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 ECG 2D Echo M-Mode Color Flow Doppler Liver Diagnosis

Case 11

Primary clinicians: Brad Gavaghan, DVM and Darcy Adin, DVM

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

joey.jpg (25522 bytes)

Signalment

bullet11-year-old male dachshund/terrier cross weighing 11 kg ("Joey")

Presenting Complaint

bulletAscites and Cough

Pertinent History

bulletKoey was diagnosed with cardiomegaly a few years ago and the owner was told to watch for any coughing, wheezing or respiratory distress.
bulletHe started coughing two months ago and was put on furosemide 50mg 1/2 tab SID and enalapril 10mg 1/4-1/2 tab BID.
bulletOne week ago the owner came home from a trip to find the dog's abdomen severely distended.
bulletAfter visiting the referring veterinarian the dosages were changed to furosemide 50 mg 1 tab BID and enalapril 10mg 1/4 tab BID.
bulletThe dog was diagnosed with ascites.
bulletThe dog is still coughing especially when on leash and in the mornings.
bulletNo vomiting or diarrhea.
bulletWas on phenobarbital for seizures but owner discontinued using. During one episode of respiratory distress the owner gave a phenobarbital.
bulletSeems uncomfortable.
bulletEating pasta, Purina kibble, boiled chicken and garlic and occasionally a scrambled egg in the mornings. Seems to be eating well.

Physical Examination

bulletTemp.: 101.2, Pulse: 144, RR: 52
bulletGeneral--BARH, Wt.:11.6kg.
bulletIntegument--Skin clear, no palpable masses.
bulletEENT--Right eye had mucous discharge. No pupillary response, nuclear sclerosis. Nose clear. Ears have a great amount of brown waxy exudate. Tonsils in crypts. Severe dental calculi.
bulletMucous membranes pink, CRT<2sec.
bulletMusculoskeletal--Asymmetry on right parietal region on head. The rest of the body was well muscled and symmetrical. BCS 3/9.
bulletCardiovascular--V/VI left apical systolic murmur. V/VI right apical systolic murmur with palpable thrill. Gallop rhythm. Jugular distension. Positive hepatojugular reflux test. Weak femoral
bulletpulses.
bulletRespiratory--No crackles or wheezes.
bulletGI--Distended fluid-filled abdomen. No organomegaly.
bulletGenitourinary--No secretions.
bulletNervous system--Not evaluated.
bulletLymph nodes--No lymphadenopathy.

Problems

bulletV/VI left apical systolic murmur
bulletV/VI right apical systolic murmur
bulletGallop rhythm
bulletAscites/Jugular vein distension

CHEMISTRY PANEL

bulletANION GAP 17 MM/L
bulletSODIUM 150 MM/L
bulletPOTASSIUM 4.2 MM/L
bulletCHLORIDE 114 MM/L
bulletCO2 TOTAL 23 MM/L
bulletCALCIUM 9.3 MG/DL
bulletPHOSPHORUS 4.3 MG/DL
bulletCREATININE 0.8 MG/DL
bulletUREA NITROGEN 17 MG/DL
bulletALBUMIN 3.1 G/DL
 

 

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