Primary clinician: Brad Gavaghan, DVM
Supervising clinician: Mark D. Kittleson,
|10-year-old FS Dalmatian weighing 32 kg ("Manny")|
|Congestive Heart Failure|
|"Manny" presented with exercise intolerance, weakness and a moist cough.
referring veterinarian, based on a recent physical exam and chest and abdominal
radiographs, diagnosed congestive heart failure. |
|She reportedly has had a heart murmur
since the owner obtained her at four years of age. |
|Approximately 2.5months ago she was
treated by the referring DVM for coughing with 2 weeks of prednisone 20mg BID. The
coughing returned post therapy and she was then treated with 2 weeks of prednisone, 20mg
BID and Lasix 25mg BID. The cough returned again upon completion of the prednisone
|She remains on Lasix. |
|Referral radiographs show pulmonary edema, an enlarged
cardiac silhouette, and hepatomegaly. |
|She is referred to the VMTH for further cardiac evaluation.|
|T=101.8, P=90, R=60|
|G: Quiet and BARH, CRT<1.5sec, MM=pink and moist, WT=32Kg,
|I: Full coat, no lesions and abrasions, 1cm dermal nodules on right sternum and left flank
|EENT: PLR bilateral, ears clean, tonsils in crypts |
|MS: full fleshed, 7/9 body condition score |
|CV: Muffled heart sounds, left apical systolic V/VI murmur, right apical III/VI systolic
murmur. Brisk femoral pulses. Positive hepatojugular reflux test. Irregular rhythm.
|R: Occasional deep wet cough, enhanced bronchovesicular sounds and crackles all areas.
Eupneic to shallow breathing |
|GI: Enlarged abdomen, ballottement does not suggest ascites, liver approximately 2cm from
sternal border, left caudal kidney pole smooth |
|GU: Vulva pink and moist, bladder smooth and roughly 2cm in size.
|LN: Submandibular, prescapular and popliteal LN<1.5cm.|
|Loud systolic heart murmur/Congestive heart failure (historical)/ Positive hepatojugular