Wheatgrass is loaded with vitamins, boosts the immune system, aids digestion and just plain tastes good to pets. Even the carnivorous cat enjoys snacking on wheatgrass. Wheatgrass is easily and cheaply grown at home:

Go to Liberty Market in Kettering and buy some organic wheat berries. Pre-soak the wheat berries by placing the desired amount in a large bowl, and then fill the bowl with water to cover the wheat berries. Let the berries soak overnight (they will absorb the water and swell up).

Fill a shallow planter with loose soil to just under the rim (a half inch or so below) and put the soaked wheat berries on the soil in a single layer, making sure they are not stacked on top of each other.

Mist the soil until damp but not soaking wet. Cover with plastic wrap and set in a sunny location. Mist the soil lightly at least every other day (make sure the soil does not dry out).

When sprouts begin to appear, remove the plastic wrap. Keep the planter in a warm sunny area and water normally. When the wheatgrass is 5 inches tall or so, you can either let your pets nibble on the grass or harvest the tips with the scissors for your pets. My pets rip the grass out by the roots so the harvesting method works best at my house.

At any given time, rabbits require a good deal of water – proportionately more than other species. A rabbit weighing five pounds will drink as much water as a dog weighing 25 pounds! With hot weather or the dry air of air conditioned rooms, rabbits will drink even more; in fact, they may consume four times as much water than food.

Rabbits will suffer serious health consequences if deprived of water for more than 24 hours (less time than that in hot weather). When temperatures rise above 84 degrees, rabbits tend to get lethargic, as they are unable to sweat (they only have one pair of sweat glands and those are on their lips!!). When the rabbit becomes lethargic it begins to drink less water and sets up a vicious cycle.

It is even more critically important for bunnies with a history of urinary sludge or urinary stones to keep extremely well-hydrated to prevent further problems.
Signs of dehydration in rabbits include poor skin turgor: lightly pinch a bit of skin that is normally taut, and gently pull it up into a little tent. When you let go, it should snap back into place with no wrinkles or folds. If the bunny is dehydrated, the skin will take several seconds to fall back into place (this is called “poor skin turgor”).

Dry mucous membranes are also a sign of dehydration; the bunny’s gums should be pink and moist.

Ways to encourage your rabbit – or other small pet – to increase his water consumption:

♦Provide both a crockery bowl and a water bottle: sometimes the novelty of a new drinking implement will get a bunny to drink more. Change the water frequently and scrub out the crockery bowl daily; rabbits are not inclined to drink stale or unclean water. Make sure the drinking tube on the water bottle is not blocked, and water still flows freely.
♦Try putting ice cubes in the water bowl
♦Add something tasty to the water. Normally, pure water is advised, due to the delicate nature of a rabbit’s digestive system, but if your bunny is in need of hydration, mixing a bit of Pedialyte, unsweetened juice (such as apple or carrot juice) or even a tiny bit of real vanilla (NOT vanilla extract) can encourage the bunny to drink. Do not give a rabbit Gatorade or other drinks high in sugar. Change the Pedialyte-water frequently to avoid the growth of bacteria.
♦Wet your pet’s greens and other vegetables
♦Try offering a small amount of watermelon, which is mostly…well, water.

If all else fails, try gently squirting water into bunny’s mouth with a syringe. This should be done only as a last resort, if your rabbit is sick and at serious risk of dehydration. Consult your veterinarian first. Be sure to place the syringe of water behind its incisors (to the side of the mouth) and squeeze sideways. Squirting the water straight into its mouth could cause water to go down the windpipe and choke the bunny.

Water is the most important and least expensive nutrient required by your rabbit. Rabbits need 24/7 access to water in order to remain healthy; one of the simplest and yet most critically important things you can do for your rabbit is provide a constant supply of clean, fresh water.

Yarrow is a perennial herb, native to Europe and Asia and found in most countries throughout the world. Yarrow is common along Dayton roadsides and in old fields, pastures, and meadows. Yarrow grows to 20 inches high, with finely cut leaf segments – very feathery and fern-like (see the photo).

