In December 2017 Meeko- a 7 month old DSH was neutered. He had a history of a grade 2 HSM on the L side. He started having PVC’s while under anesthesia. My associate asked to me do a quick ehco. At that time I thought there was concentric hypertropy, L atrial enlargement and Mitral regurgitation. I had concern about Mitral dysplasia.
Fast forward to last week. I think the changes have progressed. This time I could not hear the murmur or document a Mitral regurgitation.
I would appreciate any feedback before I refer to a cardiologist.
Thanks
In December 2017 Meeko- a 7 month old DSH was neutered. He had a history of a grade 2 HSM on the L side. He started having PVC’s while under anesthesia. My associate asked to me do a quick ehco. At that time I thought there was concentric hypertropy, L atrial enlargement and Mitral regurgitation. I had concern about Mitral dysplasia.
Fast forward to last week. I think the changes have progressed. This time I could not hear the murmur or document a Mitral regurgitation.
I would appreciate any feedback before I refer to a cardiologist.
Thanks
The 2 .jpgs were from last week. The first three cines were from December and the last 3 from last week.
Comments
I agree the LV looks thick
I agree the LV looks thick here but volume contraction from anesthesia is in play here so have to consider pseudohypertrophy and volume shifts. Lots of patients will have new murmurs or louder murmurs under anesthesia compared to fully awake. That being said, the MV looks a little thick… going with the “common things are common” saying I am betting on an emerging HCM with MV disease … there are no parameters for growing into HCM jouvenile HCm that I know of but please post of someone knows of a study…. so we really don’t know and what is HCM in the growth phase.. This may be one of those cases +/- secondary MR or concurrent MV dysplasia… btu not funcitonal yet and have to rescan at a year of age and see what the parameters are.
Thanks EL. Just a couple more
Thanks EL. Just a couple more ?
The first 3 cines are not under anesthesia. That is when I ccould not auscult a murmur.
Would you expect eccentric not concentric hypertrophy with a mitral valve dysplasia?
Is treatment warranted if not clinical- or just do another echo in 6 months.
I would have sent this in for a telemedicine consult- but this was a complimentary evaluation. I don’t know if he will go for a cardio consult.
Thanks for your help.
I dont see anything to treat
I dont see anything to treat right now. I would not expect hypertrophy with minor mv disease here so I think they are 2 separate things. If the MR were moderate to severe then secondary hypertrophy makes sense but cats get HCM more than they get primary MV disease… i would sit and wait on it and rescan in 3-6 months to see what it will do unless the cat gets clinical such as ex intollerance.