犬心力衰竭的临床营养治疗研究

充血性心力衰竭(简称心衰)是一组由不同病因引起的临床症候群,包括心功能障碍,运动耐力降低,肺、体循环充血,以及后期出现的心律失常。随着医学的发展,人们对犬充血性心力衰竭研究越来越深入。除了不断推出新的治疗药物外,营养治疗及     

中药复方和有效成分治疗犬心力衰竭研究进展

犬心力衰竭是一种以心室收缩功能障碍为特征的临床综合征,发病率高,严重危害宠物犬的生命健康。临床治疗用药主要有强心苷类药物、血管扩张剂和中药,尤以中药研究应用非常广泛。论文就中药治疗犬心力衰竭相关文献进行了回顾总结,分别从中药复方、中药有效成分、中药有效成分组进行总结概括,以期为犬心力衰竭的中药临床治疗、防治机理研究和新药研发提供一定参考。     

复方参芪软胶囊制备工艺的研究

复方参芪软胶囊是一种补气益血的药物,具有补气养血、恢复造血、增强免疫力等功效。一些患者由于气血不足会引起头昏、呕吐、双眼发黑等症状发生,在通过服用参芪软胶囊后,得到了良好的治疗效果,从而令身心免疫力加强,并恢复造血等功能。因此,本文就复方参芪软胶囊的制备工艺进行了研究,充分了解其制制备工艺的详细环节。     

中药治疗犬慢性心力衰竭研究进展

慢性心力衰竭(CHF)是心血管疾病最重要的死亡原因，随着宠物步入老龄化、肥胖化，患有CHF的宠物愈发增多，在临床中犬最为突出。西兽医对CHF的治疗一般需长期用药，对肝肾的损伤较大。相较而言，中医辨证论治和整体观念具有天然优势。犬CHF的病因病机分为心气虚、气血瘀滞、心阳虚、肾阳虚和肾阴虚等。单味中药和复方中药均对犬CHF疗效明显，常用的单味中药主要有人参、附子、白芍和黄芪等；中药复方大多是以单味中药为基础的经方，并进行临床试验研究。本文从犬CHF病因病机、中药药理作用、临床实践等方面进行探讨，为犬CHF的治疗和新型中药制剂研发提供参考。     

犬心力衰竭模型建立及药物治疗研究进展

<正>犬心力衰竭是宠物临床较常见的一种临床综合症,以心肌收缩力降低或消失为特征,主要表现为心输出量下降、心脏舒张末期容积增大导致舒张末期压力增高、心肌收缩性能下降、动脉血压下降和静脉压升高,可引起全身机能、代谢、结构等发生改变,最终导致死亡,多发于老龄的小型犬种,如博美犬、京巴犬、吉娃娃犬等。经研究表明,多种因素如各种病毒、细菌、寄生虫等引起的心肌炎症;食物中毒及营养元素缺乏等引起的心肌受损;肺炎、肺水肿等病症导致心脏负荷过重;犬细小病毒、胃炎、休克等直接影响心脏功能等均可引起犬的     

参附龙牡汤加味配合西药治疗大家畜慢性心力衰竭

大家畜的慢性原发性心力衰竭在临床上较为常见。临床上以明显的瘀血症状、病势弛张、病程持久为特征,又称充血性心力衰竭。从本病的临床表现来看,与中兽医学中的血心亏虚、心气不足、心痹、喘、痰饮、水肿、虚劳等病证相类似。多年来,笔者在西医常规治疗基础上合用参附龙牡汤加味治疗大家畜阳气虚衰型慢性心力衰竭     

7例犬急性心力衰竭病例的报道

犬急性心力衰竭是由于心肌收缩力下降、心输出量不能满足机体所需的一种常见心血管系统疾病,该病发病特征为突然发作、死亡率高、老年小型犬高发,临床表现为可视黏膜发绀、呼吸困难、呼吸急促浅表,严重者伴有淡粉色或透明细小泡沫状鼻液等症状。     

一例犬偏瘫的中兽医诊疗体会

笔者以临床及一般检查初步确诊一患犬为偏瘫。通过中兽医辨证论治,确定补气益血、活血通瘀、清热化痰、通经活络的治疗原则。处补阳还五汤加减内服,另处环跳、后三里、大转和腰百会四穴电针,肩井、前三里白针,翳风、锁口、承浆白针,另取腰百会、后三里水针。经过以上中药配合针灸治疗,患犬基本恢复正常。结果表明:中兽医治疗手段对犬偏瘫疗效确实,可推广应用于犬猫临床。     

