This examination demonstrates hypertrophy of the left ventricular walls, consistent with HCM. The disease is advanced, as there is severe secondary left atrial enlargement, mild left ventricular systolic dysfunction, and possible left ventricular myocardial fibrosis. The radiographs show a mild interstitial infiltrate caudal to the heart in the region of the caudal vena cava that likely represents mild cardiogenic pulmonary edema, and his echocardiogram demonstrates very mild pericardial and trace pleural effusion, all changes consistent with mild congestive heart failure. It is unclear whether the congestive heart failure is naturally occurring, or whether it is secondary to subcutaneous fluid administration.
The concurrent presence of renal disease significantly complicates the prognosis for the patient’s cardiac disease, as therapy for his heart disease may worsen his renal disease and vice versa. Therapy for congestive heart failure is required at this time; however, caution must be used to avoid adversely affecting the kidneys.