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Case 6
Primary clinician: Darcy Adin, DVM
Supervising clinician: Mark D. Kittleson,
DVM, PhD,
DipACVIM (Cardiology)
Signalment
 | Seven-year-old FS domestic shorthair weighing 4.4 kg
("Nastasia") |
Presenting Complaint
| Cyanosis |
Pertinent History
| Nastasia was first seen at the VMTH seven years ago and a tentative diagnosis of ventricular septal defect with pulmonic stenosis or pulmonary hypertension was made. Thoracic radiographs showed cardiomegaly with enlargement of the main pulmonary artery. Color flow Doppler was not available at that time and a definitive diagnosis could not be made. |
| Nastasia presented today as the owner has moved and can no longer keep the cat and was not able to locate another owner and so brought her here as a last resort.
|
| She was hit by a car when 1 year of age, and the owner believes she may have had broken facial bones. She completely recovered from the incident.
|
| Nastasia is an indoor/outdoor cat and is not on any medications at this
time.
|
| She has almost daily episodes of dyspnea which last 3-5 minutes, after
which she is normal. The episodes appear to be initiated by excessive
attention from the owner. The owner states that she has always had these
episodes and they have not gotten worse.
|
| No syncope. No other problems, except for occasional hairball
associated vomiting every 1-2 months.
|
| Diet is kibble and canned "fishy" foods.
|
| She is a "nervous" cat and is not good with children or dogs.
|
| However, she is very photogenic and has learned to pose for the camera
(see above).
|
| Vaccines are current.
|
Physical Examination
| T=102.4, P=180, R=48. |
| BARH. Clean skin with full hair coat. |
| Eyes- incomplete PLR (nervous), anterior chambers clear, no scleral injection.
|
| Ears-clean. |
| Mouth- mm pale pink, mild calculus on PM and M's, no oral masses.
|
| Nose appears faintly cyanotic (see above picture). CRT 1 sec. |
| BCS 5/9, symmetrical musculature. |
| Grade 2/6 left sided sternal systolic murmur (difficult to auscult due to constant purring).
|
| Tachypneic, slight abdominal effort upon breathing, "cooing like sound" audible. Breath sounds ausculted bilaterally.
|
| Smooth gut loops, left kidney smooth. No abdominal masses or organomegaly. Small bladder palpated. |
Problems
| Grade 2/6 left sided systolic murmur with history of congenital heart disease |
| Generalized cyanosis |
ECG
| ECG revealed occasional PVCs and a right-axis shift. |
Lab work
| PCV-49%, |
| TP- 8.2 gm/dl |
|
