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 Echocardiogram Tests

Case 27

Primary Clinician: Kris MacDonald, DVM

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


bullet Seven-year-old male Afghan hound weighing 41 kg ("Marso")

Presenting Complaints

bullet Bleeding From Mouth

 Pertinent History

bulletClients found "Marso" at noon standing by their pool bleeding from his mouth (about 1/2 cup). There was also some blood around the back yard. They took him to their veterinarian. He had stopped bleeding by the time they reached the clinic, where he was given a physical exam and referred to the VMTH.
bulletThe clients acquired Marso about 3 years ago as a rescue dog.
bulletHe was already debarked when they got him. He has always had a soft cough after drinking water.
bulletThe clients say that there is no rat bait, snail bait or other toxins on their property.
bulletMarso showed no sign of illness this morning or in the past few days. He has had no illnesses while he has been with the clients.
bulletHe takes a heartworm preventative (lives in Sacramento, CA), but they have missed a pill on occasion.
bulletThey have one other dog at home who is healthy.
bulletMarso is current on his vaccinations.
bulletHe is eating, drinking, defecating, and urinating normally.
bulletThere was no coughing or sneezing prior to today.
bulletHe eats a lamb & rice diet from the grocery store.

Physical Examination

bulletGEN: QAR, no increased skin turgor, BCS=4/9, T=104.0, P=130, R=pant.
bulletINTEG: full shiny coat, no evidence of fleas.
bulletEENT: Ears are clean and not erythematous. Conjunctiva is mildly injected. Cornea and anterior chambers are clear. Unremarkable fundic exam. PLRs direct and consensual are intact. Mucus membranes are injected, CRT<1sec, no oral ulcers, moderate generalized tartar. Nose is wet, black and has no discharge.
bulletMS: No gait abnormalities seen.
bulletCV: No murmurs heard over any region; no arrhythmias; good femoral pulses.
bulletResp: Normal
bulletGI: Mildly fluid-filled gut loops; no organomegaly; no masses; no pain on palpation; clean anus. Rectal exam was unremarkable, except for melena.
bulletGU: No bladder palpated; prepuce clean.
bulletCNS: Not examined
bulletLN: Prominent left prescapular node (2.0cm); all others WNL.


bulletHistorical bleeding from the mouth/Melena

Laboratory Data

bulletCBC - Hematocrit = 51%; WBC = 13,300/uL (Neutrophils = 11,200; Lymphocytes = 1,584/uL; Monocytes = 264/uL; Eosinophils = 132/uL); Platelets = 237,000/uL
bulletChemistry Panel - All values within normal limits
bulletCoagulation Panel - All values within normal limits
bulletArterial blood gas: PCO2 = 29.8 mmHg; PO2 = 91.5 mmHg


Correct Quiz

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