Both the leaves and flowers of yarrow are edible and highly nutritious. Yarrow contains several different flavonoids with antibacterial, anti-inflammatory, antimicrobial, anti-tumor and antioxidant properties; in fact, yarrow contains over 120 compounds with medicinal properties!

Yarrow is quite valuable in alternative medicine, and is used to treat colds, cramps, fevers, kidney disorders, upset stomachs, toothaches, skin irritations, hemorrhages, and as a general tonic. Crushed yarrow leaves promote blood clotting and were actually used as field dressings for wounded soldiers – we now know that an alkaloid substance in yarrow is responsible for the blood-clotting abilities.
Yarrow contains many volatile oils, including azulene, which acts as an anti-inflammatory to the digestive system; yarrow is helpful in case of indigestion and loss of appetite.

While yarrow is healthful and safe for small pets to eat, it is an herb that needs to be fed in some moderation. Huge amounts of yarrow may have a somewhat intoxicating effect on small pets, and with over 120 medicinal compounds, adding just one or two strands to your small pet’s salad is prudent. Another option would be to brew some yarrow tea, and offer a tablespoon of cooled tea to your small pet. Add 1 tsp. dried yarrow to 1 cup boiling water and steep for 10 minutes.

Yarrow is easily grown, thrives on neglect and tolerates poor soil. It likes well-drained soil in a sunny spot.

Easily grown
Marigolds are tasty, nutritious, and very healthy for small pets. Marigold leaves are pleasantly peppery; I’ve never met a rabbit who did not like them. Marigolds thrive in full sun and are easily grown (save the seeds and grow them for “free” next year). Marigolds are a nice orange and yellow complement to any garden and don’t take up much room; you can tuck a plant in most any corner of the garden or grow them in pots. Dwarf varieties are usually bushiest and provide the most leaves for your bunny, guinea pig or other small pet to munch on. Mid-July is a bit late for starting them from seeds here in Dayton, so you might as well pick some up marigold plants at one of the local farmer’s markets.

A variety of uses

Marigolds have anti-inflammatory, anti-bacterial, anti-fungal and antispasmodic properties; it is a good adjunct (additional) treatment for infections and inflammatory processes.

Marigolds are loaded with flavenoids as well as with carotenoids, including lutein, which has been studied for its effectiveness in treating colon cancer in studies conducted by the University of Utah Medical School. Lutein has also been shown to promote healthy vision.

Marigolds are high in vitamins C and A, and contain lycopene and beta-carotene.

Cold marigold tea makes a very soothing compress for the eyes, and can also be used to soothe skin irritations. Offer a drink of cooled marigold tea to your small pet (with a bit of juice mixed in, if need be) to settle GI distress and relieve diarrhea as well as constipation (marigold regulates the gut).

Marigold tea: dry some marigold flowers and add a tablespoon of the flowers to a teapot. Pour some nearly-boiling water over the flowers and let them steep. Cool thoroughly before offering to your pet.

You can also make an ointment from marigold leaves, which I have used successfully on skin irritations on rabbits:

Marigold ointment: chop up fresh flowers and add to coconut oil. Heat lightly and let cool.

As always, make sure you are using flowers that have not been treated with pesticides.

Thyme is native to Asia, southern Europe and the Mediterranean region, and is also cultivated in North America.

Thyme has a long history of use in natural medicine. Thyme contains a variety of difficult-to-pronounce volatile oils which are involved in the healing process: carvacolo, borneol, geraniol and thymol. All of these offer anti-oxidant protection of cell membranes, and thymol has been shown to provide healing properties in connection with respiratory ailments.

These volatile oils have also been proven to have antibacterial and antifungal properties, effective against a variety of microbes including staphalococcus aureus, E. coli and Shigella.

Thyme also contains flavonoids, including apigenin, naringenin, luteolin, and thymonin. These flavonoids increase the antioxidant capabilities of thyme; add to that the fact that thyme is a very good source of manganese and you have an excellent anti-oxidant food.
Thyme is also an excellent source of iron and vitamin K. It is high in fiber and a good source of calcium.

Thyme is good stuff, and small pets love it! Thyme is easily grown in the garden or in a window flower pot.

