Overview of Canine Endocarditis
Endocarditis is a serious infection involving the valves of the heart that can occur in dogs. It is usually a bacterial infection, although on rare occasions fungal infections can occur.
This condition is uncommon in dogs, and very rare in cats, and the incidence of disease increases as dogs get older. Male dogs are at slightly greater risk than females, and any breed may be affected. Previous procedures that could introduce bacteria into the blood stream, such as dentistry or intravenous catheterization, or that suppress the immune system, such as administration of glucocorticoids, may predispose dogs to the development of bacterial endocarditis. Pre-existing heart disease also increases the risk of developing endocarditis.
Because it is so uncommon, it is often overlooked and misdiagnosed with dire consequences, as the disease is often fatal.
What to Watch For
Diagnosis of Endocarditis in Dogs
Treatment of Endocarditis in Dogs
Treatment of endocarditis may include the following;
Home Care and Prevention
Administer all antibiotics as prescribed. If congestive heart failure has developed, administer all cardiac medications and/or prescription diets as recommended by your veterinarian.
Antibiotics are recommended if a dog with a previously diagnosed heart condition is going to undergo a procedure that might introduce bacteria into the bloodstream. This is a controversial preventative measure, however.
In-depth Information on Endocarditis in Dogs
Endocarditis is an often fatal disease caused by an infection of the heart valves. The infection is usually caused by bacteria, although fungal endocarditis can occur as well on rare occasions. Endocarditis occurs infrequently in dogs, and is very rare in cats and is a difficult disease to diagnose. Dogs are more likely to get be affected by endocarditis as they get older, and male dogs are slightly more susceptible than female dogs. Pre-existing heart disease increases the risk of dogs developing bacterial endocarditis.
Endocarditis most commonly affects two of the four major valves in the heart: the mitral valve and the aortic valve. Endocarditis causes little growths called “vegetations,” which affect the ability of the valves to function properly.
In order for the valves to become infected, there has to be a period of time when bacteremia, which is the presence of bacteria in the bloodstream, is occurring. In most cases, the cause of the bacteremia that leads to the endocarditis is never identified. Known causes of bacteremia include surgical procedures involving the oral, gastrointestinal, and urinary tract; dentistry procedures; intravenous catheterization; implantation of pacemakers; administration of drugs that suppress the immune system; and previous heart valve infections. Once introduced into the bloodstream, the bacteria, somehow manage to overcome the dog’s immune defenses, and an infection on the valve in established. Vegetations grow at the site of infection and cause the valve to malfunction. This usually leads to heart failure.
Making a certain diagnosis of endocarditis can be very difficult. Usually there is a vague history of lethargy and poor appetite. Eventually, most dogs develop heart failure and demonstrate the common signs of coughing, shortness of breath, weakness, or collapse. Many clinicians refer to the disease as “the great imitator” because of the variety of clinical signs in patients with the disorder.
Bacterial endocarditis often leads to a condition called septic embolization, in which microscopic pieces of the vegetations (emboli) from the infected valves break off and enter the bloodstream. These emboli travel through the bloodstream and affect other organs in the body. The most commonly affected organs are the kidney and spleen, although the brain, intestine, and the heart may also be affected.
The immune system’s response to embolization sometimes does more damage than good, often leading to arthritis and glomerulonephritis, a type of kidney inflammation. Embolization of the kidneys or the heart is a very serious consequence of endocarditis and can trigger a series of complications that may lead to a fatal outcome.
Sometimes, bacteremia can progress to a more serious condition called sepsis in which overwhelming infection in the bloodstream affects the blood flow to the vital organs. Sepsis often progresses further, and the patient succumbs to septic shock, in which blood pressure drops and many organs begin to fail. If this happens, the outcome is almost invariably fatal.
The goals of therapy for bacterial endocarditis are to sterilize the vegetations on the valves, to treat any heart failure or other heart abnormalities such as abnormal rhythms, and to manage any abnormalities that might be affecting other organ systems as a result of the heart valve infection.
Follow-up Care for Dogs with Endocarditis
Optimal treatment for your dog requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your dog does not rapidly improve.
Administer all prescribed medication as directed. Alert your veterinarian if you are experiencing problems treating your dog.
Feed any prescription diets for the management of heart failure (low sodium diets) or kidney failure (low protein diets), as recommended.
Consult with your veterinarian concerning the administration of antibiotics as a preventive measure in instances where your pet may need a procedure that is known to induce bacteremia, such as a dental cleaning or tooth extraction.