Mezi d\u011bdi\u010dn\u011b podm\u00edn\u011bn\u00fdmi nemocemi ps\u016f hraj\u00ed v\u00fdznamnou roli vrozen\u00e9 srde\u010dn\u00ed vady. Ty p\u0159edstavuj\u00ed asi 5% p\u0159\u00edpad\u016f z celkov\u00e9ho po\u010dtu onemocn\u011bn\u00ed srdce u ps\u016f. Zbylou \u010d\u00e1st tvo\u0159\u00ed z\u00edskan\u00e1 onemocn\u011bn\u00ed srdce, mezi nimi\u017e u n\u011bkter\u00fdch tak\u00e9 zji\u0161\u0165ujeme pom\u011brn\u011b v\u00fdznamn\u00e9 genetick\u00e9 dispozice.
\nV\u011bt\u0161ina vrozen\u00fdch srde\u010dn\u00edch vad m\u00e1 za n\u00e1sledek \u201ezkrat\u201c mezi mal\u00fdm a velk\u00fdm krevn\u00edm ob\u011bhem. Pokud \u010d\u00e1st krve vypuzen\u00e9 z lev\u00e9 komory te\u010de m\u00edsto srde\u010dnice (aorty) do plicn\u00ed tepny a plicn\u00edho ob\u011bhu, hovo\u0159\u00edme o zkratu zleva doprava. V tomto p\u0159\u00edpad\u011b doch\u00e1z\u00ed k p\u0159ekrven\u00ed a ed\u00e9mu plic, zat\u00edmco v\u00e1zne prokrven\u00ed zbytku t\u011bla v\u010detn\u011b v\u0161ech \u017eivotn\u011b d\u016fle\u017eit\u00fdch org\u00e1n\u016f. Nej\u010dast\u011bj\u0161\u00edmi projevy ed\u00e9mu plic jsou du\u0161nost a ka\u0161el. P\u0159i zkratu zprava doleva naopak \u010d\u00e1st krve odt\u00e9k\u00e1 z prav\u00e9 komory do aorty a v\u00e1zne pr\u016ftok krve plicn\u00ed tepnou. V tomto p\u0159\u00edpad\u011b se do velk\u00e9ho t\u011bln\u00edho ob\u011bhu dost\u00e1v\u00e1 ur\u010dit\u00e9 mno\u017estv\u00ed neokysli\u010den\u00e9 krve. Jednotliv\u00e9 tk\u00e1n\u011b a org\u00e1ny jsou tak nedostate\u010dn\u011b z\u00e1sobeny kysl\u00edkem, co\u017e se \u010dasto projevuje nafialov\u011bl\u00fdm zbarven\u00edm viditeln\u00fdch sliznic, tzv. cyan\u00f3zou. Krom\u011b uveden\u00fdch klinick\u00fdch p\u0159\u00edznak\u016f se vrozen\u00e9 srde\u010dn\u00ed vady projevuj\u00ed zaost\u00e1v\u00e1n\u00edm v r\u016fstu, slabost\u00ed a snadnou unavitelnost\u00ed posti\u017een\u00fdch \u0161t\u011b\u0148at.
\nJednou z nej\u010dast\u011bj\u0161\u00edch vrozen\u00fdch srde\u010dn\u00edch vad u ps\u016f je patentn\u00ed ductus arteriosus (PDA). Toto onemocn\u011bn\u00ed vznik\u00e1 neuzav\u0159en\u00edm embryon\u00e1ln\u00ed spojky mezi plicn\u00ed tepnou a aortou po narozen\u00ed \u0161t\u011bn\u011bte. B\u011bhem nitrod\u011blo\u017en\u00edho v\u00fdvoje \u0161t\u011bn\u011b nepou\u017e\u00edv\u00e1 mal\u00fd plicn\u00ed ob\u011bh, nebo\u0165 k okysli\u010dov\u00e1n\u00ed krve nedoch\u00e1z\u00ed vzdu\u0161n\u00fdm kysl\u00edkem v plic\u00edch, ale kysl\u00edkem z mat\u010diny krve v placent\u011b. Proto krev vypuzen\u00e1 z prav\u00e9 komory do plicn\u00ed tepny proud\u00ed spojkou naz\u00fdvanou ductus arteriosus p\u0159\u00edmo do aorty odtud do velk\u00e9ho krevn\u00edho ob\u011bhu. Po narozen\u00ed a rozta\u017een\u00ed plic vzduchem tato embryon\u00e1ln\u00ed spojka rychle zanik\u00e1 (b\u011bhem prvn\u00edch minut a\u017e hodin po porodu). Probl\u00e9m nast\u00e1v\u00e1, pokud p\u0159etrv\u00e1v\u00e1 existence ductus arteriosus i po