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Case 4
Primary clinician: Darcy Adin, DVM
Supervising clinician: Mark D. Kittleson,
DVM, PhD,
DipACVIM (Cardiology)
Signalment
 | 10-month-old MC Boxer dog weighing 29 kg ("Yankee") |
Presenting Complaints
| Heart murmur |
| Syncope |
Pertinent History
| Yankee was seen by the referring DVM two weeks ago with the complaint
of fainting spells during active play. PE at referring DVM revealed a grade
3-4/6 left basilar systolic murmur and weak pulses. |
| Treatment was begun and consisted of furosemide 50mg
once a day and atenolol 25mg TID. |
| Two days ago Yankee
suffered another fainting spell during rest and the referring DVM increased
the dose of furosemide to 50mg TID. |
| The owner has been restricting exercise
since then. Indoor at night/outdoor during the day, vaccines current, leash
exercise only at park 3x's/week. |
| No other past medical problems except cryptorchid. Neutered. |
| Diet-Lamb and Rice Pedigree kibble free choice and 1 cup of rice + 1/2
can Pedigree (PM). No c/s/v/d. |
Physical Examination
| T=103.6 (excited), HR=100, RR-pant, BCS-5/9 |
| BARH, well-fleshed, nice coat, no ms abnormalities, no organomegaly,
|
| Lymph Nodes-Left prescapular and popliteal lymph nodes slightly enlarged at
2cm. |
| Lungs auscult clearly. |
| CV: CRT-2 sec, mm-pink, weak femoral pulses, no jugular distension,
Grade 4/6 left basilar systolic murmur with radiation to the right base
and up the carotid arteries. |
Problems
| Syncope |
| Grade IV/VI left basilar systolic murmur |
| Weak femoral pulses |
|