一例犬心力衰竭症的诊治

正犬心力衰竭是由于心室收缩功能下降,心排血量减少,造成静脉系统淤血,动脉供血不足,而呈现的一系列症状。它不是一个独立的疾病,而是许多疾病过程中都可以发生的一种综合征~([1])。在宠物临床上心力衰竭病例逐年增加,且以老年犬多发,严重影响宠物生活质量。1病例介绍京巴犬,2014年11月21日前来就诊,雄性,11岁,体重6.5 kg。该犬患心脏病已1年左右,情况越来越差,最近1周食欲下降,精神不振,鼻头干裂,喘,运动不耐。     

1例犬心脏肥大的诊治

心脏肥大是指当心脏循环阻力增大或血容量增多导致心脏长时间超负荷工作,引起心肌纤维变粗、体积增大,并由此而导致心脏重量增加、心壁增厚、心脏扩大的疾病,是一种常染色体显性遗传性心肌疾病。任何年龄均可发生,常发生于猪、犬、猫等动物。患病动物心率加快、呼吸急促、咳喘,重者可心力衰竭或猝死。本文总结了1例犬心脏肥大的临床诊治,以供参考。     

Acute and Short-Term Hemodynamic,Echocardiography, and Clinical Effects of Enalapril Maleate in Dogs With Naturally Acquired Heart Failure: Results of the Invasive Multicenter PROspective Veterinary Evaluation of Enalapril Study: The IMPROVE Study Group

The efficacy of enalapril maleate in dogs with naturally acquired class III or class IV heart failure was evaluated in a multicenter study. Fifty-eight dogs with dilated cardiomyopathy (35 dogs), mitral regurgitation (22 dogs), or aortic regurgitation (1 dog) receiving conventional therapy for heart failure (furosemide with or without digoxin) were included in a randomized double-blind study. Thirty-one dogs received enalapril tablets PO at approximately 0.5 mg/kg body weight bid, and 27 dogs received placebo tablets PO bid. Physical, electrocardiographic, hemodynamic, echocardiographic, radiographic, and clinical examinations were performed on each dog before treatment and at the end of the approximately 21-day study. After treatment on day 0, the enalapril-treated dogs had significantly (P < .05) lower heart rate, mean systemic arterial blood pressure, and mean pulmonary arterial blood pressure than the placebo-treated dogs. Pulmonary capillary wedge pressure was marginally decreased (P= .0567) in the enalapril-treated dogs. When compared with those in the placebo-treated dogs, scores for pulmonary edema were significantly (P= .05) decreased on day 2 in the enalapril-treated dogs. At the end of the study, enalapriltreated dogs had significantly (P= .05) greater decreases in class of heart failure, pulmonary edema score, and mobility score relative to baseline, and had significantly (P= .05) better overall evaluation scores when compared with the placebo-treated dogs. This study shows the beneficial hemodynamic and clinical effects of adding enalapril to conventional therapy for dogs with heart failure.     

Use of the loop diuretic torsemide in three dogs with advanced heart failure

Diuretics are a mainstay of therapy in dogs with heart failure. In dogs with advanced heart failure, moderate to high doses of loop diuretics such as furosemide are used with diminishing effects as profound activation of neuroendocrine systems promote signs of congestive heart failure. The loop diuretic torsemide has several characteristics that make it suitable for treatment of advanced heart failure including longer half-life, increased potency of diuretic action, and anti-aldosterone effects. This case report details the administration of torsemide in 3 dogs with advanced heart failure and apparent furosemide resistance.     

An update on treatment and prognostic indicators in canine myxomatous mitral valve disease

Mitral regurgitation caused by myxomatous mitral valve disease is the most common cause for congestive heart failure and cardiac-related mortality in dogs. Typically, it takes several years for the disease to progress from mild, clinically silent myxomatous mitral valve disease to severe disease with signs of congestive heart failure. A proportion of dogs will never progress into congestive heart failure before they die from other causes or old age. Some variables have been shown to be predictive of onset of congestive heart failure and they might be useful to identify dogs that need more frequent monitoring and eventually treatment. Results from several controlled clinical trials are available concerning medical treatment of dogs with myxomatous mitral valve disease with or without congestive heart failure. These trials provide estimates of treatment effects and also allow identification of other variables with prognostic value for the outcome after the onset of congestive heart failure. Use of prognostic variables together with qualitative and quantitative results from clinical drug trials may aid the clinician and owner to plan and decide on optimal management of the myxomatous mitral valve disease dog. The purpose of this article is to review the current knowledge of prognostic variables and therapy for this common condition in dogs.     

