Canine Endocarditis Accession # 128315 &128314

1. Canine EndocarditisAccession # 128315 &128314 Christina Copple, DVM Radiology Resident NCSU CVM

2. “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

3. Thoracic Radiographs Acc# 128315 • Generalized cardiomegaly & left atrial enlargement – mitral valve insufficiency

4. 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

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

6. Echocardiogram – Rt parasternal short-axis view with color Doppler– heart base with PA & Aortic valve • Severe aortic regurgitation, mosaic turbulent Doppler signal during diastole

7. Echocardiogram – Lt apical 4-chamber view with color Doppler • Mild-to-moderate mitral mitral insufficiency

8. 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

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

10. Canine Infective Endocarditis • 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

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