis of bacterial pericarditis, cytological and microbiological analysis of the pericardial fluid is necessary. The technique of pericardiocentesis is relatively simple (Table), but it should only be performed if there is confirmed effusion in the pericardial cavity.

Pericardiocentesis

Required Tools

Surgical gloves, washing brush, local anesthetic, a long (10 cm) catheter placed on a large-bore needle (10–16 G), or a pericardiocentesis needle. Some authors suggest inserting a sterile urethral catheter through a catheter with a needle so that the latter does not bend.

Methodology

1. The animal, under or without sedation, is placed on its left side. An intravenous catheter is placed as a precaution. On the ventral half of the chest wall, a field is prepared in the area of ​​intercostal spaces 4–6 and treated with an antiseptic. 2. make infiltration anesthesia of the skin and intercostal muscles approximately at the second third of the distance from the sternum to the costochondral joints 3. Using a pericardiocentesis needle, slowly puncture the intercostal muscle cranial to the rib, after passing 1–2 cm under the skin 4. the needle is advanced further, preferably under ultrasound guidance and with simultaneous ECG recording, until the catheter passes through the pericardium (under ultrasound guidance), or ventricular ectopic systoles appear, or you feel the tip of the needle scratching the visceral epicardium 5. Puncture of fibrous pericardium may require considerable effort and should be performed with caution 6. After puncture, the stylet is removed and the liquid is carefully aspirated with a 50 ml syringe connected through a triple switch and a long tube until no more liquid flows into the syringe. The sterile collected fluid can be retained for microbiological and cytological examination. 7. A small volume of liquid is settled; if it clots, the fluid contains fresh whole blood and the procedure should be stopped. Two samples should be taken - with and without EDTA. 8. Drainage should be continued to the end to reduce the risk of purulent exudate entering the pleural cavity, relieve pressure on the heart and increase cardiac output.

Cytological and microbiological analysis should be carried out without delay. Cytological examination reveals a large number of neutrophils, often with degenerative changes. Macrophages may be found in smaller numbers, and both types of cells sometimes contain bacteria inside. In feline infectious peritonitis, the fluid may contain a mixed population of leukocytes with neutrophils without signs of degeneration.

Treatment

Pericardial infections in small animals are so rare that detailed recommendations does not exist.

For treatment infectious pericarditis high-dose intravenous antibiotics and subtotal pericardectomy with constant lavage through thoracic drains are required. Antibiotics are selected according to the sensitivity of microorganisms.

Antibiotics are prescribed until the results of the sensitivity test are obtained. wide range actions effective against anaerobes and aerobes.

If the main fibrotic changes are localized to the visceral layer of the pericardium, diastolic function is likely to remain insufficient.

Clive Elwood (Great Britain)

WOLMAR

FOR DOGS

Pericarditis in dogs is considered a disease characterized by inflammation of the outer lining of the heart. In this case, fibrinous or fibrinous-serous exudate accumulates in the pericardial area.

Causes of pericarditis: In most cases, pericarditis in dogs is a complication of various diseases. We are talking about plague, tuberculosis, myocarditis, pleurisy, and purulent pneumonia.The influence of unfavorable factors leads to inflammation of the pericardium. After this, fibrinous exudate penetrates into its cavity. The inner surface of the pericardium becomes rough. This leads to disruption of the sliding of its surfaces. As the disease progresses, the amount of serous exudate in the pericardial cavity increases.

As a result, nearby heart tissues are compressed. This is considered to be the cause of impaired diastolic relaxation of the heart. The consequence of this process is the appearance of cardiac tamponade. The accumulation of large amounts of serous and fibrinous exudate in the pericardium causes the development of general venous stagnation in organism. As a result, swelling appears.Diseases and recommendations for dachshunds

Pathological anatomy of pericarditis

At autopsy, thickening of the pericardium is noted. In its cavity, exudate of a purulent or fibrinous nature is found. The amount of exudate may exceed 1.5 liters.

Clinical picture of pericarditis

In the initial stages of pericarditis in dogs, there is a rise in temperature and a significant increase in heart rate. The mucous membranes become bluish. Initially, there is an increase in cardiac impulse. However, when serous exudate appears in the pericardial cavity, it becomes diffuse in nature. Late stages Pericarditis in dogs is characterized by the appearance of a splashing sound in the heart. The reason for the development this symptom considered purulent or putrefactive microflora. Percussion detects an increase in the boundaries of the heart.

Pericarditis can manifest itself as shortness of breath, bilateral barrel-shaped edema in the heart area. An increase in heart rate is typical. Hematological examination promotes the detection of an increased number of leukocytes due to neutrophils.

Diagnosis of the disease

Typical signs of pericarditis in dogs are an increase in heart rate, the appearance of murmurs in the pericardial area, enlargement of the cardiac borders, and changes in the shape of the chest. To confirm the diagnosis, ECG and ultrasound of the heart are used.Pericarditis in dogs must be distinguished from pleurisy. Note that inflammation of the pleura is characterized by focal or diffuse pain in the intercostal spaces. On auscultation, pleurisy is manifested by friction noise on inhalation and exhalation.