narozen\u00ed. V tomto p\u0159\u00edpad\u011b v n\u011bm zpravidla doch\u00e1z\u00ed k toku krve z aorty do plicn\u00ed tepny, tj. opa\u010dn\u00fdm sm\u011brem ne\u017e za embryon\u00e1ln\u00edho \u017eivota. Je to d\u00e1no t\u00edm, \u017ee lev\u00e1 komora m\u00e1 podstatn\u011b v\u011bt\u0161\u00ed v\u00fdkon ne\u017e komora prav\u00e1 a v aort\u011b je t\u00edm p\u00e1dem v\u011bt\u0161\u00ed tlak krve ne\u017e v plicn\u00ed tepn\u011b. N\u00e1sledkem t\u00e9to vady je pak p\u0159ekrven\u00ed plic. U tohoto onemocn\u011bn\u00ed se popisuje typick\u00fd poslechov\u00fd n\u00e1lez. Jde o kol\u00edsav\u00fd kontinu\u00e1ln\u00ed \u0161elest, kter\u00fd lze p\u0159irovnat ke zvuku parn\u00ed lokomotivy. Tento typ \u0161elestu v\u0161ak nemus\u00ed b\u00fdt p\u0159\u00edtomen po celou dobu trv\u00e1n\u00ed nemoci nebo m\u016f\u017ee chyb\u011bt \u00fapln\u011b. Genetickou predispozici k PDA maj\u00ed p\u0159edev\u0161\u00edm plemena: n\u011bmeck\u00fd ov\u010d\u00e1k, trpasli\u010d\u00ed a toy pudl, americk\u00fd kokr\u0161pan\u011bl, \u0161pringr\u0161pan\u011bl, malt\u00e9zsk\u00fd pin\u010d, jork\u0161\u00edrsk\u00fd teri\u00e9r a kolie. Feny b\u00fdvaj\u00ed posti\u017eeny \u010dast\u011bji ne\u017e psi. Toto onemocn\u011bn\u00ed je mo\u017en\u00e9 definitivn\u011b vyl\u00e9\u010dit pouze chirurgick\u00fdm z\u00e1krokem prost\u0159ednictv\u00edm dvojit\u00e9ho podv\u00e1z\u00e1n\u00ed PDA. Bez tohoto o\u0161et\u0159en\u00ed doch\u00e1z\u00ed k postupn\u00e9mu zhor\u0161ov\u00e1n\u00ed zdravotn\u00edho stavu a \u010dasn\u00e9mu \u00fahynu pacienta, nej\u010dast\u011bji b\u011bhem prvn\u00edho roku \u017eivota.
\nMezi vrozen\u00e9 srde\u010dn\u00ed vady zp\u016fsobuj\u00edc\u00ed zkrat zleva doprava pat\u0159\u00ed tak\u00e9 defekty komorov\u00e9 nebo p\u0159eds\u00ed\u0148ov\u00e9 p\u0159ep\u00e1\u017eky. Defekt komorov\u00e9ho septa se vyskytuje p\u0159edev\u0161\u00edm u anglick\u00fdch buldok\u016f, \u0161pringr\u0161pan\u011bl\u016f a keeshond\u016f. B\u00fdv\u00e1 tak\u00e9 pom\u011brn\u011b \u010dast\u00fd u ko\u010dek. Defekt p\u0159eds\u00ed\u0148ov\u00e9ho septa b\u00fdv\u00e1 popisov\u00e1n u samojed\u016f a dobrman\u016f. Tyto defekty se mohou u ps\u016f vyskytovat tak\u00e9 v kombinaci s jin\u00fdmi srde\u010dn\u00edmi vadami. Progn\u00f3za onemocn\u011bn\u00ed je z\u00e1visl\u00e1 na velikosti defektu. Zv\u00ed\u0159ata s mal\u00fdm defektem se mohou do\u017e\u00edt relativn\u011b vysok\u00e9ho v\u011bku, ani\u017e by vykazovala podstatn\u00e9 odchylky od norm\u00e1ln\u00edho zdravotn\u00edho stavu. U zv\u00ed\u0159at s v\u011bt\u0161\u00edmi defekty se v r\u016fzn\u00e9 intenzit\u011b vyskytuj\u00ed p\u0159\u00edznaky srde\u010dn\u00edho selh\u00e1n\u00ed, kter\u00e9 je nutn\u00e9 ovliv\u0148ovat pomoc\u00ed l\u00e9k\u016f. Definitivn\u00ed vyl\u00e9\u010den\u00ed p\u0159edstavuje pouze chirurgick\u00fd z\u00e1krok, kter\u00fd v\u0161ak vy\u017eaduje n\u00e1ro\u010dn\u00e9 vybaven\u00ed pracovi\u0161t\u011b s mo\u017enost\u00ed bypassu.
