A 13-year-old NM Japanese Chin was presented for heart failure and hemoptysis. Therapy had been furosemide and Benazepril.
A 13-year-old NM Japanese Chin was presented for heart failure and hemoptysis. Therapy had been furosemide and Benazepril.
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A 13-year-old NM Japanese Chin was presented for heart failure and hemoptysis. Therapy had been furosemide and Benazepril.
A 13-year-old NM Japanese Chin was presented for heart failure and hemoptysis. Therapy had been furosemide and Benazepril.
This is a case of severe mitral valve degeneration with chordae rupture causing severe MI. Even though the left atrium is not as large as expected this does not argue against CHF. The reason is that chordae rupture occurs often very acutely and leads to pulmonary edema before the left atrium has the time to enlarge. That could also be the reason for the pulmonary hypertension noted. To rule out any other concomitant cause for this kind of coughing (bloody) it is recommended to take radiographs in two directions. Based on these data I would start with triple therapy (Furosemide, ACEI, Pimobendan). In case of acute PE I often hospitalize the patient and administer Oxygen and Furosemide as a CRI at 1 mg/kg/h. This works very well. At discharge I continue Furosemide at least 2 mg/kg t.i.d. The dosage can then be adjusted based on radiographs.
Volume overloaded left ventricle, a moderately enlarged left atrium, a severely thickened mitral valve with the anterior leaflet severely prolapsing into the left atrium due to chordae rupture. The right ventricle and atrium are normal sized. CDI reveals severe mitral regurgitation. Flows across the LVOT and RVOT are normal in terms of velocity and flow profile. There is mild tricuspid insufficiency present; the velocity of the regurgitant jet indicates mild pulmonary hypertension. I cannot see any shut or tumor, pericardial effusion is not present in this case.
Cardiac – progressive mitral valve disease (endocardiosis/vegetative endocarditis), ruptured chordae tendinae), left atrial embolus, end-stage heart failure Pulmonary – non-cardiac pulmonary edema, embolic disease, ARDS, neoplasia, trauma, rodenticide toxicity
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