Sonopath Forum

2nd degree AV block in 11 yr old FS pitbull

11 yr old FS pitbull presented for mast cell tumor removal on dorsum
Patient had a collapsing episode in the clinic (fell down and urinated)
ECG showed 2nd degree AV block
Echocardiogram shows normal cardiac measurements, trace MVI, small TVI with velocity of 2.8m/s. No masses or effusions are seen. Concurrently run ECG shows 2nd degree block
Rule outs include AV node fibrosis, myocarditis, electrolyte imbalance, vagal stimulation, and benign (assuming that collapse episode was unrelated).

11 yr old FS pitbull presented for mast cell tumor removal on dorsum
Patient had a collapsing episode in the clinic (fell down and urinated)
ECG showed 2nd degree AV block
Echocardiogram shows normal cardiac measurements, trace MVI, small TVI with velocity of 2.8m/s. No masses or effusions are seen. Concurrently run ECG shows 2nd degree block
Rule outs include AV node fibrosis, myocarditis, electrolyte imbalance, vagal stimulation, and benign (assuming that collapse episode was unrelated).
Not sure if they will agree to cardiology consult. I have also recommended chest rads and bloodwork. Any suggestions for premends/anesthetic choice, and treatment if any for this ECG abnormality?

Comments

Peter

July 1, 2020 at 6:20 pm -

Hi!
My suggestions:
.) record

Hi!

My suggestions:

.) record an ECG, see what type of AV Block II it is (increasing PQ-Intervals or constant PQ-intervals) and to check the degree of the AV Block II high-grade/low grade

.) as the patient is attached to the ECG, perform an Atropine-response test (0,04 mg/kg Atropine IM or IV) – see if the AV-Block disappears within 5-10 min. If it does, it is caused by an increased vagal tone

.) if the AV-Block responses to Atropine – add Atropine to premedication and keep Atropine ready at hand during anesthesia

.) If the AV-Block does not diseappear after Atropine, lots of different DD come into play (as you mentioned: fibrosis, degeneration, inflammation, neoplastic infiltration, …). In this case you should have a possibility to pace the patient during anesthesia if required (external, better internal), particularly, if it’s a high grade AV-Block II

.) NEVER use alpha-2-agonists in these guys!!!

Thanks for posting and regards from Austria!

Peter