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Case 2
Primary clinician: Brad
Gavaghan, DVM
Supervising clinician: Mark D. Kittleson,
DVM, PhD, DipACVIM (Cardiology)
Signalment
 | Monte is a 13-year-old MC Doberman pinscher weighing 38 kg
("Monte") |
Presenting Complaint
| Coughing |
Pertinent History
| The owner first noticed Monte's coughing and shortness of breath about
one and a half months ago. |
| Monte was seen by the referring DVM for this problem about 6 weeks ago.
The referring DVM did a chemistry panel, CBC, ECG, thoracic radiographs, and a
cardiac ultrasound. Results are not available. |
| Monte was put on Lasix 75 mg TID, Tussigon BID, and prednisone 10 mg
EOD. |
| Monte is also on chondroitin sulfate for his arthritis. |
| Before starting the Lasix therapy, the owners report that Monte was
coughing continuously, and that he would even wake up to cough while sleeping.
Now Monte coughs when he lays down, approximately 10 times per day. The
coughing lasts for about 15 seconds. |
| The owner reports that Monte gets short of breath when he walks, but
also sometimes when he is just laying down. |
| Monte's energy level has been much lower than usual since this problem
began. |
| When he was coughing continuously Monte was anorexic. Now his appetite
is almost back to normal.
|
Physical Examination
| T= 100.2, P=180, R= 48. |
| BAR. Severe dental calculus. |
| There is bilateral varus of the carpi. He has great difficulty moving
and seems painful in all four limbs. The pelvic limbs splay out caudally when
the dog attempts to rise. |
| There is a II/VI left apical systolic murmur and a regular tachycardia.
Femoral pulses are weak. |
| Inspiratory and expiratory breath sounds are loud in all lung fields.
|
| Hepatomegaly; pendulous abdomen with positive ascites wave (a fluid
wave can be produced via ballottement). |
Problems
| Coughing/Tachypnea |
| Weak femoral pulses |
| Hepatomegaly/Ascites |
| Heart murmur |
| Tachycardia |
|
