Dear all, I would appreciate your input in this case.

10y old MN CKC.

In March 2016 was presented for echocardio to investigate degree of MVD. At this point, mild bouts of nocturnal coughing reported. EXam grade 4 systolic murmur. Xrays:no obvious signs of pulm edema. VHS:11.75

Dear all, I would appreciate your input in this case.

10y old MN CKC.

In March 2016 was presented for echocardio to investigate degree of MVD. At this point, mild bouts of nocturnal coughing reported. EXam grade 4 systolic murmur. Xrays:no obvious signs of pulm edema. VHS:11.75

Echo showed moderate MR (5.2m/s approx). mild to moderate LA enlargement (1.8 LA/Ao ratio) and LV diast dilation. After this, no medical treatment was initiated, intstead, heart supportive prescription diet and supplement with Co-Q10 and home monitoring of SRR (owner not clear about whether cough was present or not).

July 2016: echocardio and findings are similar. Very similar in M-Mode and MR readings. See pics below. Question is, SRR has been recorded and is between 25-30 consistently over weeks. Occasional cough. Changed to Metabolic Hills diet for gradual weight loss.

Question: I do not have the E wave readings, but going to the MR pictures, is it possible to estimate the value of E wave from that-approx 1m/s? I understand it would be mildly underestimated. Also, from previous scan, it appeared to me that LA and LV dilation was mild to moderate but FS is still good. I had suggested starting medical treatment from previous scan but it was decided against it by vet in charge of case due to lack of consistent symptoms. Is my grading correct? Can we use any of the parameters from the echo to decide whether medicine is adviced? Like E wave peak velocity?nI know is the eternal question, but may be I am missing something from the exam that is really important…

With the occasional cough and the slightly high SRR (less than 30 but surely not below 20), I would at least do a furosemide trial…

Thanks for any input