\nDo vrozen\u00fdch srde\u010dn\u00edch onemocn\u011bn\u00ed zp\u016fsobuj\u00edc\u00edch zkrat zprava doleva s v\u00fdraznou cyan\u00f3zou sliznic pat\u0159\u00ed tzv. Fallotova tetralogie. Jedn\u00e1 se o vrozenou kombinaci \u010dty\u0159 srde\u010dn\u00edch vad. D\u011bdi\u010dnou dispozici tohoto onemocn\u011bn\u00ed m\u00e1 keeshond a anglick\u00fd buldok. Progn\u00f3za Fallotovy tetralogie je vesm\u011bs \u0161patn\u00e1. Bez n\u00e1ro\u010dn\u00e9ho chirurgick\u00e9ho z\u00e1kroku za pou\u017eit\u00ed bypassu doch\u00e1z\u00ed v ran\u00e9m v\u011bku velmi \u010dasto k \u00fahynu pacienta.
\nDal\u0161\u00ed kapitolu vrozen\u00fdch srde\u010dn\u00edch vad tvo\u0159\u00ed vrozen\u00e1 onemocn\u011bn\u00ed chlopn\u00ed. Z\u00fa\u017een\u00ed polom\u011bs\u00ed\u010dit\u00fdch chlopn\u00ed pat\u0159\u00ed u ps\u016f spole\u010dn\u011b s PDA mezi nej\u010dast\u011bj\u0161\u00ed vrozen\u00e1 onemocn\u011bn\u00ed srdce. Pulmon\u00e1ln\u00ed sten\u00f3za (z\u00fa\u017een\u00ed pulmon\u00e1ln\u00ed polom\u011bs\u00ed\u010dit\u00e9 chlopn\u011b) se vyskytuje zejm\u00e9na u plemen: beagle, \u010divava, anglick\u00fd buldok, mastif, samojed, mal\u00fd kn\u00edra\u010d, kokr\u0161pan\u011bl, west highland white teri\u00e9r, erdelteri\u00e9r, skotsk\u00fd teri\u00e9r a foxteri\u00e9r. Onemocn\u011bn\u00ed je charakteristick\u00e9 n\u00e1lezem v\u00ed\u0159iv\u00e9ho srde\u010dn\u00edho \u0161elestu. Zna\u010dn\u00e1 \u010d\u00e1st ps\u016f s t\u00edmto poslechov\u00fdm n\u00e1lezem v\u0161ak nemus\u00ed vykazovat p\u0159\u00edznaky srde\u010dn\u00edho selh\u00e1n\u00ed. Ty se v\u011bt\u0161inou objevuj\u00ed a\u017e ve vy\u0161\u0161\u00edm v\u011bku pacienta a zahrnuj\u00ed zhor\u0161enou toleranci z\u00e1t\u011b\u017ee, synkopy (kr\u00e1tkodob\u00e1 ztr\u00e1ta v\u011bdom\u00ed), otok b\u0159icha a kon\u010detin. Progn\u00f3za onemocn\u011bn\u00ed a d\u00e9lka \u017eivota z\u00e1vis\u00ed na stupni posti\u017een\u00ed chlopn\u011b. L\u00e9\u010dba se zam\u011b\u0159uje zejm\u00e9na na medikament\u00f3zn\u00ed potla\u010den\u00ed p\u0159\u00edznak\u016f srde\u010dn\u00edho selh\u00e1n\u00ed, pop\u0159. chirurgickou korekci vady. K aort\u00e1ln\u00ed sten\u00f3ze (z\u00fa\u017een\u00ed aort\u00e1ln\u00ed polom\u011bs\u00ed\u010dit\u00e9 chlopn\u011b) maj\u00ed dispozici p\u0159edev\u0161\u00edm plemena: novofundlandsk\u00fd pes, zlat\u00fd retr\u00edvr, rotvajler, boxer, n\u011bmeck\u00fd ov\u010d\u00e1k, samojed, buldok, n\u011bmeck\u00e1 doga. Srde\u010dn\u00ed \u0161elest doprov\u00e1zej\u00edc\u00ed tuto nemoc nemus\u00ed b\u00fdt sly\u0161iteln\u00fd hned od narozen\u00ed, u n\u011bkter\u00fdch ps\u016f se objevuje a\u017e ve druh\u00e9m roce st\u00e1\u0159\u00ed. Klinick\u00fdm projevem nemoci b\u00fdv\u00e1 slabost, synkopy a levostrann\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed (du\u0161nost, ka\u0161el). Progn\u00f3za onemocn\u011bn\u00ed je v\u017edy nejist\u00e1 a z\u00e1vis\u00ed na stupni posti\u017een\u00ed chlopn\u011b. Definitivn\u00ed vyl\u00e9\u010den\u00ed p\u0159edstavuj\u00ed pouze velmi n\u00e1ro\u010dn\u00e9 operativn\u00ed techniky.