Sick dogs are advised to rest completely. The animal is fed in small portions. Preference is given to dairy products. To reduce the rate of exudate formation in the pericardial area, it is recommended to apply cold compresses to the heart area. The development of serous exudation is an indication for rubbing resorbing ointments into the heart area. When edema appears, use diuretics (furosemide, diacarb). To suppress the activity of pathogenic microorganisms, the use of antibacterial drugs broad spectrum (penicillin) and sulfonamides (etazol). To improve the functioning of the cardiovascular system and nervous system, the use of caffeine or corglycan is recommended. The main measure for the prevention of pericarditis andneumothorax in dogs is considered to be the prevention or treatment of diseases that may be complicated by pericarditis.

Kameneva A.V., veterinary cardiologist/anesthesiologist. Net veterinary centers MedVet.

Introduction

Pericarditis is an inflammation of the outer lining of the heart, both its visceral and parietal layers. The pericardium covers the heart and great vessels, normally contains from 1-15 ml of liquid rich in phospholipids, which ensures sliding without additional friction. It prevents overstretching of the heart chambers when venous return increases, but in the case of a gradual increase in the heart muscle, it stretches along with it.
Relevance of the topic. Pericarditis, according to various sources, occurs in middle-aged and elderly dogs and accounts for from 3.5 to 0.4% of all dogs examined by a cardiologist. There are no statistics among cats, but on average the figure does not exceed 1-0.5% and is mainly associated with infectious peritonitis, less often it is a consequence of congestive heart failure.

Etiology

There are idiopathic, acute exudative and chronic adhesive pericarditis (constrictive). Acute exudative pericarditis can be serous, fibrinous, purulent, hemorrhagic, mixed. Serous pericarditis is usually infectious in nature or accompanies an acute allergic reaction. Rare causes include pericardial cysts, coagulopathies, and hypoalbuminemia. The cause of purulent inflammation is most often a penetrating injury to the chest and sepsis. The cause of acute hemorrhagic exudative pericarditis is often neoplasms and metastases (angiosarcoma - more than 60%, mesothelioma, malignant lymphosarcoma, rhabdomyosarcoma). According to various sources, neoplasms cause pericarditis from 30% to 80%, which is nevertheless a low percentage of the total number of neoplasms (only about 0.19%). In cats, the figure is even lower, it is only 0.03% and it is almost always lymphoma.

Predisposition. These are mainly dogs of large and medium breeds over 5 years old, most often male, there is a breed predisposition (Labradors, golden retrievers, german shepherds, Great Danes).
Symptoms. The most common complaints from owners of dogs with pericarditis are lethargy, tolerance to physical activity, lack of appetite, collapse or fainting, bloating and shortness of breath, pale mucous membranes, bluish mucous membranes. The intensity of the clinical manifestations of pericarditis directly depends on whether the process is acute or chronic, and on the volume of free fluid in the pericardial cavity. Diagnostics. Diagnosis is based on physical examination, x-ray, Echocardiography of the heart, blood tests, ECG.
An examination of an animal with suspected pericarditis should be carried out qualitatively, but with some caution. Often the patient comes to see a doctor in serious condition, with severe symptoms right-sided heart failure due to cardiac tamponade, sometimes similar symptoms can develop within a day. In this case, weakness, shortness of breath are expressed, the cardiac impulse is reduced, the pulse is weak or not palpable at all, jugular veins dilated, pale mucous membranes, SNK more than 3-5 s. Abdominal enlargement due to ascites and wheezing due to developing pulmonary edema and chest effusion may also occur. Such patients should not be subjected to thorough diagnostics; it is enough to verify the presence of free fluid using ECHO and perform a percutaneous puncture of the pericardium.
If the patient's condition is more stable, a thorough examination is necessary. X-ray examination reveals rounded contours of the heart. The method also allows you to determine metastasis of lung tissue.

