Case Study

RADS – Cardiac Enlargement, Chronic Mitral Valve Regurgitation and Pulmonary Edema in a 12 yeear old F Miniature Pinscher dog

Owner has had this pet for the last 4-5 years; previous vet diagnosed a heart murmur 3-4/6. The patient has been non-clinical according to owner until 2-3 weeks ago, when started to cough during barking and excitement.

Physical Exam: BAR, BCS 4/9, murmur 5/6; grade 4 periodontal disease; crackles auscultated in all 4 lung fields. Unable to elicit cough on tracheal palpation

DX

The radiographic findings are compatible with left ventricular and left atrial cardiac enlargement, chronic mitral valve regurgitation and mild interstitial cardiogenic pulmonary edema. The most likely underlying cause is myxomatous mitral valve degeneration.Cardiac echo is recommended for detailed staging, to tailor appropriate medical treatment and to rule out differential diagnoses. Diuretic treatment is advised since there is radiographic evidence of congestive cardiac failure.

Image Interpretation

Rads of the right lateral, VD and DV thorax – Osseous structures: within normal limits.
Extrathoracic soft tissue structures: There was an incidental redundant tracheal membrane level with the neck. There was an ID chip and a fragment of a lead bullet within the extrathoracic soft tissues.
Intrathoracic structures:
The trachea was elevated. There was no mediastinal widening. The cardiac silhouette was increased in length and width. The caudal contour of the cardiac silhouette was steep, the caudal cardiac waist was lost, there was left atrial tenting associated with split main stem bronchi in VD/DV views. A minor focal enlargement of the cardiac silhouette was noted level with the left auricular appendage. The major vessels were within normal limits. The pulmonary veins were significantly dilated.
There was an increase in interstitial pulmonary opacity localized to the perihilar region of the caudal lung lobes.

Outcome

Cardiac echo is recommended for detailed staging, to tailor appropriate medical treatment and
to rule out differential diagnoses.
Diuretic treatment is advised since there is radiographic evidence of congestive cardiac failure.