\nMezi vrozen\u00e1 onemocn\u011bn\u00ed chlopn\u00ed pat\u0159\u00ed d\u00e1le dysplazie c\u00edpat\u00fdch chlopn\u00ed. Jedn\u00e1 se o \u0161patn\u00e9 vyvinut\u00ed struktur dvojc\u00edp\u00e9 nebo trojc\u00edp\u00e9 chlopn\u011b, kter\u00e9 vede k jejich nedomykavosti. Tato onemocn\u011bn\u00ed se vyskytuj\u00ed p\u0159edev\u0161\u00edm u velk\u00fdch plemen ps\u016f, nap\u0159. labradorsk\u00fd retr\u00edvr, n\u011bmeck\u00fd ov\u010d\u00e1k, n\u011bmeck\u00e1 doga, rotvajler, boxer, bulteri\u00e9r, novofundlandsk\u00fd pes, mastif\u2026 Psi b\u00fdvaj\u00ed posti\u017eeni \u010dast\u011bji ne\u017e feny. Klinick\u00e9 p\u0159\u00edznaky jsou stejn\u00e9 jako p\u0159i degenerativn\u00edm onemocn\u011bn\u00ed chlopn\u00ed u star\u00fdch ps\u016f. L\u00e9\u010dba spo\u010d\u00edv\u00e1 p\u0159edev\u0161\u00edm v medikament\u00f3zn\u00edm ovlivn\u011bn\u00ed n\u00e1sledk\u016f srde\u010dn\u00edho selh\u00e1n\u00ed. Progn\u00f3za je v\u011bt\u0161inou \u0161patn\u00e1.
\nJednou z dal\u0161\u00edch vrozen\u00fdch vad je perzistuj\u00edc\u00ed prav\u00fd aort\u00e1ln\u00ed oblouk. Jde o poz\u016fstatek c\u00e9vy, kter\u00e1 za norm\u00e1ln\u00edch okolnost\u00ed zanik\u00e1 b\u011bhem embryon\u00e1ln\u00edho v\u00fdvoje. Tento c\u00e9vn\u00ed oblouk je u posti\u017een\u00e9ho \u0161t\u011bn\u011bte p\u0159\u00ed\u010dinou tlaku na j\u00edcen. V m\u00edst\u011b stla\u010den\u00e9ho j\u00edcnu se hromad\u00ed potrava a zp\u016fsobuje roz\u0161\u00ed\u0159en\u00ed j\u00edcnu p\u0159ed m\u00edstem ucp\u00e1n\u00ed. Tato vada se tedy neprojevuje p\u0159\u00edznaky onemocn\u011bn\u00ed srdce a c\u00e9v, ale za\u017e\u00edvac\u00edmi pot\u00ed\u017eemi. Nemocn\u00e9 \u0161t\u011bn\u011b zaost\u00e1v\u00e1 v r\u016fstu a nej\u010dast\u011bji v obdob\u00ed odstavu a p\u0159echodu na pevnou stravu se u n\u011bj za\u010d\u00edn\u00e1 projevovat zvracen\u00ed nestr\u00e1ven\u00e9 potravy z j\u00edcnu, tzv. regurgitace. Diagn\u00f3za se stanov\u00ed na z\u00e1klad\u011b kontrastn\u00edho rentgenov\u00e9ho vy\u0161et\u0159en\u00ed. Nemocn\u00e9 \u0161t\u011bn\u011b je t\u0159eba krmit mal\u00fdmi d\u00e1vkami polotekut\u00e9 nebo tekut\u00e9 potravy. Definitivn\u00ed l\u00e9\u010dba spo\u010d\u00edv\u00e1 v chirurgick\u00e9m z\u00e1kroku. Mezi nej\u010dast\u011bji posti\u017een\u00e1 plemena pat\u0159\u00ed n\u011bmeck\u00fd ov\u010d\u00e1k, n\u011bmeck\u00e1 doga a irsk\u00fd setr.
