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Case 23
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Primary Clinician: Kris
MacDonald, DVM
-
Supervising Clinician: Mark D.
Kittleson, DVM, PhD,
DipACVIM (Cardiology)
Signalment
 | Two-year-old neutered male Labrador retriever weighing 31 kg
("Max") |
Presenting Complaint
| Cough |
Pertinent History
| Max was brought to the referring DVM one week ago for a dry nonproductive cough.
|
| The
referring DVM on physical exam found an irregular heart rhythm and pulse deficits. An ECG revealed tachycardia.
|
| Radiographs revealed severe cardiomegaly. |
| There was apparently an echocardiogram performed, but the owner was not informed
of those results. |
| Max was placed on enalapril 20mg PO BID. The owner also administered one
aspirin a day since he had heard this was a treatment in human heart failure.
|
| A second veterinarian
was consulted and on physical exam he found hepatomegaly, weak femoral pulses, and an
arrhythmia. After reviewing the radiographs and ECG he felt that a further work-up should be
performed and sent Max to the VMTH. |
| Max is a narcotics detection dog in training and leads an active life.
He doesn't seem to have any energy loss or exercise intolerance. He has always
been very thin and is a fastidious eater. His only clinical sign is the dry
nonproductive cough. |
| He is not receiving any medications at this time. |
Physical Examination
| GENERAL: BARH, acts like a healthy 2 year old lab, T=102, P=140, R=panting, Wt=31.2kg |
| INTEGUMENT: Coat clean, salivary staining on all four paws. |
| EARS, EYES, NOSE, THROAT: Eyes - cornea and anterior chamber clear, no discharge. Ears - clean.
Nose - clean and moist, no discharge. Mouth - no tartar or gingivitis |
| MUSCULOSKELETAL: Thin, BCS=4/9 |
| CARDIOVASCULAR: V/VI systolic murmur heard over the right apex; irregularly irregular
arrhythmia; jugular pulses extend 3 inches above the thoracic inlet; mm=pale pink, CRT=1.5s, peripheral pulses poor with
deficits. |
| RESPIRATORY: No crackles or wheezes. Decreased lung sounds ventrally. |
| GASTROINTESTINAL: Moderate hepatomegaly, all other organs within normal limits; no ascites, no masses, gut loops smooth. |
| GENITOURINARY: Intact male; both testicles descended. |
| NERVOUS: Not examined |
| LYMPH NODES: Within normal limits |
Problems
| Systolic heart murmur heard best over right apex |
| Arrhythmia (auscultatory) |
| Jugular pulses |
|