Now is the time to start thinking about next year’s herb gardenHerbs are extremely nutritious for small pets as well as people, and pets find them quite tasty. Often a pet whose appetite has fallen off due to stress or illness will eat herbs when nothing else appeals. The vitamins, minerals, anti-oxidants and other valuable phytonutrients in herbs are of great value in boosting the immune system of your pet, helping a sick pet to recover from illness and assisting a well pet in staying that way.

There are quite a few perennials (plants that come back every year on their own) that are easily grown in the Dayton area. Clicking on the links below will take you to articles that explain each herb’s benefit to pets:

Greek oregano, Greek basil, (sweet basil is not a perennial, but Greek basil is; Greek oregano is the only oregano I can get to overwinter), lavender, lemon balm, mint, evening primrose, catnip, rosemary, parsley, thyme, sage, yarrow, garlic greens, and marigolds. Many other perennial herbs are not listed (such as marjoram) as they are very tender to the cold and must be restarted every year in a climate such as ours.

This would be the time to get your perennials well-established in your garden before the weather turns cold. The local farm markets MAY have a few herbs left here and there, but your safest bet would be Wick’s out on North Fairfield Road (they may even have them on sale already) or Siebenthaler’s on Far Hills Avenue.

Your small pets (and you) will enjoy tasty fresh herbs at least til November if you cover the plants with a blanket or plastic sheeting on any night when a frost is predicted. Mine always last until Thanksgiving (and at that point I have generally used up most of their leaves). If you have any left, they can be dried; some small pets enjoy eating the dried herb leaves, and others prefer a bit of cooled herb tea.

When you do finally put your herbs to bed for the winter, stuffing a terra cotta flower pot with fallen autumn leaves and then turning it upside down on your herb plant makes a nice protective mulch for the winter (the pot keeps it from blowing away, of course).

Get your herbs started now and your pets will enjoy tasty herb treats, better nutrition and better health with herbs!

Plantago lanceolata is a species of plantain also known as ribwort or buckhorn plantain or narrowleaf plantain.

Both narrowleaf and broadleaf plantain are perennial herbs which grow happily in even the poorest soils. The long leaves, slightly wider in the middle, grow erect with 3-5 parallel veins running vertically through the leaves. The tiny flowers present themselves asbrown-green oblongs on tall thin stalks and generally appear May through August.

Ribwort plantain has been used as food for sheep, who find it quite delicious, as do cattle and rabbits. In Irish folklore, the plant was even valued as a nutritious food for turkeys! It is high in calcium, sodium, cobalt and copper, and lower in magnesium, potassium and phosphate. Plantain is high in fiber, rich in B complex vitamins, vitamins A, C and K and has antibacterial and anti-inflammatory properties as well. While it tends to go a bit bitter in the heat, it is delicious in spring salads!

Ribwort is easily dried by hanging bunches upside down in a well-ventilated area; in this way it can be fed to rabbits and other small pets all through the winter. Ribwort provides excellent roughage and promotes proper digestion and bowel function.

Ribwort can be found in most backyards and empty lots; make sure that you are harvesting from areas not sprayed with pesticides or chemical fertilizers and not subjected to auto exhaust fumes.

http://www.examiner.com/small-pets-in-dayton/ribwort-for-rabbits?CID=examiner_alerts_article

Acupuncture in Rabbits
Jeffrey Ryan, DVM

Traditional chinese medicine (tcm) has existed for five thousand years. It has been used to treat a wide variety of physical and emotional ailments within the context of its culture using lifestyle adjustments, herbs, and acupuncture. Recently, Western culture has become increasingly aware of the benefits of this model of medicine and has begun to integrate it into the system of scientific medicine that we practice. The International Veterinary Acupuncture Society was established in 1974 and has been training and certifying veterinarians since. The course is open only to licensed veterinarians, and includes a rigorous examination and case report requirement. This past year, the FDA approved acupuncture for use as a primary therapy in a few specific instances in humans, and the list is expected to grow. Increasingly, people are requesting the same kind of care for their pets that they seek for themselves. This has extended to acupuncture for house rabbits. In our clinic we have used acupuncture as an adjunct as well as a primary therapy to treat rabbits with a wide range of conditions. It is still considered an alternative form of medicine, and has not been proved effective in studies for any condition in rabbits. The anecdotal evidence is mounting that this is a treatment that works for many things.