\nU ps\u016f se d\u00e1le vyskytuje vrozen\u00e9 onemocn\u011bn\u00ed osrde\u010dn\u00edku (perikardu) naz\u00fdvan\u00e9 peritoneoperikardi\u00e1ln\u00ed br\u00e1ni\u010dn\u00ed k\u00fdla. Jedn\u00e1 se vrozenou komunikaci b\u0159i\u0161n\u00ed a osrde\u010dn\u00edkov\u00e9 dutiny p\u0159es neuzav\u0159enou br\u00e1nici s v\u00fdh\u0159ezem b\u0159i\u0161n\u00edch org\u00e1n\u016f do osrde\u010dn\u00edku. Onemocn\u011bn\u00ed nej\u010dast\u011bji zji\u0161\u0165ujeme u v\u00fdmarsk\u00fdch oha\u0159\u016f. Klinick\u00e9 p\u0159\u00edznaky se v\u011bt\u0161inou objevuj\u00ed u mlad\u00fdch zv\u00ed\u0159at do jednoho roku st\u00e1\u0159\u00ed, n\u011bkdy v\u0161ak a\u017e do \u010dty\u0159 let. P\u0159\u00edznaky mohou b\u00fdt velmi variabiln\u00ed, zahrnuj\u00ed jak d\u00fdchac\u00ed pot\u00ed\u017ee a p\u0159\u00edznaky srde\u010dn\u00edho selh\u00e1n\u00ed, tak za\u017e\u00edvac\u00ed poruchy v\u010detn\u011b nechutenstv\u00ed, zvracen\u00ed a pr\u016fjm\u016f. U n\u011bkter\u00fdch jedinc\u016f se v\u0161ak zm\u00edn\u011bn\u00e9 p\u0159\u00edznaky nemus\u00ed v\u016fbec projevit. Terapie spo\u010d\u00edv\u00e1 v chirurgick\u00e9m uzav\u0159en\u00ed defektu, po kter\u00e9m n\u00e1sleduje zpravidla velmi rychl\u00e9 uzdraven\u00ed. U star\u0161\u00edch zv\u00ed\u0159at bez klinick\u00fdch p\u0159\u00edznak\u016f onemocn\u011bn\u00ed nemus\u00ed b\u00fdt l\u00e9\u010dba nutn\u00e1.
\nU ka\u017ed\u00e9ho \u0161t\u011bn\u011bte posti\u017een\u00e9ho vrozenou srde\u010dn\u00ed vadou b\u00fdv\u00e1 velmi t\u011b\u017ek\u00e9 u\u010dinit rozhodnut\u00ed o progn\u00f3ze onemocn\u011bn\u00ed. Je t\u0159eba posoudit, zda je onemocn\u011bn\u00ed v\u016fbec slu\u010diteln\u00e9 se \u017eivotem. Mus\u00edme v\u017edy zv\u00e1\u017eit, zda n\u00e1m zam\u00fd\u0161len\u00e9 diagnostick\u00e9 metody pomohou stanovit p\u0159esnou diagn\u00f3zu a progn\u00f3zu a zda je mo\u017en\u00e1 n\u00e1sledn\u00e1 l\u00e9\u010dba vrozen\u00e9 vady. Majitel nov\u00e9ho \u0161t\u011bn\u011bte, u n\u011bho\u017e byla zji\u0161t\u011bna vrozen\u00e1 srde\u010dn\u00ed vada, m\u00e1 pr\u00e1vo vr\u00e1tit \u0161t\u011bn\u011b chovateli. Vzhledem k tomu, \u017ee vrozen\u00e9 vady maj\u00ed \u010dasto d\u011bdi\u010dn\u00fd z\u00e1klad, je pot\u0159eba pe\u010dliv\u011b uv\u00e1\u017eit, zda je mo\u017en\u00e9 d\u00e1le p\u0159ipou\u0161t\u011bt rodi\u010de, p\u0159\u00edpadn\u011b i sourozence posti\u017een\u00e9ho \u0161t\u011bn\u011bte.