An ECG diagnoses alteration of R waves, sometimes a decrease in voltage and depression
ST segment (Fig. 5).
The gold standard for diagnosing pericarditis is cardiac echocardiography; this method also allows one to assess hemodynamics, the presence of chest effusion, and sometimes identify neoplasms (the right atrium is most often affected). The presence of fluid in the pericardial cavity is determined in all projections as an echo-negative space limited by the pericardial layers, and abnormal (side to side) movement of the heart is also observed.
Before puncture, it is necessary to perform sedation (nalbuphine 0.4 mg/kg + propofol 6 mg/kg if necessary); Most patients behave calmly due to the severity of their condition. It is also important to ensure venous access, the availability of a resuscitation kit and monitoring electrical activity heart and blood pressure. The injection site can be infiltrated with a 1% lidocaine solution; usually the injection is performed in the 4th-5th intercostal space, slightly above the junction of the ribs with the sternum; an ultrasound probe can also be used to select the location. Due to the fact that the pericardium is overstretched, it is not always possible to feel resistance when puncturing it, so you can focus on the free movement of the needle tip, the depth of needle insertion, and the presence of fluid flowing freely under pressure. If the fluid is serous or purulent, it is important not to confuse it with the contents of the chest, and hemorrhagic exudate with blood from the chambers of the heart. To clarify the location of the needle, you can use an ultrasound sensor; also, in case of myocardial trauma, due to a puncture or contact with a needle, ventricular extrasystoles often appear on the ECG.
In response to fluid removal, the patient's condition rapidly improves primarily due to increased cardiac output. After aspiration of fluid, replacement therapy with colloid and crystalloid solutions should be carried out and patients should be observed for at least 6-12 hours.

Surgery

Often a single puncture is not enough; you have to repeat them 3-4 times or resort to pericardiectomy. It is important to inform the owner about this so that he is prepared for possible deterioration and constantly keeps in touch with his doctor.
According to some reports, timely surgery allows you to significantly increase the duration and quality of life. For patients with idiopathic pericarditis, pericardiectomy may also have healing effect and not allow concentric pericarditis to develop; in case of tumor pericarditis, this allows one to avoid tamponade, improve the quality of life and obtain material for histological examination, and therefore the opportunity for chemotherapy. Pericardiectomy is performed in stable patients; It is extremely dangerous to perform surgery in the presence of tamponade and unstable hemodynamics; it is advisable to first perform a puncture, stabilize the patient, and only then carry out surgery as usual. As for excision of tumors, opinions differ. Surgical excision of angiosarcoma carries a poor prognosis; Considering that micrometastases are usually already present, the average survival rate is about four months. With other types of neoplasms, the survival rate is slightly higher - up to 5-8 months. After pericardiotomy, survival rate increases (according to some data, up to 3 years).

Conclusion

Males with an average age of 5-12 years are more prone to pericarditis; The Labrador Retriever is a more susceptible breed. Echocardiography is the most sensitive means of diagnosing pericarditis, in particular, it allows differentiating various acquired heart diseases that cause cardiomegaly on the radiograph. Conservative therapy+ pericardiocentesis is most effective in combating tamponade, but the main method of treatment, and sometimes the only way to make a final diagnosis, is pericardiotomy. In cats, pericarditis is usually associated with viral peritonitis or lymphoma, less often it is a consequence of heart failure, in which case the prognosis is poor, since the risk of developing pulmonary edema is extremely high.

Bibliography:

1. Annika Linde,Tonatiuh Melgarejo. Review article. Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-1407, USA
2. Sisson D., Thomas R. G. Pericardial disease and cardiac tumors.
3. Philip R. Fox DVM MSc, D. David Sisson DVM DACVIM, N. Sydney Moise DVM MS. (ed.). Cardiology of dogs and cats. Textbook, edition 2. Philadelphia, WB Saunders, 1999.
4. L. Ari Jutkowitz, VMD, DACVECC CVC in Kansas (urban study). Pericarditis in dogs (materials); August 1, 2008.
5. A. Rick Alleman, DVM, PhD, University of Florida, College of Veterinary Medicine, PO Box 100103, Gainesville, FL 32610, USA.
6. K. Satish Kumar, V. V. V. Amruth Kumar, P. Nagaraj, and D. S. Tirumala Rao. Idiopathic pericarditis in dogs - a three-year study. Department of Veterinary Clinical Medicine. College of Veterinary Science, Rajendranagar Hyderabad - 500 030, Andhra Pradesh, India.
7. Kristin MacDonald, DVM, DACVIM/Cardiology, CVC IN SAN DIEGO. Pericarditis: causes and clinical outcomes in dogs (materials); November 1, 2009.
8. Lilith. Pathology of the cardiovascular system.
9. Scott Shaw, DVM, DACVECC; John E. Rush, DVM, MS, DACVIM (Cardiology), DACVECC. Pericarditis in dogs. Cummings School of Veterinary Medicine. Tufts University

Pericarditis- inflammation of the pericardium (heart lining). There are acute and chronic, dry and exudative pericarditis.

Causes and development of the disease

A scraping noise is a pathognomonic sign of dry pericarditis. Pericardial effusion is more difficult to diagnose.

DISEASES OF THE CARDIOVASCULAR AND CIRCULATORY SYSTEM IN DOGS

DISEASES OF THE CARDIOVASCULAR AND CIRCULATORY SYSTEM IN DOGS - section Medicine, INFECTION, INFECTIOUS PROCESS The Circulatory System Includes the Heart - the Central Organ, Contributing.

