– 5 year old male Cattle Dog , 20kg, seen at another clinic in May due to cough that was non-responsive to cephalexin and pred
– presented shortly after to emerg clinic in resp. distress, coughing bloody foam and tachycardia
– chest rads showed cardiomegaly, pulmonary edema and enlarged pulmonary veins; was treated for CHF and responded very well; now on furosemide, Enacard and pimo and has transferred to our clinic
– owners short on $$ but were able to come in today for follow-up bloodwork and echocardiogram (better late than never)
– 5 year old male Cattle Dog , 20kg, seen at another clinic in May due to cough that was non-responsive to cephalexin and pred
– presented shortly after to emerg clinic in resp. distress, coughing bloody foam and tachycardia
– chest rads showed cardiomegaly, pulmonary edema and enlarged pulmonary veins; was treated for CHF and responded very well; now on furosemide, Enacard and pimo and has transferred to our clinic
– owners short on $$ but were able to come in today for follow-up bloodwork and echocardiogram (better late than never)
– LAE seen on echo but can’t determine reason why? Aortic max and Pul max normal; no PAH; perhaps a trace MR? no VSD or other; EPSS normal
– the lungs showed multiple “lung-rockets” or comet tail artifcats with small areas of lung consolidation at the lung/chest wall interface; interstitial edema? other lung disease?
What has caused this patient’s CHF?
Comments
The LA is big because you can
The LA is big because you can see the deviation of the atrial septum toward the right atrium but my gut says there is more going on… just because there is chf doesnt mean there is other as well… i.e. PTE, pneumonitis, neoplasia… I would fna that lung consolidation on followup in 5-7 days if growing. Ensure a dual tx is goign on for cardiac and pneumonitis and consider causes for PTE… maybe scan the abdomen look for a cause for hypertension if present. I cant tell you how many times I’ve seen chf cases go into chf with concurrent systemic hypertension. I believe hypertention often pushes them over into chf or induces chordae rupture in some cases… and you check the abdomen and “hello pheo” or “hello infarcting kidneys” that are starting to fail just all the parameters arent there yet… don’t just stop at the heart see the patient and think of other things that also cause pulmonary edema or lung consolidations and causes may be behind the diaphragm.
More work- up is definitely
More work- up is definitely warranted. Hope they will let us!
Thanks!
Chatting with a cardiologist
Chatting with a cardiologist on this case, she also suggested a possibility of an AV fistula in this patient and recommended abdominal u/s as well.
Hmmm thats an interesting
Hmmm thats an interesting thought… rare but possible i guess since he’s 5.
She said she has seen
She said she has seen cogenital and acquired