- 10 year old FS DSH with a history of a cardiac murmur presented to E-clinic on 2/24 with acute respiratory distress. Gallop rhythm was ausculted but HR was normal.
- Chest rads read by a radiologist showed normal cardiac sihouette, enlarged pulmonary vasculature of the caudal lung lobes, and patchy alveolar and unstructured interstitial pattern in the caudal lungs suspicious for pulmonary edema secondary to CHF.
- The cat was treated with lasix and enalapril and initially improved.
- 10 year old FS DSH with a history of a cardiac murmur presented to E-clinic on 2/24 with acute respiratory distress. Gallop rhythm was ausculted but HR was normal.
- Chest rads read by a radiologist showed normal cardiac sihouette, enlarged pulmonary vasculature of the caudal lung lobes, and patchy alveolar and unstructured interstitial pattern in the caudal lungs suspicious for pulmonary edema secondary to CHF.
- The cat was treated with lasix and enalapril and initially improved.
- The cat presented to the rDVM on 2/28 for anorexia and depression. BUN was elevated (>100).
- rDVM discontinued the lasix and enalapril and initiated pimobendan due to concern for dehydration but also still assuming CHF based upon radiology report.
- Echo done today shows normal cardiac measurements. The cat has been off of the lasix for 2 days but remains on pimobendan. Cat’s respiratory rate is at 30-40rpm. HR is at 149bpm. Chest rads show improvement in the pulmonary edema but not full resolution. The cat is dehydrated, depressed, and not eating.
- rDVM thinks this is still PE secondary to CHF based upon radiology report and history of a cardiac murmur.
- Could this cat have cardiomyopathy but normal meas. now because she is dehydrated? Would pimobendan alone be enough to control pulmonary edema secondary to CHF?
Comments
In my experience Its not
In my experience Its not likely that volume overload is completely resolved after cardiac tx when full CHF is th e cause. CHF on rads shows vascular congestion… check the left crnaial artery and vein that usually tells the story. Maybe post the initial rad at presentation. IN true CHF the volume gets better but there is usually still some indications of cardiac disease and some overload after 24-48 hours… myocarditis successfully treated being the exception… and if this were cardiac and the heart is now essentially normal on your images here then the cat should be clinically normal. I would think PTE or causes of non cardiogenic edema which will partially resolve on lasix. Maybe scan the abdomen looking for primary disease
Thanks Eric!
Thanks Eric!