11.5yr Bos.Ter. Past Hx of smoke inhalation and aspiration pneumonia. Rads = cardiomegaly. Clinically doing well. Occasion gets excited; may cough or vomit and have a syncopal episode. Echo= sinus tach, mild TV reg. with normal PG, MV reg. with normal PG, LVd Cornell Idx. = 1.86, LVs Cornell idx.= 1.11, LAD:AO=2.4, MV inflow E vel=1.02m/s, E:A vel=1.37m/s. MVD stage B2. Small pericardial effusion noted, ST mass noted within LA and adjacent aorta? Apical image may be showing tumor or LN or both at base of LA. Images were obliqued to get views. Suspect neoplasia(myxoma/chemodectoma,HSA? TKs!!
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Looks like an aortic body tumor/chemodectoma given the position and echotexture. These behave clinically like a dog in stage b2+ volume overload of the LA with main stem bronchus impingement hence the cough but obviously wont be lasix or pimo responsive. These are slow growers though as opposed to HSA usually in the right auricle/rvfw position. They can have pc effusion but not as aggressively in my experience as HSA. They can grow around the heart base and obstruct CVC inflow as well and cause passive congestion and ascites. There is a chapter on this in the curbside guide if interested.
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There is MV regurge. Could the mass be incidental? Because of the dogs age and breed could MVD be the primary cause of the B2 classification and not from the mass effect with some regurge from annular displacement?
If the mitral regurge velocity is within normal limits(no increased LV pressure from increased afterload by tumor) with a normal mitral inflow E velocity ( pressure gradient across MV isn’t staying normal because of a high LA pressure from being squished by mass) should I assume MVD over mass , treat with Pimobendin. and monitor?
Congratulations and great job on the book!
Good learning tool, reference and to put things back in my head that have since fallen out. I have the E version.
Looks like there is a bit of LA enlargement from volume overload there you could try a pimo acei +/- low dose lasix trial if coughing and see how her responds as the ao body tumor grows… this is a trial and error thing since no consensus on mvd and ao body tumor combo 🙂