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The Equine Heart: Power Plant Unequaled!

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The Equine Heart: Power Plant Unequaled! March 2013 A publication of the Center for Equine Health • School of Veterinary Medicine • University of California, Davis The Equine Heart: Power Plant Unequaled! This Horse Report was made possible by the invaluable contributions of the following veterinary faculty: Dr. Bill Thomas, Dr. Gary Magdesian, Dr. Gregory Ferraro, Dr. Claudia Sonder, Dr. Mary Beth Whitcomb, Dr. Tania Kozikowski-Nicholas, and Dr. Monica Aleman. or as long as horses have been bred, raised and used by humans, Ftheir owners and caretakers have praised their "heart". This reputation for quality or quantity of "heart" is obviously based on a horse's psychological rather than anatomical characteristics: stoicism, bravery, dedication and nobility of character. In fact, these attributes of character also reflect the typically robust nature of the horse's anatomical heart and cardiovascular system as well. A horse’s heart supplies blood to all parts of one of the largest domesticated land mammals (1,000 pounds or more), not only at rest and during routine activities, but also during periods of extreme physical stress such as encountered during performing, racing and the training required for those activities. It is a power plant unequaled in any other creature! That it is able to do so attests to the system’s remarkable efficiency and The left heart collects blood returning adaptability. from the lungs via the pulmonary veins and pumps it to the body via the aorta. INSIDE THIS ISSUE … The cardiovascular system of a horse The right heart collects blood returning The Equine Heart: Power Plant consists of a pump (the heart), a from the body via the large veins and Unequaled! .............................1 distribution system (arteries), exchange directs it to the lungs via the pulmonary Director’s Message ......................2 areas (capillary beds), and a collection artery. The output of each ventricle in an and return system (veins). The heart of adult horse at rest is about 25 to 40 liters/ Message from Dr. Gregory Ferraro ...3 a 1,000-pound adult horse is about the minute (approximately 7 to 10 gallons), Baby Kaya Gets a Pacemaker ...... 10 size of a large melon and weighs about compared with 4 to 5 liters/minute in an The Art of Listening to Your 10 pounds. As in all mammals, it consists average adult human (1 liter ≈ 1.05 quart). Horse’s Heart ....................... 11 of the left and right atrial receiving Cash: The Little Horse with a chambers, left and right atrioventricular This Horse Report describes some Big Hole in His Heart .............. 13 inflow valves, left and right pumping conditions most often encountered by Cardiology Service at the VMTH ... 14 ventricles, and aortic and pulmonic One More Word About semilunar outflow valves, plus attached —Continued on page 4 Miniature Horses .................... 14 inflow veins and outflow arteries (see Oleander Poisoning: The photos on page 4). Preventable Illness .................. 15 2 - The Horse Report who needed to move quickly to stay Veterinarians will often recommend a DIRECTOR’S MESSAGE alive. Horses have incredible cardiac second exam 4 to 6 months after the reserve. They can contract their spleens original cardiac ultrasound to evaluate in moments of excitement and nearly the heart muscle’s response to altered double their oxygen carrying capacity. flow and establish prognosis for Their heart rates can jump from 30 beats athleticism. Occasionally, foals are per minute (bpm) at rest to 240 bpm in born with congenital heart defects maximal exercise. On top of that, heart including holes in the wall that disease is relatively rare in horses. divides the left and right ventricles or pumping chambers. These are Examination of the cardiovascular known as a ventricular septal defect system of the horse has come a and the size and location of the defect long way, and yet the art of cardiac determines the long-term prognosis auscultation, or listening to the of these horses. heart carefully with a stethoscope, remains the mainstay of detection of Advancements in technology have cardiovascular disease. In the 1800s, allowed us to fit Holter monitors Dr. Claudia Sonder it was a veterinary scientist that first to horses to observe the electrical described the heart sounds and activity of the heart under different In the steady gaze of the horse shines a their source within the equine heart, degrees of exercise. We have silent eloquence that speaks of love and and this work was extrapolated to improved ability to diagnose loyalty, strength and courage. It is the human medicine. The detection of arrhythmias and track normal cardiac window that reveals to us how willing abnormal heart sounds or rhythms, responses to extremes of exercise. his spirit, how generous his heart. especially in performance horses, is Endurance and three-day event often a cause for concern and raises riders use heart rate monitors to s a veterinarian, and the