The circulatory system includes the heart - central authority, which promotes the movement of blood through the vessels, and blood vessels - arteries that distribute blood from the heart to the organs; veins that return blood to the heart and blood capillaries, through the walls of which the exchange of substances between blood and tissues occurs in the organ. Vessels of all three types communicate with each other along the way through anastomoses that exist between vessels of the same type and between different types of vessels. There are arterial, venous or arteriovenous anastomoses. Due to them, networks are formed (especially between capillaries), collectors, collaterals - lateral vessels accompanying the course of the main vessel.

Pericarditis

Pericarditis is inflammation of the pericardial sac.

Etiology and pathogenesis. Pericarditis in dogs is more often of secondary origin and occurs after illness with any infectious disease, mainly tuberculosis. Primary pericarditis, which develops due to pericardial injury, is very rare in dogs.

Predisposing factors to the disease of pericarditis are all those factors that generally act on the body, reducing its resistance. This includes inadequate feeding, hypothermia (especially prolonged stay in cold water hunting dogs and divers), overwork, long-term transportation, etc. The inflammatory process can also spread to the pericardium with a number of underlying organs - the pleura, lungs, myocardium and organs located in the mediastinum.

Development inflammatory process is accompanied by hyperemia and accumulation in the pericardial cavity of a significant amount of exudate, the nature of which can be serous-fibrinous, hemorrhagic, purulent or mixed. The amount of exudate can reach up to 1.5 liters. It is often necessary to observe the so-called “cardiac tamponade”, caused by defective diastolic and systolic contractions of the heart muscle, as a result of which its suction and pumping functions are disrupted.

Impaired blood circulation in the large and small circle leads to the development stagnation, which, in turn, cause disruption of the functions of organs throughout the body.

Pericarditis can be complicated by myocardial lesions and inflammatory changes in the pleura.

Clinical picture. Pericarditis can be acute or chronic. Acute pericarditis can develop due to various infectious diseases, and therefore identifying its initial signs is difficult, and only as the process develops, the signs of pericarditis clearly appear. At the onset of the disease, body temperature rises to 40° and above, appetite is reduced or absent, and the condition is depressed. At this time, there is no exudate in the pericardial cavity or there is a very small amount of it. On palpation there is pronounced pain in the heart area. During auscultation of the heart, a friction noise is heard, and it is concentrated only in the region of the heart. This distinguishes it from friction noise during dry pleurisy, in which such noise is heard especially well at the border of the upper and middle third of the chest. In addition, with pericarditis, the noise is heard regardless of inspiration and exhalation, while with pleurisy, the noise is heard at the moment of inspiration.

As the exudate sweats out, changes occur in clinical picture. Body temperature drops. The number of pulse beats increases due to circulatory disorders. Shortness of breath appears. The boundaries of cardiac dullness increase. The boundaries of the dull sound do not shift when the dog’s body position changes. The heartbeat is weakened. Heart sounds are difficult to hear and muffled. If there are gases in the exudate, splashing noises appear. Shortness of breath and cyanosis of the mucous membranes are observed. Subsequently, swelling appears, and then dropsy of the chest and abdominal cavities may develop.

Chronic pericarditis can develop from acute pericarditis, but most often it develops due to tuberculosis and is manifested by signs of heart failure, namely: shortness of breath, an increase in the boundaries of cardiac dullness, accelerated pulse, edema, etc.

Diagnosis It can be difficult to diagnose acute pericarditis at the onset of the disease, since the underlying disease comes to the fore. The basis for diagnosis in the initial stage is pain in the heart area, friction noise, and with the accumulation of exudate, an increase in cardiac dullness. If there are gases above the exudate, a splashing noise is heard during auscultation. Phenomena of heart failure are noted. X-ray studies indicate a decrease and even disappearance of the cardiophrenic triangle. Expanding the shading area.

If chronic pericarditis is suspected, the dog must undergo tuberculinization.

Forecast adverse.

Treatment should be aimed at eliminating the underlying disease. In case of acute pericarditis, the dog must be given rest and put on a milk diet. Apply a cold compress to the heart area. During the exudation stage, irritating ointments are rubbed into the heart area. White streptocide (0.3–0.5) and other sulfonamide drugs are given orally in generally accepted dosages. To improve cardiac activity, digitalis leaves are prescribed in a dose of 0.2, strophanthus tincture in a dose of 6-15 drops 3 times a day and other cardiac remedies. Good effects are obtained from penicillin therapy. 20,000–30,000 units are administered intramuscularly after 6–8 hours.

To alleviate pain during defecation, laxatives are prescribed - calomel in a dose of 0.2–0.3 and warm enemas. To resolve the exudate, mild diuretics are prescribed. Some authors recommend lacto- and autohemotherapy. If a large amount of exudate accumulates, a puncture of the pericardium is made in the area of ​​the fifth or sixth intercostal space and the exudate is removed.

