Case Study

Dilated cardiomyopathy, pulmonary hypertension, and heart failure in a 4 year old Pit Bull mix dog

A 4-year-old Pit Bull mixed breed was presented for evaluation of coughing over a 2-3 week period. Tachycardia was present on physical examination. Survey radiographs showed generalized cardiomegaly and possible pulmonary edema. Blood work and heartworm testing were both normal.

A 4-year-old Pit Bull mixed breed was presented for evaluation of coughing over a 2-3 week period. Tachycardia was present on physical examination. Survey radiographs showed generalized cardiomegaly and possible pulmonary edema. Blood work and heartworm testing were both normal.

Sonographic Differential Diagnosis

Dilated cardiomyopathy with concurrent pulmonary hypertension and both right and left sided congestive heart failure. Mitral insufficiency velocity was 4.2 m/sec. This patient is at risk for sudden death. Taurine level and electrocardiogram would be warranted. Immediate therapy with Lasix at 2-3 mg/kg b.i.d. would be recommended. Ace inhibitor therapy at 0.5 mg/kg s.i.d. progressing to b.i.d. over the next 5-7 days would be recommended as long as renal values remain normal. Pimobendan would be indicated immediately at 0.25 mg/kg b.i.d. Recheck echocardiogram in 3-4 weeks. Potential Sildenafil therapy may be necessary.

Image Interpretation

The cranial and caudal mitral valve leaflets demonstrated mildly vegetative contour. End point to septal separation (EPSS) was excessive consistent with dilated cardiomyopathy. The left ventricle demonstrated mildly excessive volume, and normal to subnormal septal and free wall diastolic thicknesses. Ventricular function was deemed subnormal expressed by the fractional shortening. Significant tricuspid valve insufficiency was noted. This is consistent with pulmonary hypertension.