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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?

Electrocute

One response to “2nd degree AV block in 11 yr old FS pitbull”

  1. 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

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