Lily was referred to the Emergency
Service for lethargy and tachycardia.
|HPI: Cat goes outside approximately 4 x week and has
subsequent episodes 2-3 x week. The episodes involve profound lethargy.
|Episodes always follow time spent outdoors. Episode
lasts from few hours to 12 hours and then returns to normal. When cat is
outside, she spends most time eating grass and
weeds. Owner unable to identify any specific weeds or garden plants. Weed
killer has been sprayed intermittently and owners uncertain
if gardener uses pesticides.|
|Today's episode has been ongoing for past ~12 hours.
|One seizure 4 1/2 months ago. Owner reports she slept
for 12 hours that day then at midnight he was woken up by her thrashing,
rolling, and flipping. This is the only time the owner has observed a seizure
|Vaccines current, rabies given last week.
|Physical exam: QAR, MM - pink, HR>300bpm. No murmur is ausculted.
Pulses are weak and synchronous. |
|ECG: HR 380bpm, supraventricular tachycardia (SVT), suspect alternative
pathway, mea 120. |
|Echocardiographic objective findings: IVSd= 4.3 mm, LVFWd= 6.4mm, EDD =
10.2mm, IVSs= 7.2mm, ESD= 6.5mm, LVPWs= 7.7mm, LA= 14.9 mm, Ao= 10.2 mm, LA/Ao=
1.5, FS~36%, RVOT vel. ~ 0.6m/s, LVOT vel.= 0.6.m/s. |
|Echocardiographic subjective findings: The left ventricle and the
papillary muscles have normal size and shape. There is mild to moderate left
ventricular concentric hypertrophy and moderate papillary muscle hypertrophy.
This finding may be consistent with pseudohypertrophy.|
|Lily was sent home on atenolol 6.25 mg q12 hours.|