Acute collapse and tachyarrhythmia in a 9 year old FS Golden Retriever


  • 9 yr old FS Golden Retriever presented for acute collapse during a walk.  The dog had additional syncope like episodes at the clinic.  A tachyarrhythmia was ausculted that ranged from 150bpm to runs of 240bpm.  ECG showed runs of tachycardia with no PVC’s (per primary DVM). No abdominal pain present.  The owner reported normal appetite with no vomiting or wretching.
    • 9 yr old FS Golden Retriever presented for acute collapse during a walk.  The dog had additional syncope like episodes at the clinic.  A tachyarrhythmia was ausculted that ranged from 150bpm to runs of 240bpm.  ECG showed runs of tachycardia with no PVC’s (per primary DVM). No abdominal pain present.  The owner reported normal appetite with no vomiting or wretching.
    • Chem prof showed mildly elevated liver enzymes (ALP=200) and mild phosphotemia.  CBC showed a mild leukoctyosis with no anemia.  Chest radiographs appeared normal.  Abdominal rads showed a mild to moderately gas filled stomach (aerophagia) and hepatomegaly.
    • Echo showed normal cardiac measurements with no visible masses or effusions.  LA=31, Ao=23, LA/Ao=1.4, IVSd=12.8, LVIDd=36.5, LVPWd=12.3, IVSs=16.5, LVIDs=24.5, LVPWs=16.1, FS=33%.  HR=160-180bpm
    • Abdominal US showed lacey and nodular hepatic parenchyma with a hypoechoic nodule on the left side.  The spleen was in normal position and had normal color flow Doppler.  There were no visible abdominal effusions.
    • I am wondering if the cause of this dog’s tachycardia and syncopal episodes is  primary cardiac disease or secondary to other systemic disease.  I always think HSA with acute collapsing Golden but cannot find evidence to support that in this dog.  Could there be a small cardiac mass in the heart causing the arrhythmia?  Could the liver pathology be causing the arrhythmia?  Rads did not show any evidence of GDV and the dog has no GI signs.  I have never seen a liver lobe torsion but the liver enzymes were only mildly elevated, there was no effusion, no obvious abdominal pain and no GI signs.  Excessive panting prevented adequate Doppler study.  I will try to get a copy of the ECG.
    • What else should be on the rule out list?

7 responses to “Acute collapse and tachyarrhythmia in a 9 year old FS Golden Retriever”

  1. The heart structurally seems

    The heart structurally seems fine and good contractility and obscure cardiac masses that aren visible dont typically cause an issue unless they are bleeding causing tamponade or obstructing inflow or outflow… which you would typically see. The lacey liver appearance may be hyperplasia or possibly lsa so a shopping spree of fna liver +/- spleen would be the place to start and run a BP as hypertensive crises can cause collapse and of course image the adrenals well if not done already. Then go to a holter moniotr (we have thse with cardiologist review if needed just email info@sonopath.com or call the 800 838 4268) or event monitor to check for 24 hour or paroxysmal arrythmias that you may not be picking up on your short strip. Chest rads for surprises… ensure not an orthopedic collapse too.

  2. Thanks Eric. The dog is not

    Thanks Eric. The dog is not anemic, had a CRT<1.0sec, and platelets were in the 200,000’s.  Blood pressure measurements were 132/105 with a MAP=118. The chest rads were nonremarkable.  The abdominal rads showed a gas filled stomach and hepatomegaly. I am trying to get ahold of the ECG…it was stored on the associate’s phone who was no longer present. The adrenals were normal. The dog was in moderate distress so I can’t help but feel I am missing something here.  The acute onset of the tachyarrhythmia and collapse makes me feel like I should be seeing something on ultrasound but other than the liver pathology, I just don’t.    I cannot connect the liver pathology to the tachycardia and collapse unlesss I am missing something like a torsion.  I will pass on your recommendations to the client.

  3. There are lots of

    There are lots of arrhythmegnic episodes out there with normal cardiac structure and function until the arrhythmia hits… hence the need for ambulatory ecg

  4. Hi Melissa
    I had one of these

    Hi Melissa
    I had one of these this week. Wicked tachyarrhythmia and dog just ADR. Ab ultrasound/ chest rads normal. Sent ECG and Echo to a cardiologist as I could’nt find structural disease either. One of the DVMs while holding the dog thought she felt a thyroid mass. It was actually a lipoma in the skin but I did look at the thyroid and found a decent sized mass fairly vascularized on Doppler with a cystic core. Cytology came back as blood only but I am suspicious for possible thyroid carcinoma. T4 was normal. Owner going no further and we are trying to control the arrhythmia with meds. Not sure if thyroid mass is incidental or not?

  5. Another DDx would be acute

    Another DDx would be acute infectious myocarditis or myocardial ischemia/infarction. Considering running cardiac troponin.

  6. Even thought the Adrenals

    Even thought the Adrenals imaged OK I would still not RI/RO a Pheo:

    From VIN Associate:

    Pheochromocytoma is a catecholamine-producing tumor derived from the chromaffin cells of the adrenal medulla. Chromaffin cells are also found associated with sympathetic ganglia located in the neck, mediastinum, pelvis, urinary bladder, and along the aorta. Paragangliomas are pheochromocytomas not associated with the adrenal gland. Pheochromocytomas should be considered malignant until proven otherwise. 1-6

    A cardiac Consult would be a good idea. Consider Dr Olson or U of M or Dr Stauthammer

  7. Thanks Randy.  Very

    Thanks Randy.  Very interesting.  I did recommend a cardiac consult which the client declined.  I am not sure if pheo is still a differential since the patient was not hypertensive.  BP measurements were taken while the patient was symptomatic.  I called for an update but the doctor in charge of the case is out until Monday.  So it looks like I am going to be in suspense for a while.  For a long while if the client does not puruse anything further….

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