Myocarditis . This is an inflammatory lesion of the heart muscle, occurring mainly as a complication of sepsis, acute intoxication, systemic erythematous lupus, pyometra, uremia, pancreatitis. There is, however, evidence of a large number of viruses, fungi and protozoa that primarily cause myocarditis.

Currently, the highest incidence of this disease is observed in parvovirus enteritis. Toxins or pathogens spread in the body through the hematogenous route. Inflammatory changes in the heart muscle occur as a result of an allergic reaction of the body, sensitized by one or another antigen. Antigens and toxins, acting on tissue, form tissue autoantigens in it. In response to this, the body produces autoantibodies, which cause extensive damage to the myocardium. Exudative and proliferative processes develop in the interstitial tissue (interstitial myocarditis) or dystrophic changes in myocytes (myocardial dystrophy). Myocarditis may also occur as a result of sensitization of the body to certain medicines(drug-induced allergic myocarditis).

Symptoms. Myocarditis manifests itself in disturbances in the rhythm of cardiac activity. Against the background of the underlying disease, the general condition of the animal worsens with the appearance of tachyarrhythmia up to 180-200 heartbeats per minute. In case of infection, body temperature rises to 40 °C. Pronounced cyanosis, soft arrhythmic pulse, weakened diffuse apical impulse. Laboratory research show moderate neutrophilic leukocytosis, increased ESR.

Forecast. Myocarditis in most cases proceeds favorably and, when the underlying disease is cured, ends in recovery. However, there may be cases sudden death(for parvovirus enteritis). Focal myocardiosclerosis or congestive cardiomyopathy may develop.

Treatment. Rest and exercise limitation are prescribed. They act on the cause that caused the disease (antibiotics, desensitizing agents, corticosteroid hormones). To eliminate heart failure and disorders heart rate cardiac glycosides are prescribed.

Myocardial infarction . This is a focus of necrosis in the muscle of the left ventricle of the heart, resulting from cessation of blood supply, i.e. ischemia. Extensive coronary infarctions developing against the background coronary disease hearts, do not occur in dogs, since vascular atherosclerosis is not typical for this type of animal, hypertonic disease, nervous overload. There are isolated cases of extensive myocardial infarction due to multiple severe trauma; due to a decrease in coronary blood flow during massive blood loss and circulating blood volume (hypovolemia), during embolism coronary vessels emboli detached from the valves aortic valve with septic endocarditis. However, the violation of myocardial trophism itself as a concomitant phenomenon of congestive cardiomyopathy, myocardial hypertrophy with atrioventricular valve defects occurs quite often - in 26.4% of cases. In this regard, non-coronarogenic intramural microinfarctions occur.

Symptoms. For heart attacks they are nonspecific. Microinfarctions go unnoticed. Their development should be assumed during the period of decompensation of the underlying disease. Extensive myocardial infarction inevitably leads to the death of the animal. Changes are detected only at autopsy.

Treatment. Due to the impossibility of timely diagnosis, therapeutic measures are usually not taken.

The possibility of preventing myocardial infarction depends on the diagnostic experience and alertness of the doctor. Hypovolemia is eliminated by drip infusion of plasma-substituting solutions (glucose, polyglucin), injuries are anesthetized, and in case of sepsis, thrombolytic agents (streptokinase) are administered. For the prevention of microinfarctions in cardiomyopathies and valve defects, beta blockers (obzidan, anaprilin 10-40 mg 2 times a day) and calcium antagonists (Corinfar 4-20 mg 3 times a day) and peripheral vasodilators (prazosin 0.1-0 .5 mg 2 times a day).

Cardiac rhythm disturbances. Blockade of intracardiac conduction. Paroxysmal tachycardia . Sometimes it is necessary to observe individual cases of the disease when the only symptom is periodically recurring epileptiform seizures of Morgagni-Edams-Stokes, occurring with a sudden fall of the animal, short-term loss of consciousness, tonic and, less often, clinical convulsions, opisthotonus. The reason for this is frustration cerebral circulation arising in connection with a sharp arrhythmia of cardiac activity. Such rhythm disturbances occur with myocarditis, congestive cardiomyopathy, myocardiosclerosis, i.e., with those processes in which the interstitial tissue is damaged. Edema and pathological proliferation of connective tissue disrupt the functions of the heart fibers that conduct excitation impulses. In some cases, conduction blockade rarely occurs. In such animals, along with epileptiform seizures, pronounced bradycardia is noted, when the number of heart contractions ranges from 60 to 20 beats per minute. Sometimes you can auscultate the merging of two heart sounds into one loud “gun tone.” In others (much more often), ectopic foci of excitation are formed or additional pathways are formed, which is why significantly more excitation impulses are supplied to the heart muscle. Then Morgagni-Edems-Stokes seizures occur against the background of paroxysms of tachycardia associated with extrasystole or atrial fibrillation atria. The number of heart contractions can reach 180-240 per minute, but with a pulse deficiency. A pendulum-like heart rhythm is characteristic. The attacks last from several seconds to several minutes and end as suddenly as they began.

