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 Diagnosis

Case 2

Primary clinician: Brad Gavaghan, DVM

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

Signalment

bulletMonte is a 13-year-old MC Doberman pinscher weighing 38 kg ("Monte")

Presenting Complaint

bulletCoughing

Pertinent History

bulletThe owner first noticed Monte's coughing and shortness of breath about one and a half months ago.
bulletMonte was seen by the referring DVM for this problem about 6 weeks ago. The referring DVM did a chemistry panel, CBC, ECG, thoracic radiographs, and a cardiac ultrasound. Results are not available.
bulletMonte was put on Lasix 75 mg TID, Tussigon BID, and prednisone 10 mg EOD.
bulletMonte is also on chondroitin sulfate for his arthritis.
bulletBefore starting the Lasix therapy, the owners report that Monte was coughing continuously, and that he would even wake up to cough while sleeping. Now Monte coughs when he lays down, approximately 10 times per day. The coughing lasts for about 15 seconds.
bulletThe owner reports that Monte gets short of breath when he walks, but also sometimes when he is just laying down.
bulletMonte's energy level has been much lower than usual since this problem began.
bulletWhen he was coughing continuously Monte was anorexic. Now his appetite is almost back to normal. 

Physical Examination

bulletT= 100.2, P=180, R= 48. 
bulletBAR. Severe dental calculus. 
bulletThere is bilateral varus of the carpi. He has great difficulty moving and seems painful in all four limbs. The pelvic limbs splay out caudally when the dog attempts to rise.
bulletThere is a II/VI left apical systolic murmur and a regular tachycardia.  Femoral pulses are weak.
bulletInspiratory and expiratory breath sounds are loud in all lung fields.
bulletHepatomegaly; pendulous abdomen with positive ascites wave (a fluid wave can be produced via ballottement).

Problems

bulletCoughing/Tachypnea
bulletWeak femoral pulses
bulletHepatomegaly/Ascites
bulletHeart murmur
bulletTachycardia

 

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