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 Echoes Color Flow Doppler Diagnosis

Case 29

Primary Clinician: Gerhard Wess, DVM

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

Signalment

bulletSix-month-old female spayed Domestic Shorthair cat ("Nimbus")

Presenting Complaints

bulletHeart Murmur

Pertinent History

bulletClient obtained cat from shelter one month ago. The shelter obtained the cat in November at 4 months of age. When they received her, she was febrile, lethargic, weak, and had hind-end pain. She was treated with antibiotics and fluids and responded well. Radiographs were taken at that time.
bulletWhen the client obtained Nimbus from the shelter, she took her to her referring veterinarian for an exam and vaccinations. The referring veterinarian interpreted previous rads as showing cardiomegaly and repeated rads, which were again interpreted as showing cardiomegaly. A III/VI systolic murmur was ausculted, and a radiologist performed a cardiac echo three weeks ago that demonstrated congenital heart disease.
bulletUpon presentation to the Cardiology Service today the client reports that the kitten is doing great at home. She is very active with a great appetite, no coughing, intermittent sneezing with no discharge (~10 sneezes/day), no v/d/pu/pd. Occasionally acts like she is trying to bring up after eating dry food (3 occurrences in last month). Owner has not noticed any respiratory difficulties or exercise intolerance.
bulletShe is spayed, and currently due for her third FVRCP vaccine.

Physical Examination

bulletGen: BARH, WT 2.8kg, T 101, P 180, R 40, sniffing
bulletInt: clean full hair coat, no masses, no fleas noted
bulletEENT: eyes: clean, clear, no d/c, no scleral injection. ears: clean. nose: clean, no d/c, three sneezes heard in exam room, no discharge. throat: mm pale pink, permanent dentition, no calculus or gingivitis, nothing under tongue, tonsils not visualized.
bulletMS: lean, well muscled, symmetric, normal gait, BCS 5/9
bulletCV: IV/VI left basilar systolic ejection murmur, strong synchronous femoral pulses, mm pale pink, CRT<1s, no jugular distention or pulses
bulletResp: eupneic, increased bronchovesicular sounds all fields
bulletGI: no masses or organomegaly palpated, smooth bowel loops palpated
bulletGU: smooth kidneys bilaterally, small smooth bladder, no vulvar discharge
bulletN: plr and palpebral intact OU, full exam not performed
bulletLN: mandibular, prescapular, popliteal <5mm

Problems

bulletSystolic heart murmur
bulletUltrasound report of congenital heart disease

 

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