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 Diagnosis

Case 21

Primary Clinician: Darcy Adin, DVM

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

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Signalment

10-year-old MC domestic shorthair cat weighing 4.9 kg ("Freckles")

Presenting Complaints

Paralyzed

Pertinent History

bulletOwner noticed that Freckles was not getting off the bed this evening. When owner returned from the shower, Freckles was still lying there.
bulletOwner felt his back paws and thought they felt cold. She then looked at his gums and they appeared pale.
bulletOwner took Freckles to referring DVM where he was diagnosed with a saddle thrombus.
bulletThoracic radiographs taken at the referring DVM revealed an enlarged cardiac silhouette.
bulletFreckles is an indoor only cat with a history of flea allergy dermatitis.
bulletHe lives with one other cat. He eats Bumble Bee tuna.
bulletThe owner inherited Freckles from her father.

Physical Examination

bulletQAR-H. T=98.7 P=190 R=30 Wt= 5.6kg
bulletINT: Full and clear coat. No areas of alopecia except for shaved region on ventral thorax.
bulletEENT: Clear (cornea, anterior chamber, lens, conjunctiva) and no discharge OU. Ears clean
bulletand not malodorous. No nasal discharge. mm=pale pink CRT = 2 sec. Mild tartar on premolars and molars bilaterally.
bulletMS: BCS 6/9; No muscle atrophy. Contracture of gastrocnemius muscle bellies. Pelvic paws cold to the touch. Nail beds and pads cyanotic. Paretic. Tail does not have voluntary
bulletmovement, however hind limbs do.
bulletCV: grade 2/6 heart murmur heard best at left apex (sternum) and gallop rhythm ausculted. No femoral pulses palpable bilaterally.
bulletResp: Mild tachypnea. Clear breath sounds bilaterally. No wheezes or crackles ausculted. However, Freckles became stressed during the examination and became more tachypneic and
bulletmoderately dyspneic.
bulletGI/GU: Irregular surface to the kidneys. No abdominal masses or organomegaly. No penile discharge.
bulletNeuro: Paraparetic. Decreased tail tone.
bulletNo peripheral lymphadenopathy.

Problems

bulletGrade 2/6 heart murmur; gallop sound (rhythm); tachypnea/dyspnea
bulletRear limb paresis with absent femoral pulses, cold limbs, and cyanotic nail beds and pads (probable saddle thromboembolus)

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