\nMezi z\u00edskan\u00e1 onemocn\u011bn\u00ed srdce s v\u00fdraznou d\u011bdi\u010dnou predispozic\u00ed pat\u0159\u00ed zejm\u00e9na chronick\u00e9 degenerativn\u00ed onemocn\u011bn\u00ed srde\u010dn\u00edch chlopn\u00ed (tzv. endokardi\u00f3za) a degenerativn\u00ed onemocn\u011bn\u00ed srde\u010dn\u00ed svaloviny (tzv. prim\u00e1rn\u00ed dilata\u010dn\u00ed kardiomyopatie). Endokardi\u00f3za je v\u016fbec nej\u010dast\u011bj\u0161\u00edm onemocn\u011bn\u00edm srdce u ps\u016f. Degenerativn\u00ed zm\u011bny posti\u017een\u00fdch chlopn\u00ed zp\u016fsobuj\u00ed jejich nedomykavost. Nej\u010dast\u011bji b\u00fdv\u00e1 posti\u017eena dvojc\u00edp\u00e1 chlope\u0148 (mezi levou p\u0159eds\u00edn\u00ed a levou komorou), m\u00e9n\u011b \u010dasto se setk\u00e1v\u00e1me s nedomykavost\u00ed trojc\u00edp\u00e9 chlopn\u011b (mezi pravou p\u0159eds\u00edn\u00ed a pravou komorou). P\u0159esn\u00e1 p\u0159\u00ed\u010dina vzniku onemocn\u011bn\u00ed nen\u00ed dosud zn\u00e1ma. Vyskytuje se p\u0159edev\u0161\u00edm u mal\u00fdch plemen ps\u016f. Mezi nejv\u00edce posti\u017een\u00e1 plemena pat\u0159\u00ed pudl, jezev\u010d\u00edk, mal\u00fd kn\u00edra\u010d, kaval\u00edr King Charles \u0161pan\u011bl, ostatn\u00ed \u0161pan\u011bl\u00e9, \u010divava a pekingsk\u00fd pal\u00e1cov\u00fd ps\u00edk. Poslechov\u00fd n\u00e1lez (dm\u00fdchav\u00fd \u0161elest nad posti\u017eenou chlopn\u00ed) se v\u011bt\u0161inou za\u010d\u00edn\u00e1 objevovat u ps\u016f ve st\u0159edn\u00edm v\u011bku, ale ke klinick\u00fdm p\u0159\u00edznak\u016fm n\u00e1sledn\u00e9ho srde\u010dn\u00edho selh\u00e1n\u00ed zpravidla doch\u00e1z\u00ed a\u017e ve vy\u0161\u0161\u00edm v\u011bku, tj. nad sedm let. Specifick\u00e1 l\u00e9\u010dba degenerativn\u00edho onemocn\u011bn\u00ed chlopn\u00ed u ps\u016f neexistuje. Definitivn\u00ed vyl\u00e9\u010den\u00ed t\u00e9to nemoci by znamenalo pouze pou\u017eit\u00ed um\u011bl\u00e9 chlopn\u011b. V l\u00e9\u010db\u011b nemocn\u00fdch ps\u016f se zam\u011b\u0159ujeme p\u0159edev\u0161\u00edm na potla\u010den\u00ed n\u00e1sledk\u016f srde\u010dn\u00edho selh\u00e1n\u00ed pomoc\u00ed l\u00e9k\u016f. P\u0159i vhodn\u011b zvolen\u00e9 kombinaci l\u00e9k\u016f je mo\u017en\u00e9 prodlou\u017eit ps\u016fm \u017eivot na pom\u011brn\u011b dlouhou dobu, \u0159\u00e1dov\u011b a\u017e o n\u011bkolik let.
\nDilata\u010dn\u00ed kardiomyopatie je degenerativn\u00ed onemocn\u011bn\u00ed srde\u010dn\u00ed svaloviny spojen\u00e9 s dilatac\u00ed srdce (zv\u011bt\u0161en\u00ed objemu srde\u010dn\u00edch dutin za sou\u010dasn\u00e9ho zten\u010den\u00ed srde\u010dn\u00edch st\u011bn). Tyto zm\u011bny maj\u00ed za n\u00e1sledek \u0161patnou srde\u010dn\u00ed sta\u017elivost. Jednozna\u010dn\u00e1 p\u0159\u00ed\u010dina vzniku onemocn\u011bn\u00ed nen\u00ed zn\u00e1ma. Jako nejd\u016fle\u017eit\u011bj\u0161\u00ed vyvol\u00e1vaj\u00edc\u00ed faktor se uv\u00e1d\u00ed nedostatek aminokyseliny L-karnitinu. Sp\u00ed\u0161e ne\u017e prost\u00fd deficit L-karnitinu ve v\u00fd\u017eiv\u011b je v\u0161ak p\u0159edpokl\u00e1d\u00e1n geneticky podm\u00edn\u011bn\u00fd metabolick\u00fd defekt, kter\u00fd znemo\u017e\u0148uje jeho n\u00e1le\u017eit\u00e9 vyu\u017eit\u00ed v srde\u010dn\u00ed svalovin\u011b. Dilata\u010dn\u00ed kardiomyopatie se nej\u010dast\u011bji vyskytuje u velk\u00fdch plemen ps\u016f, jako je