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MVD with SAM or SAS in a puppy

Sonopath Forum

Sonopath Forum

MVD with SAM or SAS in a puppy

Hi everyone,

Just wanted to get an opinion on this case. 9 week old, entire male Wesh terrier with grade 5 heart murmur. Puppy is asymptomatic however, he is the runt of the litter. Puppy is also tachycardic where heart rate measured at least 200 bpm.

There was concentric hypertrophy of the LV . The mitral valve appeared thickend and irregular. There is also evidence of SAM.

I know SAM is quite rare in a dog and was wanting to know what you think(based on the images and video) Shouldn’t we expect a ‘knife point’ spectral Doppler if there is SAM??

Hi everyone,

Just wanted to get an opinion on this case. 9 week old, entire male Wesh terrier with grade 5 heart murmur. Puppy is asymptomatic however, he is the runt of the litter. Puppy is also tachycardic where heart rate measured at least 200 bpm.

There was concentric hypertrophy of the LV . The mitral valve appeared thickend and irregular. There is also evidence of SAM.

I know SAM is quite rare in a dog and was wanting to know what you think(based on the images and video) Shouldn’t we expect a ‘knife point’ spectral Doppler if there is SAM??

I could not see any fibrous nodules to suggest Subaortic stenosis or aortic insufficiency. However, can you rule it out??

Are we leaning more towards MVD given the presence of SAM? Would atenolol help us differentiate if this dog has SAS or MVD??

 

Comments

Peter
October 11, 2018 at 6:52 pm -

Yes, I see SAM here. It can

Yes, I see SAM here. It can be seen in cases with extreme sympathetic tone (young dogs), sometimes with LV underload (decreased preload) and with mitral dysplasia. The high heart rate makes the interpretation of 2D-images almost impossible. 

I would re-scan the dog in 2-3 months and administer butorphanol first in order to get the HR down. I have see cases where SAM disappeared and the LV disappeared as well (without Atenolol). Atenolol can be tried but not if the LV is underfilled (dehydration). 

Peter

lookpris
October 13, 2018 at 6:30 am -

thanks peter! this echo was

thanks peter! this echo was done under 0.2mg/kg butorphanol and 0.01mg/kg acepromazine. knocked the dog out!

because it is a breeder puppy, the breeder couldn’t afford to refer it to a cardiologist:( puppy is most likely going to be put to sleep…

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