Case Studies In Small Animal

Cardiovascular Medicine

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

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. He was already debarked when they got him. He has always had a soft cough after drinking water. The clients say that there is no rat bait, snail bait or other toxins on their property. Marso 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. He takes a heartworm preventative, but they have missed a pill on occasion. They have one other dog at home who is healthy. Marso is current on his vaccinations. He is eating, drinking, defecating, and urinating normally. There was no coughing or sneezing prior to today. He 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.