Congestive heart failure caused by intracardiac tumours in two dogs

Congestive heart failure is a common presentation in small animal practice. Cardiac tumours are an unusual cause of congestive heart failure and, when they occur, usually cause clinical signs associated with pericardial effusion and cardiac tamponade. This case report outlines the clinical and histological findings in two dogs presented with clinical signs of congestive heart failure caused by obstruction of blood flow by intracavitary cardiac tumours. Case 1 showed signs of left-sided heart failure caused by osteosarcoma within the left atrial lumen, and case 2 presented with clinical signs of right-sided heart failure due to haemangiosarcoma occupying the right atrial and ventricular lumens. This case report provides further evidence for the inclusion of intracardiac neoplasia in the differential diagnosis for dogs with clinical signs of congestive heart failure.     

Evidence for or against efficacy of beta-blockers and aspirin for management of feline cardiomyopathies.

Feline myocardial diseases today are largely represented by disorders involving LV hypertrophy. They may be attended by arrhythmias, congestive heart failure, systemic hypertension, thromboembolic complications, and sudden death. These structural myocardial disorders and their hemodynamic and electrocardiographic derangements may cause or result in variable degrees of diastolic dysfunction. Propranolol and aspirin represent two agents commonly employed to treat feline cardiomyopathies for more than 15 years. Nevertheless, clinical data describing their effect on morbidity and mortality are lacking. It is likely that propranolol administered at moderate to high doses effects favorable responses in some cats with clinical signs attributable to severe hypertrophy, outflow obstruction, or tachyarrhythmias. It is unknown whether clinical improvements are due to direct myocardial effects or (more likely) secondary responses to a beta-adrenergic blockade reduction in heart rate or contractility. Personal experience also indicates that high numbers of cats have received the drug for many years in combination with other therapies (especially furosemide) and remain in a compensated state of heart failure without untoward drug effects. On the other hand, many cardiomyopathic cats experience heart failure, arrhythmias, and death despite treatment with beta-blocking agents. Feline thromboembolism is a devastating complication of cardiomyopathic disorders. Until or unless the primary cause(s) of current diseases is elucidated to promote disease reversal, factors responsible for thrombus formation will accompany the heart diseases, protected from effective management. It appears unlikely that aspirin as currently recommended produces any obvious benefit in treating or preventing thromboembolism. Modifications of therapeutic protocols prescribing these frequently used drugs await well-constructed clinical trials evaluating their efficacy with respect to cardiovascular morbidity and mortality.     

Clinical Applications of the Renin-Angiotensin-Aldosterone-Vasopressin Axis in the Horse and Future Directions for Research

The renin–angiotensin–aldosterone–vasopressin axis (RAAV) is known to play significant roles in preserving hemodynamic stability in response to changes in blood volume, blood pressure, electrolytes, and water. In the previous years, some studies focused on RAAV in the horse, showing substantial future clinical and research applications. Early studies assessed the response of this axis to different types of exercise (increasing intensity exercise vs. endurance). Aldosterone and vasopressin concentrations were measured in horses with mild dehydration induced by endurance exercise in comparison with horses suffering from exhaustion and metabolic problems after prolonged exercise. More recently, the neurohumoral response to heart failure, mainly in congestive states, has received special attention. The activation of the RAAV in congestive heart failure has important prognosis applications and inhibitors of this axis have been clinically studied, as the angiotensin-converting enzyme inhibitors. However, inhibitors of renin, aldosterone, and vasopressin have not been studied in horses. Additionally, the investigation of the changes in blood pressure during dehydration, sepsis, and endotoxemia in foals and adult horses might show important applications in the treatment of states that induce modifications in blood pressure. Inappropriately low RAAV activity has been detected in human patients with prolonged vasodilatory shock, and exogenously administered vasopressin could be used as a potent vasopressor agent to stabilize cardio-circulatory function. Similarly, it might be administered to septic foals for similar purposes. Finally, the RAAV axis also has important implications in the development as well as in the treatment of the chronic renal failure, although it has not been investigated in horses.     

