I would like to refer to a post that I made on June 29, 2016

https://sonopath.com/forum/non-cardiogenic-pulmonary-edema-0

I continued to treat Gnosi with a relatively low dose of furosemide. He stayed stable but his RRR never really dipped much below the high 30’s and most of the time was in the 40’s.

I repeated X-rays and the echo. On follow up exam he did not have a murmur but I was certain he had a gallop rhythm that seemed to resolve as he relaxed.

Radiology summary:

I would like to refer to a post that I made on June 29, 2016

https://sonopath.com/forum/non-cardiogenic-pulmonary-edema-0

I continued to treat Gnosi with a relatively low dose of furosemide. He stayed stable but his RRR never really dipped much below the high 30’s and most of the time was in the 40’s.

I repeated X-rays and the echo. On follow up exam he did not have a murmur but I was certain he had a gallop rhythm that seemed to resolve as he relaxed.

Radiology summary:

Persistent generalized cardimegaly- differential diagnoses in older cats include: thyrotoxic mycardial hypertrophy (Gnosi had a normal T4) and chronic valvular disease

However given the clinical history provided for this animal indiating that no cardiac anormalities were found on echocardiography, this heart may be within normal limits or could have changes secondary to pumonary hypertension secondary to chronic lower airway pathology or feline heartworm disase (Gnosi is negative for HW).

Diffuse bronchial pattern + pulmonary hyperinflation: rule out lower airway pathology (ie feline allergic bronchtiis/asthma, inflammatory lung disease. No sign of pneumonia.Prominent tortuous pulmonary arteries: rule out pulmonary hypertension, possibly secondary to chronic lower airway disease vs feline heartworm disease vs other

I starated Gnosi on Prednisolone base on the most recenent radilogy report and a follow up exam indicated that Gnosi’s resting respiratory rate had dropped into the low 30’s and he was feeling better.

I repeated the echo and I am submitting 2 picutres and 2 cines. I would have sent this as a telemedicine consult- but the owners are tapped out.

Here is what I believe I see:

1. Some mild basilar hypertrophy of the IVS

2. Systolic anterior motion of the anterior mitral valve

3. Enlarged L atrium

Please compare these images to those on June 29.

Any comments would be appreciated