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 Echo Diagnosis

Case 21

Primary Clinician: Darcy Adin, DVM

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

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Signalment

10-year-old MC domestic shorthair cat weighing 4.9 kg ("Freckles")

Presenting Complaints

Paralyzed

Pertinent History

bulletOwner noticed that Freckles was not getting off the bed this evening. When owner returned from the shower, Freckles was still lying there.
bulletOwner felt his back paws and thought they felt cold. She then looked at his gums and they appeared pale.
bulletOwner took Freckles to referring DVM where he was diagnosed with a saddle thrombus.
bulletThoracic radiographs taken at the referring DVM revealed an enlarged cardiac silhouette.
bulletFreckles is an indoor only cat with a history of flea allergy dermatitis.
bulletHe lives with one other cat. He eats Bumble Bee tuna.
bulletThe owner inherited Freckles from her father.

Physical Examination

bulletQAR-H. T=98.7 P=190 R=30 Wt= 5.6kg
bulletINT: Full and clear coat. No areas of alopecia except for shaved region on ventral thorax.
bulletEENT: Clear (cornea, anterior chamber, lens, conjunctiva) and no discharge OU. Ears clean
bulletand not malodorous. No nasal discharge. mm=pale pink CRT = 2 sec. Mild tartar on premolars and molars bilaterally.
bulletMS: BCS 6/9; No muscle atrophy. Contracture of gastrocnemius muscle bellies. Pelvic paws cold to the touch. Nail beds and pads cyanotic. Paretic. Tail does not have voluntary
bulletmovement, however hind limbs do.
bulletCV: grade 2/6 heart murmur heard best at left apex (sternum) and gallop rhythm ausculted. No femoral pulses palpable bilaterally.
bulletResp: Mild tachypnea. Clear breath sounds bilaterally. No wheezes or crackles ausculted. However, Freckles became stressed during the examination and became more tachypneic and
bulletmoderately dyspneic.
bulletGI/GU: Irregular surface to the kidneys. No abdominal masses or organomegaly. No penile discharge.
bulletNeuro: Paraparetic. Decreased tail tone.
bulletNo peripheral lymphadenopathy.

Problems

bulletGrade 2/6 heart murmur; gallop sound (rhythm); tachypnea/dyspnea
bulletRear limb paresis with absent femoral pulses, cold limbs, and cyanotic nail beds and pads (probable saddle thromboembolus)

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