The mechanism of acupuncture is poorly understood. Research in Chinese and Western universities has suggested multiple mechanisms involving nerves, blood vessels, hormonal responses, and local tissue responses to have its full effect. In rabbits, a study has demonstrated the ability of acupuncture to cause the release of endorphins and neuropeptides in the cerebrospinal fluid of treated individuals that can transfer analgesia, or pain relief, to another rabbit by injection.1?It also functions on the principle of Qi or energy, a concept largely ignored in Western medicine. TCM also uses the concept of Yin and Yang, two opposites existing at once, to describe the balance within an individual. Because rabbits have such a high level of energy, they are considered to be Yang: active, alert, fast moving. This causes them to respond to fewer needles than other animals, and need treatment for a shorter needling duration. Most rabbits tolerate the needles very well. The purpose of the treatments is to restore health by restoring balance in the body.

A wide variety of ailments can be treated with acupuncture. We have treated rabbits with head tilts, kidney disease, paralysis and weakness, urinary incontinence, cancer side effects, and nasal disease. As with any medicine, it does not work all the time. Acupuncture heals illness fairly well, but if the disease has resulted in tissue death, the treatments will fail. Several rabbits with severe head tilt caused by middle ear infections improved rapidly after initiating treatment. The few that did not make a full recovery appeared to be more chronically affected. One, Perry, mentioned in the accompanying article, still has a head tilt, but finds his balance restored after treatment. The discomfort and lack of appetite caused by kidney disease improve after needling. As with all therapy for kidney disease, however, this is not a cure for the disease. All of the rabbits we have treated with needles for weakness or paralysis have improved to some degree. One, nearly paralyzed from a young age, regained the ability to walk after several years of being unable to do so. Urinary incontinence can be the result of many problems. Several rabbits whose incontinence had no definable cause improved during treatment with needles. All needed maintenance therapy to prevent severe relapse, but their quality of life was greatly improved. Often, the greatest discomfort of cancer is not the tumor, but its effects. We have used acupuncture to decrease pain and fluid accumulation in cancer patients, as well as attempting to enhance their immune system’s battle against the disease. Nasal infection is a very frustrating disease to treat, often resulting from the immune system’s inability to kill the infecting organism. Acupuncture holds promise of improved immune function for these rabbits, helping in the fight to rid the body of infection.

No therapy is a cure-all. However, many diseases of rabbits are the result of their immune system’s inability to defeat infection, or the inflammation it causes in the attempt. Traditional Chinese Medicine can restore balance to the ill body, boosting the weak areas, and calming the excesses. This form of medicine can be used in conjunction with Western medicine to provide an entire treatment that respects the body’s innate energy and ability to heal itself with as few negative effects as possible.

Reference
1. Hans, J.S. and L. Terenius, “Neurochemical Basis of Acupuncture Analgesia.” Annual Review of Pharmacology and Toxicology 22:193-220. 1982. Further Reading
Cheng, SJ, et al. Studies on improving the nonspecific immune effectiveness of rabbits by different acupuncture conditions. Proceedings of International Conference on Veterinary Acupuncture. China Academic Publishers, Beijing: 1987.
Kaptchuk, Ted J., OMD. The Web That Has No Weaver. Congdon and Weed. New York: 1983.
Schwartz, C. Four Paws Five Directions. Celestial Arts Publishing, Berkeley, Ca: 1996.
The Veterinary Acupuncture Page http://users.med.auth.gr/~karanik/english/veter.htm

The heart is a large muscular organ which constantly pushes oxygen-rich blood to the brain and extremities and transports oxygen-poor blood from the brain and extremities to the lungs to gain oxygen. Blood comes into the right atrium from the body, moves into the right ventricle and is pushed into the pulmonary arteries in the lungs. After each ventricular contraction (systole), the ventricle muscles need to relax to allow blood from the atria to fill the ventricles. This relaxation of the ventricles is called diastole. After picking up oxygen, the blood travels back to the heart through the pulmonary veins into the left atrium, to the left ventricle, and out to the body’s tissues through the aorta.

