INFECTIVE ENDOCARDITIS

Myocarditis is a focal or diffuse inflammation of the myocardium with myocyte degeneration and/or necrosis. It is rare in companion animals, although there are numerous causes, including several viruses and bacteria.
Often caused by infectious agents, that is, bacterial, viral, rickettsial, fungal, and protozoal agents directly affecting the heart or reaching the heart from other body parts can lead to myocarditis.
Drug toxicity to the heart can also be a factor.

The inflammation itself may be focal or diffused throughout the myocardium. Other symptoms associated with myocarditis include:

Complete blood count (CBC), blood culture biochemistry profile, and urinalysis - used to isolate and identify the causative organism. The abnormalities revealed by these tests, however, will depend on the affected organ.
Echocardiogram to evaluate the extent of myocardial damage and abnormal accumulation of fluid around the heart. In addition to evaluating the abnormalities related to heart dysfunction, EKG findings help in differentiating the location of the lesions within heart.
Thoracic X-rays help evaluate the heart size, whether fluids are located in the lungs, and other such abnormalities.
Other more specific testing include pericardiocentesis.

Treatment should be aimed at improving cardiac contractility, relieving congestion, and decreasing vasoconstriction.
Pimobendan and digoxin are used most commonly to improve contractility.
Furosemide is indicated to control clinical signs of pulmonary edema.
Corticosteroids are often used when cardiac isoenzymes are increased and a viral infection is deemed unlikely.

The overall prognosis for myocarditis depends on the extent and severity of disease.
Dogs with CHF as a result of myocarditis, for example, have very poor prognosis, while those with milder forms of the disease respond well to treatment.
Monitor progress and response to treatment.
Restricted exercise and dietary salt is advised.

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