CANINE ENDOCARDITISACCESSION # 128315 &128314

Christina Copple, DVMRadiology Resident

NCSU CVM

“SCOUT” 5yr old, Male, Treeing Walker Coonhound

Lethargy Anorexia Weight loss Progressive anemia One episode of vomiting PE:

Diastolic murmur Tachycardia Enlarged Lt superficial

cervical ln

Thoracic RadiographsAcc# 128315

Generalized cardiomegaly & left atrial enlargement – mitral valve insufficiency

Echocardiogram – Rt parasternal long-axis view – LVOT/Aortic Valve

Pedunculated and mobile vegetation is seen on the left coronary cusp Smaller vegetative lesions are noted on the right and non-coronary cusps of the aortic valve Marked LV eccentric hypertrophy

Echocardiogram – Rt parasternal short-axis view – heart base with PA & Aortic valve

Echocardiogram – Rt parasternal short-axis view with color Doppler– heart base with PA & Aortic

valve

Severe aortic regurgitation, mosaic turbulent Doppler signal during diastole

Echocardiogram – Lt apical 4-chamber view with color Doppler

Mild-to-moderate mitral mitral insufficiency

Canine Infective Endocarditis Endothelium of heart valves becomes invaded

and infected by microbial organisms Aortic valve & Mitral valve Most common organisms:

Staphylococcus Streptococcus E. coli Bartonella is most common cause of culture negative

infective endocarditis Sequelae:

Most common – acute congestive heart failure Immune-mediated glomerulonephritis or polyarthritis Thromboembolic disease

MacDonald, Kristin, DVM, PhD. “Infective Endocarditis in Dogs: Diagnosis and Therapy.” VetClinNASAPract 40(2010); 665-684

MacDonald, Kristin, DVM, PhD. “Infective Endocarditis in Dogs: Diagnosis and Therapy.” VetClinNASAPract 40(2010); 665-684

Bacteremia & endothelial disruption necessary for infective endocarditis to develop Subaortic stenosis → turbulent blood flow →

damage aortic valve cusps Common sources of bacteremia:

Discospondylitis Prostatitis Pneumonia UTI Pyoderma Periodontal dz Long-term indwelling central line catheter

MacDonald, Kristin, DVM, PhD. “Infective Endocarditis in Dogs: Diagnosis and Therapy.” VetClinNASAPract 40(2010); 665-684

Canine Infective Endocarditis

Difficult to diagnosis Medium-to-large breed dogs, middle-aged to

older, males Echocardiography - Vegetative lesions on

heart valves Culture both blood and urine (consider

Bartonella PCR) Thoracic radiographs – evaluate for heart

failure Grave prognosis despite aggressive long term

antibiotics

Canine Infective Endocarditis

MacDonald, Kristin, DVM, PhD. “Infective Endocarditis in Dogs: Diagnosis and Therapy.” VetClinNASAPract 40(2010); 665-684