The heart is a pump that works together with the lungs.

· It pumps blood from the heart to the lungs, where it picks up oxygen. The oxygenated blood returns to the heart.

It then pumps the oxygenated blood out into the system of blood vessels that carry blood through the body.

The heart consists of 4 chambers.

The upper chambers are called atria and the lower chambers are called ventricles.
The right atrium and ventricle receive blood from the body through the veins and then pump the blood to the lungs.
The left atrium and ventricle receive blood back from the lungs and pump it out the aorta into the arteries ~ feeding all organs and tissues of the body.
Because the left ventricle has to pump blood through the entire body, it is a stronger pump than the right ventricle.

COMPENSATION ~

At first the heart tries to make up for this by:

Enlarging. When the heart chamber enlarges, it stretches more and can contract more strongly, so it pumps more blood.
Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
Pumping faster. This helps to increase the heart’s output.

The body also tries to compensate in other ways:

The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power.
The body diverts blood away from less important tissues and organs to maintain flow to the most vital organs, the heart and brain.

These temporary measures mask the problem of heart failure, but they don’t solve it. Heart failure continues and worsens until these substitute processes no longer work.

IMPACT ON OTHER ORGANS ~

Heart failure affects the kidneys’ ability to dispose of sodium and water. This retained water increases swelling in the body’s tissues (edema).

Congestive heart failure can affect many organs of the body. For example:

The weakened heart muscles may not be able to supply enough blood to the kidneys, which then begin to lose their normal ability to excrete salt (sodium) and water. This diminished kidney function can cause the body to retain more fluid.
The lungs may become congested with fluid (pulmonary edema).
Fluid may likewise accumulate in the liver, thereby impairing its ability to rid the body of toxins and produce essential proteins.
The intestines may become less efficient in absorbing nutrients and medicines.
Fluid also may accumulate in the extremities, resulting in edema (swelling) of the ankles and feet.
Accumulation of fluid in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.
Eventually, untreated, worsening congestive heart failure will affect virtually every organ in the body.

CAUSES ~

The pumping action of the heart can be impaired by several mechanisms:

Heart muscle damage (cardiomyopathy).
Heart attack (myocardial infarction). This can cause scar tissue, which interferes with the heart muscle’s normal function.
High blood pressure (hypertension). Abnormally high blood pressure increases the amount of work the left ventricle has to do to pump blood out into the circulatory system. Longstanding high blood pressure can result in a thickened (hypertrophied) heart.
Heart valve problems: The valves of the heart normally keep the blood flowing in the right direction through the heart. Abnormal heart valves impede this forward flow in 1 of 2 ways.
An incompetent valve is a valve that does not close properly when it should and allows blood to flow backward in the heart, “against the current.” When blood flows the wrong way across a valve, the heart has to work harder to keep up its output. Eventually, this backed up blood accumulates in the lungs and the body.
A stenotic valve is a valve that does not open properly when it should. Blood flow through the narrowed opening is blocked, creating an increased workload on the heart.
Abnormal rhythm or irregular heartbeat ~ Arrythmias. Abnormal heart rhythms lower the heart’s effectiveness as a pump. The rhythm may be too slow or too fast, or irregular. The heart has to pump harder to overcome these rhythm disorders. If this excessively slow or fast heartbeat is sustained over hours, days, or weeks, the heart can weaken, which can cause heart failure.
Other conditions may have injured the heart such as thyroid disorders (too much or too little thyroid hormone) or treatments for cancer (radiation or certain chemotherapy drugs).
In some cases, although the pumping action and filling capacity of the heart may be normal, abnormally high oxygen demand by the body’s tissues (for example, with hyperthyroidism or anemia) may make it difficult for the heart to supply an adequate blood flow (called high output heart failure).
Coronary artery disease (a narrowing of the arteries that supply blood to the heart muscle)
Congenital heart defects (present at birth)
Severe anemia, hyperthyroidism, hypothyroidism
Exposure to toxins