If intracardiac conduction is blocked, an intravenous infusion of isoprenaline (1 mg in 200 ml of 5% glucose solution) is urgently administered. Then, during the day, another 0.1-0.2 mg of this drug is injected subcutaneously.

At paroxysmal tachycardia, which occurs without convulsive seizures, owners are taught to stop the seizure by pressing their fingers on the animal’s eyes for 10-20 seconds until the symptoms disappear. In more severe cases, convulsive phenomena are relieved by intravenous administration of seduxen, and tachyarrhythmia - antiarrhythmic drugs - anaprilin.

Pericarditis . This is an inflammation of the pericardium with the accumulation of fluid in the cavity of the cardiac sac, developing as a complication of other primary diseases of an inflammatory or non-inflammatory nature. Pericarditis can occur against the background of hemorrhage into the pericardial cavity (hemopericarditis) with traumatic damage to the main vascular trunks or the left atrium, with destruction of the base of the heart by a tumor (brachiocephalic chemodectoma, metastases of thyroid and parathyroid cancer). Complication bacterial infection there may be exudative pericarditis with accumulation of pus. There are known cases of idiopathic serous-hemorrhagic pericarditis of unknown etiology. During inflammation, sometimes the pericardial layers become fused with the disappearance of the pericardial cavity (adhesive pericarditis). Often, lime is deposited in such a pericardium and the so-called armored heart is formed. Scar tissue tightens the pericardium, causing compression of the heart (constrictive pericarditis).

Symptoms. The occurrence of pericarditis complicates the course of the underlying disease. The existing symptoms are accompanied by signs of cardiovascular failure associated with cardiac tamponade due to accumulated exudate. Later, when the disease moves into the next phase, signs of failure are caused by the formation of scar strictures. Clinically, weakening or absence of the apical impulse and heart sounds, a small rapid pulse are noted; in severe cases - swelling of the neck veins, enlarged liver, ascites and hydrothorax. Additionally, exudative pericarditis is indicated by different pulse fillings on symmetrical limbs, displacement of the apical impulse when changing body position. Radiographically, when there is a large accumulation of fluid in the pericardial cavity, the trachea is pushed towards the spine. The greatly enlarged silhouette of the heart can fill the entire pulmonary field and is shaped like a pumpkin. The longitudinal diameter of the heart is larger than the vertical one. The cranial and caudal vena cava are dilated; detect the horizontal level of liquid in the cavities during radiography of a standing animal. With adhesive pericarditis, it is possible to auscultate a presystolic murmur, retraction of the intercostal spaces in the heart region during systole, and the absence of respiratory excursion of the organs of the upper abdomen due to a sharp limitation of the mobility of the diaphragm are noted.

Constrictive pericarditis and “shell heart” are recognized in an x-ray image by the deformation of the heart shape and the layering of uniform intense shadows of bone density on it.

Diagnosis. It is placed after pleuropericardiocentesis. First, the nature of the aspirated fluid (transudate or exudate) is determined under a microscope, then it is sent for bacteriological and cytological studies. Obtaining fluid from the pericardial cavity also serves as evidence of pericarditis when differentiating it from myocardial hypertrophy.

Purulent pericarditis, if not taken urgently therapeutic measures, extremely dangerous to life. Serous pericarditis may result full recovery. Adhesive pericarditis creates a persistent painful condition.

Treatment. Eliminate the underlying disease by prescribing antibiotics, cardiac glycosides and diuretics. Repeated pericardiocentesis is also necessary to aspirate fluid. The so-called idiopathic pericarditis can sometimes be cured after several punctures of the heart sac.

In case of constrictive pericarditis, surgical intervention is necessary.

Operation technique. General anesthesia with artificial ventilation. Right lateral position of the animal. A thoracotomy is performed in the right fourth intercostal space. A rectangular flap of 7 x 1 cm is cut out from the outer sheet of the heart sac so that the pericardial cavity remains open and the heart is no longer compressed. Stitched up chest wall. Air is aspirated from the pleural cavity. Apply a pressure bandage.

Symptoms. Obstruction of the lumen of the pulmonary artery leads to the sudden development of severe cardiopulmonary failure, ending in the death of the animal over the next 2-3 days. The animals are in a state of extreme severity, they groan, and weakness quickly increases. Shortness of breath, anemia of the mucous membranes, and tachycardia appear. The apical impulse is sharply weakened. X-rays reveal enlargement and darkening of the diaphragmatic lobes of the lungs and hydrothorax.

The prognosis is unfavorable. When attempting treatment, heparin is used as a “remedy of desperation”.

Thrombosis that is not accompanied by cardiopulmonary semiotics includes thrombosis of the iliac arteries, which can sometimes be observed in old obese animals by sudden lameness or paresis of one of the pelvic limbs. In such cases, evidence of the diagnosis is the determination by touch of a decrease in local body temperature below the level of thrombosis and the absence of a pulse wave at the sites of the pulse.

