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 Color Flow Doppler Coronary Arteries Angiograms *   Event Recorder Diagnosis

Case 13

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

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bullet1.5 year old female English bulldog weighing 18.6 kg ("Daisy")

Presenting Complaint

bulletHeart Murmur


bulletDaisy was adopted about five months ago at which time the new owners knew she had been previously diagnosed with a heart murmur.
bulletA couple months ago, Daisy had an episode in which the owner described as beginning with a choking-like action followed by Daisy falling into lateral recumbency. Daisy remained unconscious for about one minute without movement or defecation/urination. After regaining consciousness, it took Daisy about a day to fully recover to her normal attitude.
bulletA second episode occurred last week while Daisy was going down some stairs. The owner was following behind and tried to help her get off the stairs at which time her front legs buckled under her and she remained unconscious for less than one minute. After this episode, she seemed to perk up immediately after the episode and seemed unaffected. During this episode, Daisy's tongue went white, her body was cold, and she urinated.
bulletDaisy is fairly active and climbs a long set of stairs to the owner's work everyday without evidence of tiring. She is fed once a day.

Physical Examination

bulletBARH; T=102.4; P=120; R=72; wt=18.6 Kg
bulletSkin clean except for skin fold pyoderma on the nasal region.
bulletThere is a small skin mass in the intrascapular lesion.
bulletTeeth clean, ears clean.
bulletWell-fleshed and symmetrical.
bulletFemoral pulse strong, jugular pulse can be seen about 1/3rd up the neck. A V/VI systolic murmur was ausculted at the left heart base.
bulletStertor was ausculted.
bulletNo abdominal abnormalities were palpated.
bulletMandibular, prescapular, and popliteal lymph nodes were all about 2 cm diameter.


bulletV/VI systolic left basilar heart murmur
bulletSyncopal episodes


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