INFECTION of the heart valves and/or heart muscle itself — endocarditis and/or myocarditis. Common agents in rabbits are Staphylococcus and Pasturella
Endocarditis ~ In rabbits this can occur as a result of Staph infections from bite wounds

· STRESS ~ Rabbits are prey animals, thus they become extremely stressed very easily

o Incidents of high stress cause the release of hormones, including Norepinephrine, which underlies the Fight-Or-Flight response.

o Stress hormones act by mobilizing energy from storage to muscles; increasing heart rate, blood pressure and breathing rate, and shutting down metabolic processes such as digestion, growth, and immunity.

o Constant stress causes continual release of stress hormones, which then causes:

§ A depletion of energy storage

§ High blood pressure

§ Stress-induced hypertension

§ Adverse affects on metabolic processes

§ Ulcers (digestion)

§ Hampered growth

§ Increased likelihood of infectious diseases

· KIDNEY PROBLEMS ~ Along with their other functions, the kidneys also ‘fine-tune’ the blood pressure (via hormones). All kidney problems have an adverse impact on heart function.

o Older rabbits are very subject to kidney infection and inflammation, which then degrades the ability of their heart to function normally.

§ “Older” = 7/8 in the larger breeds; 10 in the smaller breeds

CLOSTRIDIUM bacteria in the intestines ~ Clostridium proliferates during periods of GI Stasis (gut slowdown). This bacteria also produces toxins which must be cleansed by the liver.

SYMPTOMS ~

There may or may not be symptoms, and symptoms can vary from mild to severe. They can also come and go.

Common symptoms are:

· Shortness of breath with activity, or after lying down for a while

· Swelling of the abdomen (from fluid retention)

· Weight gain (from fluid retention)

· Irregular or rapid heartbeats

· Difficulty sleeping

· Fatigue, weakness, fainting

· Loss of appetite, indigestion

· Dizziness and confusion

· Open mouth breathing ~ rabbits are obligate nose breathers, so when they exhibit open mouth breathing they are suffering from severe congestive heart failure and it is the only way they can get some oxygen.

Other symptoms may include:

· Decreased alertness

· Decreased urine production

· Nausea

Some patients with heart failure have no symptoms. In these individuals, the symptoms may develop only with these conditions:

· Abnormal heart rhythm ~ Arrhythmias

· Anemia

· Hyperthroidism

· Infections

· Kidney disease

EXAMINATION AND TESTS ~

A physical examination may reveal the following:

· Fluid around the lungs (pleural effusion)

· Irregular heartbeat

· Swelling of the liver

Listening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds.

The following tests may be used to diagnose or monitor heart failure:

· Chest x-ray

· Electrocardiogram (ECG)

· Echocardiogram ~ Ultrasound is used to image the heart muscle, valve structures, and blood flow patterns. Virtually all patients in whom the diagnosis of congestive heart failure is suspected should undergo echocardiography early in their assessment.

This disease may also alter the following test results:

· Blood chemistry

· BUN

· Complete blood count

· Creatinine

· Creatinine clearance

· Liver function tests

· Uric acid – blood test

· Sodium – blood test

· Urinalysis

TREATMENT ~

Diuretics ~ In rabbits, the administration of diuretics is the major treatment of congestive heart failure. These help prevent or alleviate the symptoms of fluid retention. Diuretics cause the rabbit to urinate more than normal, with the result that the body has to pull fluids from other places (like the lungs) to stay hydrated.

Lasix (furosemide) is a popular diuretic used by vets. These drugs help keep fluid from building up in the lungs and other tissues by promoting the flow of fluid through the kidneys. Although they are effective in relieving symptoms such as shortness of breath and leg swelling, they have not been demonstrated to positively impact long-term survival.

There are also drugs that can help with the contractibility of the heart. Certain medications may make heart failure worse and should be avoided. In humans, these include nonsteroidal anti-inflammatory drugs, thiazolidinediones, metformin, cilostazol, PDE-5 inhibitors, and many drugs that treat abnormal heart rhythms.

