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

ECG Radiographs 2D Echo More Echoes Therapy

Case 24

Primary Clinicians: Darcy Adin, DVM & Chris Adin, DVM

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

Signalment

bulletSix-year-old neutered male Doberman Pinscher ("Nitro")

Presenting Complaints

bulletVomiting

Pertinent History

bulletNitro was treated for pancreatitis by the referring DVM last week. He received fluids and Baytril. He recovered and was getting better when he started vomiting the last few days.
bulletThe owner thinks that maybe he introduced the regular dog food too soon and should have kept him on cottage cheese and rice longer.
bulletYesterday he began vomiting more and became very lethargic. He was taken to the referring DVM. Because the heart sounds were muffled, chest x-rays were taken which showed an enlarged cardiac silhouette.
bulletThe referring DVM gave him 1L Lactated Ringer's Solution IV and Nitro improved although he still appeared slightly shocky.
bulletHe was referred to the VMTH.
bulletBlood work was done last week. The owner said the white cell count was elevated and the liver enzymes showed evidence of toxicity. 

Physical Examination

bulletGeneral: QAR, moderately dehydrated, presents in sternal recumbency, reluctant/unable to stand.
bulletHR=200, RR= 30 
bulletIntegument: Full coat, somewhat dry. No cutaneous masses.
bulletEENT: Eyes--clear, Ears--clean, tonsils in crypts. 
bulletMusculature: well muscled, BCS 6/9 
bulletCardiovascular: Mm pale; muffled heart sounds; pulses decrease on inspiration and increase on expiration; no murmur ausculted; rhythm is regular but tachycardic; jugular vein distension noted. 
bulletRespiratory: lungs clear in all fields
bulletGI/GU: no ascites appreciated; smooth gut loops; no palpable masses. Kidneys/bladder not palpable. 
bulletNo peripheral lymphadenopathy.

Problems

bulletAbnormal pulses 
bulletMuffled heart sounds 
bulletJugular vein distension
bulletTachycardia
bullet 2-3/6 systolic heart murmur 

Quiz 

Correct Quiz

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