Review Paper Heart Failure in Small Animals - Advances in Clinical Case Management

Abstract

The rationale for the use of drugs and supportive therapy in the management of heart diseases (HDs) and heart failure (HF), is discussed in the light of contemporary concepts. The in-adequacy of the age-long therapy of heart failure with oxygen supplementation, cardiac glycosides, rest and the withholding of salt in food is explained. The weaknesses of certain agents in the management of HF, particularly their inability to halt or reverse pre-existing pathologies, is also briefly discussed. The irreversible nature and the eventual fatal termination from HF has been attributed to sub-cellular changes or remodelling in the intracellular organelles and extra-cellular tissues of the heart, the blood vessels and possibly other internal organs under the influence of nor-adrenaline, angiotensin II, serotonin, aldosterone, growth hormones and anti-diuretic hormone (ADH). In addition, some of these agents downgrade or alter the functions of bradykinin, nitric acid and natriuretic peptides - hormones essential for normal cardio-vascular functions. Some of the newer drugs currently used in the management of HF tend to attenuate the progression of the intra- and extra-cellular changes associated with HF. Others either halt or actually reverse them. Although they do not prevent the eventual fatalities from HF, they tend to prolong the survival periods between the diagnosis of HF and death from it, an outcome which in some circumstances could be of immense importance or benefit.

Key words:     Management, Heart Failure, Small Animals.