Hello
Rex is a 10 year old boxer that presented to their regular vet for wt loss, excercise intolerance and edema around the hind legs.
They referred to us for an echo.
The Right side of the heart appears enlarged and there is a “stelate” hyperechoic pattern within the Rt ventricle extending from the IVS. I had a recent case that was thought to have a heart tumor. This is similar but has a strange odd appearence.
Dog has a significant MR regurge with moderate TR regurge.
Hello
Rex is a 10 year old boxer that presented to their regular vet for wt loss, excercise intolerance and edema around the hind legs.
They referred to us for an echo.
The Right side of the heart appears enlarged and there is a “stelate” hyperechoic pattern within the Rt ventricle extending from the IVS. I had a recent case that was thought to have a heart tumor. This is similar but has a strange odd appearence.
Dog has a significant MR regurge with moderate TR regurge.
Because of EL’s previous reccomendations to search the abdomen we performed a complimentary abdominal US and found what appears to be one liver lobe that is irregular and nodular with a heterogenous appearence. Had difficulty tracing the mass to the liver as I would lose the image. Was on a tight time schedule with my kids destroying the clinic so I would have needed to try standing him or rolling him to complete the abdominal ultrasound but the mass appeared to be between the Rt kidney and liver. In contact with the Rt kidney.
The majority of the liver appears normal and homogenous and shows no venous congestion. There is a moderate amount of free abdominal fluid.
The edema in the hind legs goes along more with cancer than heart disease but I was hoping I could get a comment on the heart images.
Thanks. Brent
Comments
To me the right ventricular
To me the right ventricular outflow tract is very dilated when compared to the aorta in cine loop 1. They describe trabeculation extending from the R vetnricular wall in cases of Arrhymogenic Right Ventricular Cardiomyopathy. I guess I would not totally rule out right sided CHF in this dog.
Often with ARVC the left side of the heart functions normally.
Any indication of hepatic venous congestion?- sorry I see you already ansered that question. Does make R sided CHF less likely.
Any arrhythmias?
We can wait and see what the experts say.
No obvious arrythmias!
Dog is
No obvious arrythmias!
Dog is cold but we do not have chest X-rays due to cost at this point but does not sound wet. Definitely had heart disease symptoms. Temp was 37.1’C.
Brent –
Thanks for your
Brent –
Thanks for your post!
This does not look like a cardiac tumor to me, although they can sometimes be small and could be missed on the images provided. There is right heart enlargement visible. But based on the SAX on the level of the ventricles it does not seem severe enough to cause right heart failure. Usually those dogs show septal flattening. And I have never seen a dog with edema of the hind limbs due to cardiac disease who did not have ascites at the same time. How was the caudal vena cava? Was it enlarged? Did it change its diameter with respiration? Was the liver enlarged?
The right heart enlargement could be caused by Volume overload (Tricuspid regurgitation, severe pulmonary insufficiency, ASD, ARVC) or acute pressure overload (acute pulmonary hypertension).
Could you post a few other views? (right long axis 4-chamber, apical)? This would be very helpful.
Best regards!
Peter
Hello. I posted more
Hello. I posted more images.
I was hoping for a comment on the hyperechoic spider web like pattern in the Rt ventricle. Can be best seen on the 3rd Short-axis view posted.
I tried posting images of the liver area but for some reason they will not save.
The liver does not appear enlarged and there is ascites present. d
Thanks. Brent.
The last video post is of the
The last video post is of the liver. Thanks again.
They look like separate
They look like separate issues to me.. TV disease and separate liver mass.
Sorry. Initially started with
Sorry. Initially started with 3 videos. My apologies!
I was wondering what your
I was wondering what your thoughts are on the hyperechoic area in the right ventricle on the 3rd short-axis view that was initially posted? I’ve researched it but cannot find anything similar.
Thanks. Brent
If that linear structure in
If that linear structure in the lumen is what you are referring to that’s a papillary muscle or chordae you are catching in chrot axis in the 3rd video.
I tried to state in my post
I tried to state in my post that sometimes “trabeculations” are noted coming from the right ventricular wall. I am attaching an image I downloaded from the web that shows an example of these “trabeculations”. I don’t know that we are seeing in the second and third cine loop – but I wanted to at least throw it out there for consideration and discussion.
Thanks Randy. Appreciate the
Thanks Randy. Appreciate the comments