11830 Westline Industrial Drive St. Louis, Missouri 63146 MANUAL OF CANINE AND FELINE CARDIOLOGY FOURTH EDITION Copyright © 2008 by Saunders, an imprint of Elsevier Inc. ISBN: 978-1-4160-2398-2 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail:
[email protected] You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions. Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. The Publisher Previous editions copyrighted 2001, 1995, 1985. Library of Congress Control Number: 2007928036 Vice President and Publisher: Linda Duncan Senior Acquisitions Editor: Anthony Winkel Developmental Editor: Shelly Stringer Publishing Services Manager: Pat Joiner-Myers Senior Project Manager: Gena Magouirk Design Direction: Karen O’Keefe Owens Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my wife, Jeri, my son, Kyle, mother, Dorothy In honor of that secret correspondence and love within our hearts Larry P. Tilley To the ever-popular Ben Smith and his charming sister Jade, thanks for keeping life fun. You are the best! To my wife May, who warms my heart every day, thanks for always being there. Francis W. K. Smith, Jr. To my parents, who made this all possible. To Emi, K.A., Miya, and Audrey, who keep the kid in me alive. Mark A. Oyama To Dave, whose support enables my dreams; and my father, who inspired them. Meg M. Sleeper Contributors Jonathan A. Abbott, DVM, DACVIM (Cardiology) Associate Professor Department of Small Animal Clinical Sciences Virginia-Maryland Regional College of Veterinary Medicine Virginia Polytechnic Institute and State University Blacksburg, Virginia Acquired Valvular Disease Janice McIntosh Bright, BSN, MS, DVM, DACVIM (Cardiology and Internal Medicine) Professor of Cardiology Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins, Colorado Pacemaker Therapy Scott A. Brown, VMD, PhD, DACVIM (Internal Medicine) Josiah Meigs Distinguished Professor Associate Dean for Academic Affa