dobrman, n\u011bmeck\u00e1 doga, bernard\u00fdn, irsk\u00fd vlkodav, boxer, novofundlandsk\u00fd pes a n\u011bmeck\u00fd ov\u010d\u00e1k. Z mal\u00fdch plemen b\u00fdv\u00e1 n\u011bkdy posti\u017een kokr\u0161pan\u011bl nebo buldok. Onemocn\u011bn\u00ed se nej\u010dast\u011bji prezentuje u ps\u016f st\u0159edn\u00edho v\u011bku, tj. mezi 4. a 10. rokem \u017eivota. Psi b\u00fdvaj\u00ed posti\u017eeni \u010dast\u011bji ne\u017e feny. A\u010dkoliv se nemoc pravd\u011bpodobn\u011b vyv\u00edj\u00ed pozvolna, klinick\u00e9 p\u0159\u00edznaky se v\u011bt\u0161inou objev\u00ed n\u00e1hle. Mezi nej\u010dast\u011bj\u0161\u00ed p\u0159\u00edznaky pat\u0159\u00ed slabost, snadn\u00e1 unavitelnost, nechutenstv\u00ed, du\u0161nost, ka\u0161el a otoky b\u0159icha. Z\u00e1sadn\u00ed v\u00fdznam pro diagnostiku onemocn\u011bn\u00ed m\u00e1 ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed srdce. L\u00e9\u010dba dilata\u010dn\u00ed kardiomyopatie je zam\u011b\u0159ena na zvl\u00e1dnut\u00ed p\u0159\u00edznak\u016f srde\u010dn\u00edho selh\u00e1n\u00ed. Definitivn\u00ed vyl\u00e9\u010den\u00ed by bylo mo\u017en\u00e9 pouze proveden\u00edm transplantace srdce. Progn\u00f3za je v\u011bt\u0161inou \u0161patn\u00e1. V\u011bt\u0161ina ps\u016f nep\u0159e\u017e\u00edv\u00e1 d\u00e9le ne\u017e 3 a\u017e 6 m\u011bs\u00edc\u016f od n\u00e1stupu klinick\u00fdch p\u0159\u00edznak\u016f srde\u010dn\u00edho selh\u00e1n\u00ed. Obzvl\u00e1\u0161\u0165 \u0161patn\u00e1 progn\u00f3za b\u00fdv\u00e1 u dobrman\u016f. \u017divot m\u016f\u017ee pacientovi prodlou\u017eit pouze v\u010dasn\u00e1 diagnostika. Proto u ps\u016f se sn\u00ed\u017eenou toleranc\u00ed z\u00e1t\u011b\u017ee, ob\u010dasnou slabost\u00ed, synkopami \u010di s n\u00e1hodn\u00fdm n\u00e1lezem srde\u010dn\u00edho \u0161elestu nebo poruchy srde\u010dn\u00edho rytmu je v\u017edy indikov\u00e1no podrobn\u00e9 kardiologick\u00e9 vy\u0161et\u0159en\u00ed.
\nTak\u00e9 z\u00edskan\u00e1 onemocn\u011bn\u00ed perikardu u ps\u016f maj\u00ed ur\u010dit\u00e9 plemenn\u00e9 predispozice. Nej\u010dast\u011bj\u0161\u00edm onemocn\u011bn\u00edm b\u00fdv\u00e1 napln\u011bn\u00ed osrde\u010dn\u00edkov\u00e9 dutiny krvavou tekutinou. P\u0159\u00ed\u010dinou mohou b\u00fdt n\u011bkter\u00e9 n\u00e1dory srdce (nap\u0159. hemangiosarkom u n\u011bmeck\u00fdch ov\u010d\u00e1k\u016f, zlat\u00fdch a labradorsk\u00fdch retr\u00edvr\u016f nebo n\u00e1dor srde\u010dn\u00ed b\u00e1ze u boxer\u016f, bostonsk\u00fdch teri\u00e9r\u016f a buldok\u016f). Velmi \u010dast\u00e9 b\u00fdv\u00e1 spont\u00e1nn\u00ed krv\u00e1cen\u00ed do perikardu z nezn\u00e1m\u00fdch p\u0159\u00ed\u010din, zejm\u00e9na u n\u011bmeck\u00fdch ov\u010d\u00e1k\u016f, zlat\u00fdch retr\u00edvr\u016f, n\u011bmeck\u00fdch dog a bernard\u00fdn\u016f. Klinick\u00e9 p\u0159\u00edznaky onemocn\u011bn\u00ed se objevuj\u00ed v p\u0159\u00edpad\u011b, \u017ee tlak tekutiny v perikardu p\u0159ekro\u010d\u00ed tlak krve v prav\u00e9 polovin\u011b srdce a nast\u00e1v\u00e1 tzv. srde\u010dn\u00ed tampon\u00e1da. Hlavn\u00edm projevem jsou otoky v oblasti b\u0159i\u0161n\u00ed dutiny. Progn\u00f3za nemoci je v\u011bt\u0161inou \u0161patn\u00e1, nejlep\u0161\u00ed v\u00fdsledky v p\u0159e\u017e\u00edv\u00e1n\u00ed psa jsou po chirurgick\u00e9m z\u00e1kroku spo\u010d\u00edvaj\u00edc\u00edm v odstran\u011bn\u00ed \u010d\u00e1sti perikardu.