MONITORING AND CARE ~

· Administer medications as directed

· Limit sodium intake

· If overweight, change the rabbit’s diet so that she/he can lose weight

· Monitor weight ~ gain can indicate that more fluid is being retained, signaling a worsening of the condition

PROGNOSIS (EXPECTATIONS) ~

The course of the disease in any given individual, however, is extremely variable. Factors involved in determining the long term outlook (prognosis) for a given patient include:

the nature of the underlying heart disease,
the response to medications,
the degree to which other organ systems are involved and the severity of other accompanying conditions,
the individual’s symptoms and degree of impairment, and
other factors that remain poorly understood.

COMPLICATIONS ~

· Irregular heart rhythms (can be deadly)

· Pulmonary edema (abnormal build up of fluid in the air sacs of the lungs)

· Total heart failure (circulatory collapse)

SOURCES ~

· http://www.emedicinehealth.com/congestive_heart_failure/article_em.htm

· “Pub Med Health” at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001211 Copyright © 2011, A.D.A.M., Inc.

· http://www.webmd.com/heart-disease/guide-heart-failure

· http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsp (new web site of American Heart Assn)

· http://www.americanheart.org/presenter.jhtml?identifier=4585 (old web site of American Heart Assn)

· http://www.medicinenet.com/congestive_heart_failure/article.htm

· Todd Cecil, DVM; Pet Emergency and Specialty Center, La Mesa, California

The heart muscle becomes inflamed and doesn’t work as well as it should. There may be multiple causes including viral infections. It is often associated with diseases involving other organs, as well.

Can be classified as “Primary/Instrinsic” or “Secondary/”Extrinsic”

· PRIMARY/INTRINSIC ~ cannot be attributed to a specific cause

o Genetic

§ Hypertrophic cardiomyopathy ~ a portion of the heart muscle becomes thickened; see below for additional information

§ Arrhythmogenic right ventricular cardiomyopathy ~ genetic defects of a specific part of the heart muscle

§ Isolated ventricular non-compaction ~ “spongiform cardiomyopathy”; a rare congenital defect

§ Mitrochondrial myopathy ~ mitochondria convert the energy of food molecules in the “ATP” that power most cell functions

o Mixed

§ Dilated cardiomyopathy ~ the heart becomes weakened and enlarged; about one in three cases of Congestive Heart Failure is due to Dilated Cardiomyopathy; see below for additional information

§ Restrictive cardiomyopathy ~ stiffening of the walls of the atria and ventricles; see below for additional information

o Acquired

§ Takotsubo cardiomyopathy ~ “stress cardiomyopathy”; see below for more information

§ Loeffler endocarditis ~ a form of “endocarditis”, which is an inflammation of the inner layer of the heart (the endocardium); it usually involves the heart

valves

· SECONDARY (also “Extrinsic”) ~ due to specific causes

o Metabolic/Storage

§ Amyloidosis ~ amyloid proteins are abnormally deposited in organs and/or tissues

§ Hemochromatosis ~ iron overload in the heart muscle

o Inflammatory

o Infections due to viruses

o Endocrine

§ Diabetic cardiomyopathy ~ this is not relative since diabetes is extremely rare in rabbits, due to their diet

§ Hyperthyroidism ~ an overactive thyroid which produces excess hormones

· Thyroid hormone functions as a controller of the pace of all of the processes in the body (metabolism). If there is too much thyroid hormone, every function of the body tends to speed up. Weight loss, sometimes significant, despite a good appetite, may occur.

There are three main types of cardiomyopathy ~ Dilated, Hypertrophic, and Restrictive

DILATED (CONGESTIVE) CARDIOMYOPATHY ~

This is the most common form. The left ventricle (the heart’s main pumping chamber) becomes enlarged (dilated), its pumping ability becomes less forceful, and blood doesn’t flow as easily through the heart. Abnormal heart rhythms (arrhythmias) and disturbances in the heart’s electrical conduction may also occur. Since the blood flows more slowly through an enlarged heart, blood clots may form.

* A blood clot that forms in an artery or in the heart is called a “thrombus”.

