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 Echoes Color Flow Doppler Diagnosis

Case 29

Primary Clinician: Gerhard Wess, DVM

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

Signalment

bulletSix-month-old female spayed Domestic Shorthair cat ("Nimbus")

Presenting Complaints

bulletHeart Murmur

Pertinent History

bulletClient obtained cat from shelter one month ago. The shelter obtained the cat in November at 4 months of age. When they received her, she was febrile, lethargic, weak, and had hind-end pain. She was treated with antibiotics and fluids and responded well. Radiographs were taken at that time.
bulletWhen the client obtained Nimbus from the shelter, she took her to her referring veterinarian for an exam and vaccinations. The referring veterinarian interpreted previous rads as showing cardiomegaly and repeated rads, which were again interpreted as showing cardiomegaly. A III/VI systolic murmur was ausculted, and a radiologist performed a cardiac echo three weeks ago that demonstrated congenital heart disease.
bulletUpon presentation to the Cardiology Service today the client reports that the kitten is doing great at home. She is very active with a great appetite, no coughing, intermittent sneezing with no discharge (~10 sneezes/day), no v/d/pu/pd. Occasionally acts like she is trying to bring up after eating dry food (3 occurrences in last month). Owner has not noticed any respiratory difficulties or exercise intolerance.
bulletShe is spayed, and currently due for her third FVRCP vaccine.

Physical Examination

bulletGen: BARH, WT 2.8kg, T 101, P 180, R 40, sniffing
bulletInt: clean full hair coat, no masses, no fleas noted
bulletEENT: eyes: clean, clear, no d/c, no scleral injection. ears: clean. nose: clean, no d/c, three sneezes heard in exam room, no discharge. throat: mm pale pink, permanent dentition, no calculus or gingivitis, nothing under tongue, tonsils not visualized.
bulletMS: lean, well muscled, symmetric, normal gait, BCS 5/9
bulletCV: IV/VI left basilar systolic ejection murmur, strong synchronous femoral pulses, mm pale pink, CRT<1s, no jugular distention or pulses
bulletResp: eupneic, increased bronchovesicular sounds all fields
bulletGI: no masses or organomegaly palpated, smooth bowel loops palpated
bulletGU: smooth kidneys bilaterally, small smooth bladder, no vulvar discharge
bulletN: plr and palpebral intact OU, full exam not performed
bulletLN: mandibular, prescapular, popliteal <5mm

Problems

bulletSystolic heart murmur
bulletUltrasound report of congenital heart disease

 

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