daughter questions about future athletic direct fitness training and monitor Aof a man who lived with heart potential and performance. Many a physiologic stress in competitions. disease, I have long been fascinated pre-purchase exam has come to a halt We now have the capability to look with the resilience and simplicity upon the identification of a murmur. at cardiac enzymes such as troponin of the four chambered heart. Most As cardiac ultrasound has become in horses to detect evidence of heart of us take it for granted that this marvelous biological pump within us Despite all of our advanced testing and diagnostic capabil- functions for years on end without ities in veterinary medicine, heart rate continues to be one of our conscious input or control. What manufactured device can the best prognostic indicators associated with diseases such exist under pressure and perform as colic in the horse. at variable speeds for eighty to one hundred years without a tune more advanced and accessible, we muscle injury. Human pacemakers up? We attribute many qualities to now know that there are physiologic have been installed in horses with our hearts and we do the same to murmurs that can be quite loud arrhythmias and the prospect of animals. The words heart and horse and that are not associated with biological pacemakers introduced go together. Throughout history, underlying heart disease or pathology. through gene therapy has been horses have been praised for their These murmurs often dissipate with investigated in dogs. Thankfully, the hearts- in terms of valor, loyalty, exercise. We know that there are flow incidence of heart disease continues and strength. I have known horses murmurs that occur under physiologic to be lower in horses than in other with incredible work ethics that are stress that are transient and of little species and is not associated with devoted and committed despite consequence to athleticism. Cardiac obesity as it is in humans. Because physical limitations and I described ultrasound can reveal the source of of their size and their poor tolerance these animals as having a great deal a pathologic murmur, whether it be of thoracic surgery, open-heart of heart. The truth is that horses need a leaky valve or area of blood vessel surgery and treatment with advanced good hearts. Greater than 50% of constriction leading to or from the pharmacology is still not on the their body mass is skeletal muscle heart. immediate horizon. Sadly, horses and they evolved as prey animals with congestive heart failure pose a www.vetmed.ucdavis.edu/ceh March 2013 - 3 safety issue for those around them and options for treatment are limited. MESSAGE FROM DR. GREGORY FERRARO Early detection and management of cardiac disease carries with it the best chances for long term survival, which Therefore, with Dean Lairmore’s for the average horse is 630,720,000 endorsement, Dr. Sonder has taken heart beats in a lifetime. the reins of the CEH directorship effective January 15, 2013, while This Horse Report reviews the anatomy the formal recruitment process is and functionality of the equine heart and completed. This is a change that I discusses several of the most common welcomed and facilitated because equine heart problems. The videos I sincerely believe it is in the best contained in the electronic Horse Report interests of the CEH, the School of (Zmag) will guide the horse owner and Veterinary Medicine and the horse serve as a reference tool for veterinarians enthusiasts we serve. I ask that you as to the normal sounds of the equine welcome Dr. Sonder to her new heart and the process of auscultation. position and provide her with the The Cardiology Service at UC Davis works same enthusiastic support that you closely with the Large Animal Ultrasound have given to me during my tenure. I department to identify underlying Dr. Gregory Ferraro am certain that with your help she can heart disease and offer guidance and take the Center to new heights. treatment options for horses with ate last year while thinking about abnormalities detected in the field. Lhow far the Center for Equine As for me, I’m not going anywhere. I Health has advanced during my tenure will continue my participation in the We encourage horse owners to buy and where it needed to go in the CEH as a senior advisor for as long a stethoscope and practice listening future, it suddenly dawned on me that as needed to effect a smooth and to your horse’s heart. Despite all of at the end of 2012, I would have been productive leadership transition. I am our advanced testing and diagnostic its Director for 15 years. As rewarding also currently serving the School of capabilities in veterinary medicine, and satisfying as my job has been, 15 Veterinary Medicine as the Associate heart rate continues to be one years is a sufficient tenure for political Director of its Large Animal Clinic and of the best prognostic indicators office holders, Deans, Chancellors will be participating in any other areas associated with diseases such as colic and Center Directors.
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