The efficacy and safety of milrinone for treating heart failure in dogs

Milrinone has been studied in a variety of situations. In experimental dogs it has been documented to increase contractility to a similar degree as beta-receptor agonists and to produce mild arteriolar dilation in dogs. In canine patients with heart failure, milrinone produces demonstrable improvement in echocardiographic ventricular function and hemodynamic variables. In addition, it improves clinical signs in these patients, improving their quality of life. Milrinone is superior to digoxin as evidenced by the improvement in clinical signs noted in dogs that were unresponsive or no longer responding to digoxin administration. There is no doubt that milrinone improves short-term prognosis and in so doing prolongs life. Many of the patients that the author has observed would not have gone home without the benefits of milrinone. Milrinone's effects on long-term survival cannot be assessed, but its effects on survival time are certainly not dramatic enough to be evident without a comparison population. Therefore, milrinone administration should be considered palliative, as is administration of all other cardiovascular medications for heart failure. In addition to its beneficial effects, milrinone also appears to be relatively safe when compared with the alternative of digoxin administration. Fatal events attributable to milrinone administration are rare, and those directly attributable to enhanced ventricular arrhythmia can generally be avoided by monitoring an electrocardiogram after initial milrinone administration commences. Milrinone does not increase the incidence of sudden death in Doberman Pinschers. It is possible that a small number of dogs with mitral regurgitation may develop mitral chordal rupture. For this reason and possibly others, milrinone probably will not be indicated in early heart failure due to mitral regurgitation when heart failure is readily responsive to diuretic administration. The risk-to-benefit ratio turns markedly in the favor of milrinone administration in the dog with mitral regurgitation that is partially or completely refractory to other cardiovascular drugs. Milrinone appears to be a more effective and safer positive inotrope for long-term treatment of dogs with congestive heart failure than drugs currently available. The author and all the investigators involved in the milrinone clinical trials hope that it will soon be available for use by the veterinary community.     

Use of pimobendan in 170 cats (2006–2010)

Hypothesis/ObjectivesTo describe the therapeutic use of pimobendan in cats, describe the patient population to which it was administered, document potential side effects and report the clinical course following administration of pimobendan in conjunction with standard heart failure therapy. It is hypothesized that cats with advanced heart disease including congestive heart failure from a variety of causes will tolerate pimobendan with a minimum of side effects when used in treatment in conjunction with a variety of other medications.Animals, materials and methodsOne hundred and seventy client owned cats with naturally occurring heart disease, one hundred and sixty four of which had congestive heart failure. Medical records were reviewed and owners and referring veterinarians were contacted for follow-up data. Data collected included pimobendan dose, other medications administered concurrently, data collected at physical examination, presence or absence of heart failure, adverse effects, classification of heart disease, echocardiographic data and survival time. The data were analyzed for significance between the initial visit and any follow-up visits.ResultsAll cats were treated with pimobendan. The median pimobendan dose was 0.24 mg/kg q 12 h. Pimobendan was used in combination with multiple concurrent medications including angiotensin converting enzyme inhibitors, diuretics and anti-thrombotics. Five cats (3.0%) had potential side effects associated with pimobendan. One cat (0.6%) had presumed side effects severe enough to discontinue pimobendan use. Median survival time for 164 cats with congestive heart failure after initiation of pimobendan was 151 days (range 1–870).ConclusionPimobendan appears to be well tolerated in cats with advanced heart disease when used with a variety of concurrent medications. Randomized controlled studies need to be performed to accurately assess whether it is efficacious for treatment of congestive heart failure in cats.     

Genomic and genetic aspects of heart failure in dogs - a review

The most common causes of heart failure in dogs are valvular disease, predominantly endocardiosis, and myocardial disease, predominantly dilated cardiomyopathy. They are related to changes in the expression of several genes in the heart muscle and in peripheral blood nuclear cells which could be considered as prognostic or diagnostic markers of heart disease in dogs. Since many human genetic markers of heart failure have turned out to be useless in dogs, the screening for genomic markers of canine heart failure could give more insight into the molecular pathology of these diseases and aid the development of new treatment strategies.     

Pharmacology of Furosemide in the Horse: A Review

Furosemide, a diuretic, is frequently administered to horses for the prophylaxis of exercise-induced pulmonary hemorrhage and the treatment of a number of clinical conditions, including acute renal failure and congestive heart failure. Furosemide increases the rate of urinary sodium, chloride, and hydrogen ion excretion. Plasma potassium concentration decreases after furosemide administration but urinary potassium excretion in horses is minimally affected. Renal blood flow increases after furosemide administration. Systemically, furosemide increases venous compliance and decreases right atrial pressure, pulmonary artery pressure, pulmonary artery wedge pressure, and pulmonary blood volume. The systemic hemodynamic effects of furosemide are only manifest in the presence of a functional kidney, but can occur in the absence of diuresis, emphasizing the importance of the renal-dependent extra-renal effects of furosemide. The renal and systemic hemodynamic effects of furosemide are modified by prior administration of nonsteroidal anti-inflammatory drugs. Furosemide administration attenuates exercise-induced increases in right atrial, aortic, and pulmonary artery pressures in ponies. Furosemide prevents exercise and allergen-induced bronchoconstriction in humans and decreases total pulmonary resistance in ponies with recurrent obstructive airway disease. These pharmacologic effects are frequently used to rationalize its questionable efficacy in the prevention of exercise-induced pulmonary hemorrhage. Neither the effect of furosemide on athletic performance nor its efficacy in the prevention of exercise-induced pulmonary hemorrhage has been convincingly demonstrated.