* A clot that breaks free, circulates in the bloodstream and blocks a small blood vessel is called an “embolus”

* Clots that stick to the inner lining of the heart are called “mural thrombi”

- If the clot breaks off the right ventricle (the pumping chamber), it can be carried into the pulmonary circulation in the lung, forming “pulmonary emboli”.

- Blood clots that from in the heart’s left side may be dislodged and carried into the body’s circulation to form “cerebral emboli” in the brain, “renal emboli” in the kidney, “peripheral emboli”, or even “coronary artery emboli”.

When the heart is significantly enlarged, the mitral and tricuspid valves may not be able to close properly, resulting in “murmurs”.

Blood pressure may increase because of increased sympathetic nerve activity. These nerves can also cause arteries to narrow. This mimics “high blood pressure”.

Treatment in humans can include ACE Inhibitors (improve heart’s pumping capability), ARBs (for those who cannot take ACE Inhibitors), Beta blockers (to improve heart function), Digoxin (digitalis; increases the strength of heart muscle contractions), and diuretics.

HYPERTROPHIC CARDIOMYOPATHY ~

The muscle mass of the left ventricle enlarges/thickens (“hypertrophies”).

In one form, the wall between the two ventricles (pumping chambers) becomes enlarged/thickened and obstructs the blood flow from the left ventricle. The syndrome is known as “hypertrophic obstructive cardiomyopathy” or “asymmetric septal hypertrophy”; it is also called “idiopathic hypertrophic subaortic stenosis”.

As thickening occurs, the heart tends to stiffen and the size of the pumping chamber may shrink, interfering with the heart’s ability to deliver blood to the body.

Besides obstructing blood flow, the thickened wall sometimes distorts one leaflet of the mitral valve, causing it to leak.

In the other form, blood flow is not obstructed.

Treatment in humans may include Beta blockers to relax the heart, slow its pumping action, and stabilize its rhythm.

RESTRICTIVE CARDIOMYOPATHY ~

This is the least common type. The heart muscle (myocardium) of the ventricles becomes excessively “rigid”, meaning the heart can’t properly expand and fill with blood between heartbeats. The condition may be caused by diseases elsewhere in the body that affect the heart.

Treatment in humans may include diuretics.

TAKOTSUBO CARDIOMYOPATHY ~

Now more commonly referred to as “stress-induced cardiomyopathy”, “broken-heart-syndrome” and “apical ballooning syndrome”. It is a type of cardiomyopathy in which there is a sudden, temporary weakening of the heart muscle. It is brought on by extremely stressful situations, and is the result of the heart’s reaction to a surge of stress hormones. A part of the heart enlarges and doesn’t pump well, while the remainder of the heart functions normally, or with even more forceful contractions. Stress cardiomyopathy is a well-recognized cause of acute (sudden, severe) heart failure, lethal ventricular arrhythmias, and ventricular rupture.

The typical presentation is a sudden onset of Congestive Heart Failure, or chest pain associated with ECG (electrocardiogram) changes suggestive of an anterior wall “myocardial infarction” (heart attack). A bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted. It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name “tako tsubo”, or ‘octopus trap’ in Japan, where it was first described.

It appears to involve high circulating levels of “catecholamines” (mainly adrenaline/epinephrine). Adrenaline and epinephrine are associated with Fight-or-Flight.

If the individual survives the initial presentation, the left ventricular function improves within 2 months.

CAUSES ~

Most of the time the cause of the cardiomyopathy is unknown, but possible causes include ~

· Long-term high blood pressure

· Heart valve problems

· Heart tissue damage from a previous heart attack

· Chronic rapid heart rate

· Metabolic disorders, such as thyroid disease

· Nutritional deficiencies of essential vitamins or minerals

· Certain viral infections

· Iron buildup in the heart muscle

SOURCES ~

http://www.americanheart.org/presenter.jhtml?identifier=4468

http://en.wikipedia.org/wiki/Cardiomyopathy

http://www.mayoclinic.com/health/cardiomyopathy

http://www.nlm.nih.gov/medlineplus/ency/article/001105.htm