Case Study

Hypertrophic cardiomyopathy in a 1 year old MI DSH cat

A 1-year-old intact male DSH was presented for anorexia over a 1-2 day period. Abnormalities on physical examination included hypothermia, a grade IV/VI systolic murmur, and ataxia. Leukocytosis was present on CBC. On survey radiographs, the intestines appeared to be bunched.

Sonographic Differential Diagnosis

Hypertrophic cardiomyopathy with left sided congestive heart failure and systolic anterior motion/dynamic obstruction. Pleural effusion. Minor potential of FIP.

Image Interpretation

The echocardiogram for this patient presented an enlarged left atrium with a corresponding increased LA/AO ratio. The cranial and caudal mitral valve leaflets demonstrated mildly vegetative contour, yet extension and closure were adequate at this time. Systolic anterior motion of the mitral valve was noted. Minor tricuspid valve insufficiency was noted. Pleural effusion was noted in this patient and considered mild to moderate. Some lung consolidation was noted. Bradyarrhythmia is suspected.

DX

Hypertrophic cardiomyopathy, left sided congestive heart failure. Pleural effusion. Bradyarrhythmia.

Outcome

The patient was lost to follow-up.

Comments

The bradyarrhythmia in this patient was concerning and an electrocardiogram would be warranted. If a sinus rhythm is present then thoracocentesis should be performed with fluid analysis. It is recommended to treat for cardiac disease with heart support and electrocardiogram and blood pressure measurements would also be indicated. Lasix at 2-3 mg/kg b.i.d. until the respiratory rate diminishes. Enalapril at 0.5 mg/kg would also be warranted. A recheck echocardiogram would be warranted in 7-8 weeks in order to refine therapy as once the patient is out of heart failure the necessary medications may change. Guarded prognosis.