Case Studies In Small Animal

Cardiovascular Medicine

Home Up 1    Pleural Fluid 2              Cough 3   Heart Murmur 4           Syncope 5       Tachypnea 6           Cyanosis 7   Heart Murmur 8   Heart Murmur 9              Cough 10    Heart Failure 11              Ascites 12    Pleural Fluid 13           Syncope 14     Bradycardia 15     Tachycardia 16                Blind 17   Heart Murmur 18   Resp. Distress 19        Collapsing 20    Heart Failure 21          Paralysis 22    New Murmur 23              Cough 24          Vomiting 25       Tachypnea 26   Heart Murmur 27      Hemoptysis 28  Limb Swelling 29  Heart Murmur 30 Acute Collapse 31 Enlarged Heart 32               Blind 33             Cough 34         Collapse 35         Collapse 36 Thromboembolus 37  Heart Murmur 38  Heart Murmur

.    Radiographs 2D Echo .    Cardiac Cath Diagnosis

Case 1

Primary clinician: Darcy Adin, DVM

Supervising clinician: Mark D. Kittleson, DVM, PhD, DipACVIM (Cardiology)


Signalment

bulletFive-year-old MC Labrador retriever weighing 56 kg ("Monty")

Presenting Complaint

bulletPleural Effusion

Pertinent History

bulletMonty presented on emergency for management of a pleural effusion.
bulletThe owners noticed that Monty was panting more than usual about 6 days ago.
bulletHe has always been a finicky eater but they felt that his appetite had decreased in the past few days.
bulletHe has been less active for the past few days and was unwilling/unable to go running with the owner three days ago (he usually goes running about once a week).
bulletIn the last few days he has had difficulty breathing when laying on his side but seems comfortable when sternal or standing.
bulletHe was presented to the referring DVM two days ago. Radiographs were taken which showed an enlarged liver and pleural effusion. The heart could not be evaluated because it was obscured by the fluid. Blood work was done. It was unremarkable except for a mild monocytosis of 1296.
bulletThe chest was tapped and 70ml of fluid was removed. The fluid was submitted for analysis which showed a lymphocytic plasmacytic modified transudate, SpGr 1.026, WBC 2,950/ul,   RBC 20,000/ul, protein 4.1 gm/dl.
bulletHeart disease was suspected and Monty was referred to the VMTH for further evaluation.
bullet The owners have had Monty since he was a puppy. He was neutered at six months of age. He has had foxtails in the past but his medical history is unremarkable otherwise.
bullet He is current on his vaccinations.
bullet He is a yard dog who is allowed to roam freely (he usually remains in his yard).
bullet He is fed a Pedigree kibble and canned food diet.
bullet The owners have not noticed coughing, sneezing, vomiting or diarrhea.
bullet Current medication: Clavamox 375mg 2 tablets PO BID (started two days ago).

Physical Examination

bulletAlert. Hydrated. T=100.5, P=115, R=pant.
bulletClean full coat. Eyes clear bilaterally.
bulletEars clean.
bulletNose moist.
bulletSymmetrically muscled with no gait abnormalities.
bulletHeart sounds muffled. Weak femoral pulses. Jugular pulses present. Mucous membranes pink. CRT 1 second.
bulletIncreased lung sounds in dorsal lung fields. Diminished lung sounds ventral to the costochondral junction.
bulletAbdomen full ventrally. Palpably enlarged liver. No fluid wave to indicate ascites.
bulletNo peripheral lymphadenopathy.

Problems

bulletPleural effusion
bulletHepatomegaly with jugular pulsation

 

Mark D. Kittleson, D.V.M., Ph.D. All rights reserved.