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Case 7
Primary clinician: Darcy Adin, DVM
Supervising clinician: Mark D. Kittleson,
DVM, PhD,
DipACVIM (Cardiology)
Signalment
 | Four-month-old female toy poodle weighing 2.2 kg
("Cindy") |
Presenting Complaint
| Heart murmur/Congenital Heart Disease |
Pertinent History
| Cindy was diagnosed two months ago with severe congenital heart disease but she was too
small to intervene at that time. She has grown a little since that time.
|
| The owner reports
significant worsening of clinical signs. She reports that Cindy is more active
(attempts to play with new puppy) but her shortness of breath is gradually getting worse
such that any activity precipitates dyspneic episodes.
|
| She gags when she drinks water.
|
| She
has no persistent vomiting, diarrhea, coughing or sneezing.
|
| Her appetite is very good, her
urination and drinking are normal in volume/frequency.
|
| Her diet is still Pedigree Puppy
and Nutromax kibble.
|
Physical Examination
| Temperature 101.3, pulse 148, respiration 52. |
| The general physical examination was unremarkable. |
| Cardiovascular/Respiratory examination: Lung sounds unremarkable
bilaterally, though difficult to auscult due to the loudness of the heart
murmur. Femoral pulses moderately strong bilaterally. No jugular pulse noted.
Grade V-VI/VI systolic murmur heard loudest and palpated strongest on the
right, but prominent at the left base as well. Possible split S2. Mucous
membranes are slightly darker than normal, however this is difficult to
evaluate in light of the slight membrane pigmentation. Mucous membranes moist,
with a 1 second capillary refill time. |
ECG
| Heart rate - 100 beats/minute. Normal sinus rhythm. Deep S waves in the left and caudal
limb leads (I, II, III, and aVF) producing a terminal right axis deviation.
The QRS complex duration is normal (0.04 seconds). |
Lab Work
| PCV = 68%; Systemic arterial oxygen tension when breathing 100% oxygen soon after being
anesthetized was 55 mm Hg (normal is greater than 90 mm Hg on room air [21% oxygen] and is
greater than 400 mm Hg when breathing 100% oxygen). |
Quiz
Correct Quiz
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