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 Echoes Diagnosis

Case 36

Primary Clinicians: Patrizia Knafelz, DVM

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

Signalment

bulletTen-year-old intact female Maine coon cat ("Newman")

Presenting Complaints

bulletHistory of systemic thromboembolism

Pertinent History

bulletNewman was referred to the VMTH Emergency Service three days ago after his veterinarian diagnosed a partial saddle aortic thromboembolus. Three days ago he was knuckling his right hind leg and dragging it. The right caudal foot was cool and the femoral pulse was weak in this leg. He is back for a recheck examination today. The client says the foot has now warmed up and Newman is walking better, although his right hind leg has been stiff.
bulletA murmur was first noted 3 months ago by a veterinarian in Pennsylvania.
bulletNewman has seemed less active for the last couple of weeks. He has panted when stressed (at veterinarian's office; after bath) for a long time. He has never been seen panting after exercise. No coughing.
bulletNo other known problems. No surgery since neuter. Vaccinated for travel in April.
bulletTRAVEL: Newman has lived in Portland and Spokane. He has been in Philadelphia for the last four years and recently moved to Fairfield, CA.
bulletENVIRONMENT: He lives with one other cat (Newman's brother) and one dog - both healthy. Cats are mostly outdoors.
bulletDIET: Science Diet hairball adult. Recently some wet food.
bulletNo C/S/V/D/PU/PD.

Physical Examination

bulletGEN: BAR, hydrated by skin turgor. T=102.5, HR=220, RR=72. Wt=6.1kg.
bulletINT: Full coat, no masses or lesions noted. Small amount of flea dirt.
bulletEENT: Ears: Mild wax. Eyes: Sclera, cornea and anterior chamber clear, no discharge. Nose: No discharge. Mouth: mm pink, CRT~1sec. Mild tartar.
bulletMS: Symmetric musculature, BCS 6/9. Ambulatory x 4. No knuckling. Walk is symmetric; hind feet stay very close to floor during walk. Able to jump to counter easily.
bulletCV: III-IV/VI left apical systolic murmur. No arrhythmia ausculted. Femoral pulses strong and synchronous.
bulletRESP: No crackles or wheezes ausculted.
bulletGI: Bowel loops smooth with no thickening. No masses or organomegaly palpated.
bulletGU: No discharge.
bulletNS: Grossly normal; full neuro exam not performed.
bulletLN: Axillary LNs~1cm, popliteal~1.5cm.

Problem List

bulletSystolic heart murmur
bulletHistory compatible with the presence of a thromboembolus to the right hind leg

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