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How I Treat... Congestive Heart Failture Without A Cardiologist?
I. Sosa
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The presentation of the congestive heart failure depends mainly on the patient we are dealing with, as well as the underlying disease. We are going to talk about the most typical scenarios that are presented to us in the clinic, and decide the most appropriate therapeutic treatment for these patients.
Ambulatory and stable canine patient
This would be the typical small dog that is presented without breathing distress. The owner has noticed an increase in respiratory rate (at rest) and even exercise intolerance. This is the ideal scenario, and is the result of educating the owners to monitor the progress of the disease. In this way we can diagnose the CHF in early stages. Although echocardiography can be useful to confirm the valvular problem and detect other lesions associated with valvular disease, the key diagnostic test is the thoracic radiography. If we have not seen the patient for some time, I would recommend a complete blood and urine analysis to the owner. At least, I would recommend a renal profile, as this would help us to decide the appropriate dose of diuretic agents Blood pressure is also a useful test, since, in case of systemic hypertension, we should treat more aggressively with vasodilators. ...
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