Case Study

Unclassified cardiomyopathy and left-sided congestive heart failure in a 12 year old MN DLH cat with pleural effusion

A 12-year-old MN DLH cat was presented for evaluation of dyspnea of four days duration. Radiographs showed severe pleural effusion that responded well to thoracocentesis, Lasix, and oxygen.

A 12-year-old MN DLH cat was presented for evaluation of dyspnea of four days duration. Radiographs showed severe pleural effusion that responded well to thoracocentesis, Lasix, and oxygen.

Sonographic Differential Diagnosis

These images are consistent with unclassified cardiomyopathy and left sided congestive heart failure.

Image Interpretation

The left atrium was severely enlarged with a vegetative mitral valve. The left ventricle presented adequate contractility; there was only mild septal and free wall thickening and minor, echogenic remodeling. Pleural effusion was noted. LA max was 2.3; LA:AO ratio was 2.0.

DX

Unclassified cardiomyopathy and left-sided congestive heart failure

Outcome

Recommend treating the patient with Lasix at 12.5 mg t.i.d. to b.i.d. until respiratory rate normalizes, oxygen therapy, Nitroglycerin, and cage rest. Ace inhibitor therapy and Pimobendan can also be considered. Ace inhibitor at 0.5 mg/kg s.i.d. Blood pressure measurements when the patient is calm would also be recommended. Torbutrol injections would also be helpful in minimizing oxygen consumption. Pimobendan could be considered long term with off label use at 0.25 mg/kg b.i.d. Aspirin therapy every 48 hours. Recheck echocardiogram in one week. Guarded prognosis.

Clinical Differential Diagnosis

Cardiac disease – cardiomyopathy (dilated/hypertrophic), valvular disease, myocarditis, hypertrophy secondary to systemic hypertension. Pleural disease – infection, sterile inflammation, neoplasia, lung lobe torsion, para-pneumonic effusion.