Case Study

15_00061 Annie N MI, TI, LAE

A 10-year-old FS Boston terrier was presented for evaluation of progressive coughing that had worsened over the last month. On physical examination grade IV/VI murmur and pulmonary crackles were present. Therapy with furosemide, Clavamox, Vetmedin, Enalapril, and aminophylline resulted in some improvement.

A 10-year-old FS Boston terrier was presented for evaluation of progressive coughing that had worsened over the last month. On physical examination grade IV/VI murmur and pulmonary crackles were present. Therapy with furosemide, Clavamox, Vetmedin, Enalapril, and aminophylline resulted in some improvement.

Sonographic Differential Diagnosis

Mitral and tricuspid insufficiency. Vegetative endocardiosis. Prolapsing mitral and tricuspid valves. Severe mitral insufficiency. Mild tricuspid insufficiency. Persistent left atrial enlargement. This is consistent with stage B1 valvular disease.

Image Interpretation

The echocardiogram presented a prominent right heart with mild right ventricular hypertrophy and mildly enlarged right atrium. Moderate tricuspid insufficiency was noted in this patient not to the point of pulmonary hypertension; however, this may be an emerging issue. Prolapse of the tricuspid valve was present. The pulmonary artery was uniformly prominent with maintained outflow velocity. The mitral valve was insufficient and considered severe with prolapse of the mitral valve. There was left atrial enlargement. Mitral insufficiency velocity 5.0 m/sec. Tricuspid insufficiency velocity 2.43 m/sec.