Treatment. Iliac artery thrombosis is not treated. It is only necessary to wait until collateral circulation is formed.

Vasculitis . They are represented mainly by hemorrhagic and lupus vasculitis, which, however, due to the predominance of symptoms of another specific nature, will be discussed in the appropriate sections. In addition, phlebitis of peripheral veins may develop as a result of the infusion of certain chemotherapy drugs (cytostatics, etc.), as well as with paravenous injection of irritating substances or with prolonged implantation of an infusion catheter into a vein.

In the area of ​​inflammation, swelling and redness of the soft tissues are detected, the vein is palpated under the skin in the form of a thick cord and is painful. If the inflammation is caused by the catheter, it is removed immediately. In the case of paravenous injection of irritating substances, the injection site is injected with 20-30 ml of a 0.25% solution of novocaine. To prevent phlebitis from cytostatics, the vein is washed with 10-20 ml of physiological solution. It is recommended to rub heparin ointment into the affected area at least 2-3 times a day until the inflammation disappears.

In dogs, these diseases develop independently very rarely, probably due to species resistance. If they occur, then bronchitis and bronchopneumonia in the first years of life as a complication of specific infections, in older age as a complication of diseases of the heart, liver, kidneys, etc. Diseases of the respiratory system (excluding diseases of the upper respiratory tract) are to some extent an indicator characterizing the body's resistance .

Symptoms. Shortness of breath, cough, vomiting, changes in breathing type, difficulty breathing when lying down, and hemoptysis are observed.

If a foreign body (spikelets of cereals, etc.) gets into the nasal passage, unilateral catarrh occurs after some time. Initially, there may be bleeding from the nose (epistachys), and after 5 days they appear purulent discharge. With unilateral purulent rhinitis, you must always keep in mind the possibility of a foreign body getting into the nasal passage! An important sign The disease is also caused by the fact that the animal, trying to get rid of irritation and pain, rubs the damaged side of the nose with a paw or on some object.

Rhinitis caused by infection (plague, infectious hepatitis) is always bilateral. The animal often snorts and rubs its nose with its paw. Nasal discharge can range from mucous to purulent. Sometimes severe swelling of the mucous membrane and crusts deposited on the walls of the nasal passages block the free passage of air and the dog breathes through the mouth, which is noticeable by the swelling of the cheeks.

To establish a diagnosis and remove a foreign body from the nasal passage, rhinoscopy is performed.

Laryngitis, acute edema larynx . The inflammatory process in the larynx always occurs simultaneously with inflammation of the pharynx as laryngopharyngitis. Common causes of the disease are infections (rabies, plague, infectious tracheobronchitis), exposure to allergens and aerogenic irritants (smoke, chemical vapors), transfer of inflammation from the tissues of the pharynx, as well as mechanical trauma to the larynx with an endotracheal tube.

Symptoms. Dogs of brachymorphic breeds are predisposed to laryngeal stenosis. Laryngitis is indicated by hoarseness or loss of voice (warning: rabies), cough. When examining the larynx, redness of the mucous membrane, white foamy mucus, and thickened vocal cords are noted. In addition, concomitant tonsillitis is often found. Sometimes the disease occurs with symptoms of swelling and stenosis of the larynx, which is expressed in severe inspiratory shortness of breath, cyanosis, etc.

Differential diagnosis is aimed only at identifying infection.

Treatment. When an infection is established, the underlying disease is treated. In case of tissue damage due to mechanical and chemical factors, it is recommended to instill 2-3 drops of menthol or peach oil into the nose for 5-6 days to relieve irritation.

State allergic laryngitis relieved by administering diphenhydramine and prednisolone.

Acute edema and stenosis of the larynx require an urgent set of measures. First, diphenhydramine, prednisolone and Lasix are administered. Then the animal is intubated and inhaled with an oxygen-air mixture until the attack of suffocation is eliminated. If intubation is not possible, a tracheostomy is performed. The absolute indication for tracheostomy is acute attack suffocation associated with obstruction of the upper respiratory tract.

Tracheostomy technique. The animal is placed in a dorsal position and its neck is stretched. The tissue is cut along the white line of the ventral surface of the neck at the level of the first tracheal rings. The 2nd to 4th tracheal ring is opened, the edges of the hole are moved apart with Faraber hooks and, according to the diameter of the hole, a tracheostomy tube is selected and inserted into the lumen of the trachea (Fig. 33). Using straps, the tracheostomy tube is fixed around the neck, and the gaping edges of the wound are carefully sutured. Depending on the severity of the condition, the tracheostomy is maintained for life or only for acute period. The tracheostomy tube is regularly removed, cleaned and reinserted. The skin around the tracheotomy tube is wiped with alcohol to prevent maceration.

