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A-fib, Great Dane

Sonopath Forum

Sonopath Forum

A-fib, Great Dane

-4 year old Great Dane

-A-fib was noted on pre-surgical exam

-non-clinical at this time aside from the arrhythmia.

I had a VERY hard time getting images of him as he is fearful and strong.  I am attaching a couple of clips to see if you have any words of wisdom.

I will try to get more images tomorrow.

This does not appear to be classic advanced DCM as I was expecting.

Thanks for any insight.

 

Suzanne

 

-4 year old Great Dane

-A-fib was noted on pre-surgical exam

-non-clinical at this time aside from the arrhythmia.

I had a VERY hard time getting images of him as he is fearful and strong.  I am attaching a couple of clips to see if you have any words of wisdom.

I will try to get more images tomorrow.

This does not appear to be classic advanced DCM as I was expecting.

Thanks for any insight.

 

Suzanne

 

Comments

randyhermandvm
February 7, 2015 at 12:17 pm -

I agree that structurally the

I agree that structurally the heart does not look all that bad. Most common causes of A Fib would be DCM and severe Mitral valve disease.

That being said A Fib can occur in Great Danes with morphologically normal looking hearts.

Waiting for the experts to weigh in here. Whatever the cause you need to slow that heart down.

randyhermandvm
February 7, 2015 at 12:17 pm -

I agree that structurally the

I agree that structurally the heart does not look all that bad. Most common causes of A Fib would be DCM and severe Mitral valve disease.

That being said A Fib can occur in Great Danes with morphologically normal looking hearts.

Waiting for the experts to weigh in here. Whatever the cause you need to slow that heart down.

EL
February 7, 2015 at 12:43 pm -

arrythmias will drop the fs%

arrythmias will drop the fs% considerably. I can see a subjective epss in your rt ps long axis of about 0.5 cm so not dcm… FS% is likely dropping abou 6-10% here because of the arrythmia so tx that first and go from there.

maybe start with 

Diltiazem 1-2mg/kg po bid to tid

or

2-4 mg/kg bid extended release .

Then reecho in a week… Holter may be a good option here as well to fully characterize the arrythmia.

Ill see if Peter (http://sonopath.com/about/specialists/peter-modler-dvm-dipl-tzt) and Mandi (https://sonopath.com/about/specialists/mandi-e-kleman-dvm-dacvim) can chime in.

EL
February 7, 2015 at 12:43 pm -

arrythmias will drop the fs%

arrythmias will drop the fs% considerably. I can see a subjective epss in your rt ps long axis of about 0.5 cm so not dcm… FS% is likely dropping abou 6-10% here because of the arrythmia so tx that first and go from there.

maybe start with 

Diltiazem 1-2mg/kg po bid to tid

or

2-4 mg/kg bid extended release .

Then reecho in a week… Holter may be a good option here as well to fully characterize the arrythmia.

Ill see if Peter (http://sonopath.com/about/specialists/peter-modler-dvm-dipl-tzt) and Mandi (https://sonopath.com/about/specialists/mandi-e-kleman-dvm-dacvim) can chime in.

smbrowndvm
February 7, 2015 at 1:42 pm -

Thanks for the comments.  I’m

Thanks for the comments.  I’m not sure I can get a lot more useful images on him but I’m going to try.  He was started on diltiazem and digoxin a few days ago.

 

I’ll let you know if I get any follow-up.

 

Suzanne

 

smbrowndvm
February 7, 2015 at 1:42 pm -

Thanks for the comments.  I’m

Thanks for the comments.  I’m not sure I can get a lot more useful images on him but I’m going to try.  He was started on diltiazem and digoxin a few days ago.

 

I’ll let you know if I get any follow-up.

 

Suzanne

 

Peter
February 7, 2015 at 6:34 pm -

Hi!
Basically, there seem to

Hi!

Basically, there seem to exist 2 differenet forms of DCM in Great Danes, like in Dobermans. One form is an arrhythmogenic form (ventricular arrhythmia), the other one is characterized by dilation, reduced contractility and eventually CHF.

Afib occurs either as lone afib (mainly in large and giant breed dogs) or due to atrial enlargement. Notably, the absolute size of the atrium appears to be more related to the development than the relative atrial size. This explains why it occurs earlier in large breed dogs compared to small breed dogs.

To my knowledge, afib is not a sign of DCM in Great Danes. Due to the decreased preload (increased heart rate), systolic function appears a bit low in this case. But there is no dilation visible.

I would strongly recommend a Holter-ECG recording to rule out any other forms of arrhyhmia and to determine the heart rate when the patient is relaxed.

Primary afib (no visible structural heart disease) can be addressed with a combination of antiarrhythmics  (not always successful). Electrical cardioversion can be attempted as well. If there is structural heart disease present (atrial enlargement), I would base the decision on the heart rate. High heart rates should be decreased with Diltiazem, Digoxin or a combination of both.

Peter

 

Peter
February 7, 2015 at 6:34 pm -

Hi!
Basically, there seem to

Hi!

Basically, there seem to exist 2 differenet forms of DCM in Great Danes, like in Dobermans. One form is an arrhythmogenic form (ventricular arrhythmia), the other one is characterized by dilation, reduced contractility and eventually CHF.

Afib occurs either as lone afib (mainly in large and giant breed dogs) or due to atrial enlargement. Notably, the absolute size of the atrium appears to be more related to the development than the relative atrial size. This explains why it occurs earlier in large breed dogs compared to small breed dogs.

To my knowledge, afib is not a sign of DCM in Great Danes. Due to the decreased preload (increased heart rate), systolic function appears a bit low in this case. But there is no dilation visible.

I would strongly recommend a Holter-ECG recording to rule out any other forms of arrhyhmia and to determine the heart rate when the patient is relaxed.

Primary afib (no visible structural heart disease) can be addressed with a combination of antiarrhythmics  (not always successful). Electrical cardioversion can be attempted as well. If there is structural heart disease present (atrial enlargement), I would base the decision on the heart rate. High heart rates should be decreased with Diltiazem, Digoxin or a combination of both.

Peter

 

EL
February 7, 2015 at 6:41 pm -

If I may plug our service we

If I may plug our service we have Holter monitoring with Dr Mandi Klemen (http://sonopath.com/about/specialists/mandi-e-kleman-dvm-dacvim) available just email at info@sonopath.com ro call our 800 number 800-838-4268

EL
February 7, 2015 at 6:41 pm -

If I may plug our service we

If I may plug our service we have Holter monitoring with Dr Mandi Klemen (http://sonopath.com/about/specialists/mandi-e-kleman-dvm-dacvim) available just email at info@sonopath.com ro call our 800 number 800-838-4268

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