- 7 year old male 43kg Doberman presented with dyspnoea following episode of syncopy after slowing down on walk.
- He had a tachyarrhythmia with pulse deficits, tachypnoea and cyanosis. Bloods unremarkable.
- Was treated with O2, IVFT and furosemide prior to me seeing him, was said to be much improved.
- When I saw him he had a sinus rhythm with frequent intermittent single VPCs, normal respiration.
- 7 year old male 43kg Doberman presented with dyspnoea following episode of syncopy after slowing down on walk.
- He had a tachyarrhythmia with pulse deficits, tachypnoea and cyanosis. Bloods unremarkable.
- Was treated with O2, IVFT and furosemide prior to me seeing him, was said to be much improved.
- When I saw him he had a sinus rhythm with frequent intermittent single VPCs, normal respiration.
- Echo showed normal left atrial size. LV measured dilated for 43kg dog but wnl for Dobrman range in Boon and equivocal/reduced systolic function.
- I tried to take my measurements on beats with no adjacent arrhythmia but they still varied quite alot
- The peak septal and free wall movements did not correlate, do you still take LV measurements on m mode when this is the case or rely on SMOD?
- I suspect he had a run of ventricular tachycardia which caused the collapse but unfortunately owners cannot afford holter exam. I started sotalol (no access to mexilitine).
- Do you think this heart has structural change? ie. occult DCM? Should I add in pimobendan?
- Many thanks in advance
Comments
Hi
Systolic function seems to
Hi
Systolic function seems to be reduced based on LVs, EPSS and ESV measurements . This makes DCM likely and Pimo is indicated.
Re arrhythmias: There is one VPC seen on one clip – this is of course highly suggestive of cardiomyopathy-associated arrhythmias.
Problem is: You can’t do any risk assessment or monitoring of anti-arrhythmic therapy without Holter-ECG . This is simly impossible.
The dog has a relatively high risk of SCD as far as my guts are telling me. If the owners are still unable to affort a Holter-ECG, I would consider simply giving Mexiletine, but document that you informed the owners about risks/benefits. They should as well be aware that there is still a risk of SCD even if the dog is on Mexiletine and that the dog will likely die from the disease sooner or later, no matter what we do.
Peter
Are you using Cornell or
Are you using Cornell or breed specific measurements Peter?
Breed specific
Breed specific measurements
male 48/36 mm, female 46/36 mm, EDV 95 ml/m2 BSA, ESV 55 ml/m2 BSA (European Data by Gerhard Wess).
Peter