Rice. 33. Tracheostomy: 1 - larynx, 2 - cricoid cartilage, 3 - insertion of a tracheostomy tube into the tracheal incision, 4 - tracheal ring

At the onset of bronchitis, hyperemia and swelling of the bronchial mucosa, hypersecretion of mucus and diapedesis of leukocytes appear; then desquamation of the epithelium and the formation of erosions occur; in severe bronchitis, inflammation can spread to the submucosal and muscular layers of the bronchial wall and peribronchial interstitial tissue.

Allergic bronchitis. It is indicated by a sudden deterioration general condition dogs and improvement with a change of place or climate, rapid response to glucocorticoids and relapse of the disease after their withdrawal. An accumulation of eosinophils is found in the bronchial secretions. Acute pulmonary emphysema with expiratory shortness of breath and an increase in chest volume are also characteristic.

Chronic bronchitis Consider bronchitis of any etiology with a permanent cough for more than 2 months. It is characterized by resistance to treatment and complications such as emphysema, atelectasis, bronchiectasis and fibrosis. Shortness of breath slowly increases, the secretion of bronchial mucus is increased. Auscultate hard breathing, dry scattered wheezing; X-rays reveal thickening of the walls of the lobular bronchi (symptom of “rails”) and shadowing of the pulmonary pattern. The disease must be differentiated from cardiac asthma, when symptoms of cardiac pathology are mixed with the symptoms of bronchitis.

Emphysema. This is increased airiness of the lungs due to overstretching of the alveoli or their destruction. Most common cause There are obstructive chronic forms of bronchitis. Emphysema also occurs with severe mechanical overstretching of the alveoli in frequently barking dogs. It develops mainly in old, weakened animals, but sometimes it also occurs in young ones as a complication of bacterial destructive bronchopneumonia. Changes in pulmonary emphysema are characterized by at different stages destruction of the partitions between the alveoli, as a result of which the alveoli merge, forming bubbles. Destroyed alveoli can no longer be restored. The lungs become swollen and lose their elastic properties. The thin walls of the resulting cysts may rupture and develop spontaneous pneumothorax. These disorders together create difficulties in the functioning of the right heart, which causes its overload. In animals, severe expiratory shortness of breath is observed with the participation of the abdominal muscles in breathing, retraction of the sides and exposure of the edge of the chest. The latter has been expanded. The cough ranges from silent to painful, usually dry and muffled. Breathing is weakened, dry and moist scattered soft wheezes are auscultated; when percussing the lungs, there is a boxed sound. The X-ray pattern of the lung is depleted, the dome of the diaphragm is smoothed, the point of intersection of the diaphragm with the spine in the lateral projection is shifted caudally to the 12-13th thoracic vertebra. The heart shadow is reduced in size. Differential diagnosis is not difficult.

Bronchiectasis. Bronchiectasis is a local or generalized dilatation of the bronchi due to destruction of their walls. The disease develops when bronchiectasis becomes infected. It is considered the same as a form of chronic nonspecific pneumonia. The disease usually occurs due to chronic recurrent bronchitis. Additional reasons may include severe rickets, foreign bodies in the bronchi, obstruction of the bronchi by tumors. Siberian huskies are predisposed to bronchiectasis. Bronchiectasis is formed when the inflammatory process spreads to all layers of the bronchial wall. In these areas, loss of wall tone, thinning and sac-like expansion occur. Sputum accumulates in the lumen of the bronchi. Granulation formations formed at the site of inflammation, and then connective tissue aggravate bronchial deformation. Inflammation may spread further into the interstitial peribronchial tissue of the lung.

Clinically, the animal shows signs of severe recurrent bronchitis: a wet, easily excitable cough with copious department foul-smelling sputum, hemoptysis, expiratory dyspnea and tachypnea with motor excitement. The animal's performance is reduced. On auscultation, ringing moist, variable-sized wheezing-crackling noises are heard over emphysematous foci and bronchial breathing over pneumonic or atelectatic areas.

Diagnosis put on the basis x-ray examination lungs. On radiographs, the pattern of the bronchi is greatly thickened, the lumen of the bronchi is expanded in the form of bags, which generally forms multiple round shadows of the same size, grouped at the roots of the lungs.

Treatment. In acute bronchitis, favorable results are obtained. It is enough to prescribe broad-spectrum antibiotics for a period of 7 days. In chronic and allergic forms of bronchitis, only long-term treatment (1-2 months) leads to remission of the disease. Antibiotics, glucocorticoids, aminophylline, bromhexine, mucaltin are prescribed. To treat allergic bronchitis, sometimes only glucocorticoids are sufficient.

Emphysema and bronchiectasis gradually progress. Death may occur from pulmonary heart failure. The animal owner should always be informed about the duration of treatment and the possibility of relapse of the disease. Treatment is ineffective and is the same as for chronic bronchitis. In severe cases, cardiac glycosides are additionally prescribed or strophanthin is administered.