Case Study

Severe degenerate valve disease in a MN Pomeranian

A male neutered Pomeranian dog of unknown age presented for evaluation of syncopal episodes. A grade 4/6 heart murmur was present on auscultation. Current therapy included benazepril and furosemide.

A male neutered Pomeranian dog of unknown age presented for evaluation of syncopal episodes. A grade 4/6 heart murmur was present on auscultation. Current therapy included benazepril and furosemide.

DX

Severe DVD, severe MI, mild TI, severe left ventricular overload, LV systolic dysfunction, LAE

Sonographic Differential Diagnosis

Severe degenerative valve disease causing mitral and mild tricuspid insufficiency, severe left ventricular volume overload, left ventricular systolic dysfunction, and severe left atrial enlargement.

Image Interpretation

These images show a severely volume-overloaded left ventricle with clear evidence of systolic dysfunction (septal hyperkinesia). The mitral valve leaflets are severely thickened, both of them prolapsing into the left atrium. The left atrium is severely enlarged. The tricuspid valve shows moderate thickening, but the right atrium and ventricle are normal. There is severe mitral and mild tricuspid insufficiency present. Additionally there is mild pulmonary and aortic insufficiency. Systolic flow across the LVOT and RVOT is normal, but the RVOT flow profile is asymmetric which can be a sign of pulmonary hypertension.