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 2D Echoes Diagnosis

Case 31

Primary clinician: Brad Gavaghan, DVM

Supervising clinicians: Mark D. Kittleson, DVM, PhD, DipACVIM (Cardiology) and William P. Thomas, DVM, DipACVIM (Cardiology)

Signalment

bullet13-year-old neutered male domestic shorthair cat ("Boris")

Presenting Complaints

bulletEnlarged heart

Pertinent History

bulletBoris presented today for further workup of heart disease diagnosed by the referring veterinarian.
bullet Boris presented to the referring veterinarian for vomiting. The referring veterinarian took thoracic radiographs and found an enlarged heart. He then found a positive heartworm antibody test at 100 AbU/ml.
bulletThe owner also reports lethargy of 3 weeks duration.
bulletThe animal originally presented to the referring veterinarian for urinating outside the litter box and the owners observing one area of urine that was dark brown in color. A urinalysis was performed, but the results are unknown. The animal was started on tetracycline, which was completed yesterday. The owner reports that clinical signs of lethargy and urinating inappropriately have resolved.
bulletThe owners have recently moved back to northern California from Texas. During the year that the owners lived in Texas the cat was not on heartworm preventative.

Physical Examination

bulletWt 4.3 kg, T 100, HR 156, RR 42. BAR hydrated by skin turgor. Full coat; clear skin.
bulletEars free of erythema thickening, discharge. Eyes  - anterior chamber, cornea, conjunctiva clear OU. PLR intact OU. No nasal discharge. Teeth clean.
bulletBS 5/9. Small thyroid nodule palpable.
bulletNormal rhythm, pulses adequate, mm pink, CRT 1 sec. A jugular pulse is present to the level of the angle of the jaw; distension is also present. A soft grade 2/6 sternal systolic heart murmur is present.
bulletInspiratory breath sounds bilaterally dorsally and ventrally.
bulletNo organomegaly or abdominal masses.
bulletBladder smooth.
bulletNE. WNL.

Problems

bulletCardiomegaly with jugular distension/pulsation
bulletPositive heartworm antibody test
bulletDark colored urine

Quiz

Correct Quiz

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