\nU v\u011bt\u0161iny vrozen\u00fdch i z\u00edskan\u00fdch geneticky p\u0159en\u00e1\u0161en\u00fdch srde\u010dn\u00edch vad nen\u00ed p\u0159esn\u011b zn\u00e1m typ d\u011bdi\u010dnosti. V\u011bt\u0161ina d\u011bdi\u010dn\u00fdch vad b\u00fdv\u00e1 recesivn\u00ed, tzn.\u017ee se projev\u00ed jen tehdy, kdy\u017e jedinec z\u00edsk\u00e1 defektn\u00ed geny k\u00f3duj\u00edc\u00ed danou vadu od obou rodi\u010d\u016f. Dominantn\u00ed typ d\u011bdi\u010dnosti, kdy na projeven\u00ed vady u potomka sta\u010d\u00ed defektn\u00ed vloha od jednoho rodi\u010de, je velmi vz\u00e1cn\u00fd. Tento typ se p\u0159edpokl\u00e1d\u00e1 nap\u0159. p\u0159i p\u0159enosu aort\u00e1ln\u00ed sten\u00f3zy v populaci novofundlandsk\u00fdch ps\u016f a zlat\u00fdch retr\u00edvr\u016f. Velmi \u010dast\u00fd b\u00fdv\u00e1 tak\u00e9 polygenn\u00ed typ d\u011bdi\u010dnosti, tzn.\u017ee na p\u0159enosu ur\u010dit\u00e9 vady se pod\u00edl\u00ed v\u00edce gen\u016f sou\u010dasn\u011b. Polygenn\u00ed typ d\u011bdi\u010dnosti m\u00e1 nap\u0159\u00edklad Fallotova tetralogie u keeshond\u016f. Na v\u00fdskyt vrozen\u00fdch srde\u010dn\u00edch vad m\u00e1 tak\u00e9 velk\u00fd vliv p\u016fsoben\u00ed vn\u011bj\u0161\u00edch faktor\u016f prost\u0159ed\u00ed na fenu b\u011bhem b\u0159ezosti (nap\u0159. ultrafialov\u00e9 nebo RTG z\u00e1\u0159en\u00ed, t\u011b\u017ek\u00e9 kovy, v\u00fdfukov\u00e9 plyny a pr\u016fmyslov\u00e9 exhalace, tab\u00e1kov\u00fd kou\u0159, n\u011bkter\u00e1 l\u00e9\u010diva, aditiva do krmiv, toxiny pl\u00edsn\u00ed a n\u011bkter\u00e9 viry). Z toho vypl\u00fdv\u00e1, \u017ee ot\u00e1zka p\u0159enosu d\u011bdi\u010dn\u00fdch srde\u010dn\u00edch vad u ps\u016f je velmi slo\u017eit\u00e1 a jejich eliminace v ps\u00ed populaci bude vy\u017eadovat zna\u010dn\u00e9ho \u00fasil\u00ed.<\/p>\n
MVDr. Martin \u0160ando<\/p>\n","protected":false},"excerpt":{"rendered":"
Mezi d\u011bdi\u010dn\u011b podm\u00edn\u011bn\u00fdmi nemocemi ps\u016f hraj\u00ed v\u00fdznamnou roli vrozen\u00e9 srde\u010dn\u00ed vady. Ty p\u0159edstavuj\u00ed asi 5% p\u0159\u00edpad\u016f z celkov\u00e9ho po\u010dtu onemocn\u011bn\u00ed srdce u ps\u016f. Zbylou \u010d\u00e1st tvo\u0159\u00ed z\u00edskan\u00e1 onemocn\u011bn\u00ed srdce, mezi nimi\u017e u n\u011bkter\u00fdch tak\u00e9 zji\u0161\u0165ujeme pom\u011brn\u011b v\u00fdznamn\u00e9 genetick\u00e9 dispozice.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[4],"tags":[],"_links":{"self":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts\/9"}],"collection":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9"}],"version-history":[{"count":0,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts\/9\/revisions"}],"wp:attachment":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}