Sonopath Forum

Preanesthetic Echo in a Chihuahua with MVI

12 yr old FS Chihuahua with mitral murmur in need of cataract surgery-belongs to vet tech
Dog is asymptomatic-chest rads show no evidence of pulmonary edema
Measurements are all within normal limits (see attached images)-there is no LA dilation and LA/AO-2D=1.0.
MVI has a velocity of 5.75m/s, TVI is present with a velocity of 1.7m/s, PI=0.7m/s. Ao Velocity is 1.25m/s.
The MVI is moderate to severe. There is quite a bit of remodeling and clubbing of the MV. There is also clubbing of the TV.

12 yr old FS Chihuahua with mitral murmur in need of cataract surgery-belongs to vet tech
Dog is asymptomatic-chest rads show no evidence of pulmonary edema
Measurements are all within normal limits (see attached images)-there is no LA dilation and LA/AO-2D=1.0.
MVI has a velocity of 5.75m/s, TVI is present with a velocity of 1.7m/s, PI=0.7m/s. Ao Velocity is 1.25m/s.
The MVI is moderate to severe. There is quite a bit of remodeling and clubbing of the MV. There is also clubbing of the TV.
It looks to me like there is mitral prolapse, and if that is the case, would you discourage elective eye surgery or just be careful with anesthetic protocol?

Comments

July 20, 2014 at 4:41 am -

I have only had one of these

I have only had one of these go south on me in a chf crisis underanesthesia and he got really tachycardic on induction..ruptured a chordae to a flail leaflet and decompensated over the following 48 hours.. this was many years ago. Since then I premed wiht opioid (torbutrol) induce propofol and maintain isofluorane ease on down and ease on up to avoid the excitement phases and have never had a problem since. if the Bp is ok and bloods wnl with proper anesthesia, IV support and so forth I don’t see an issue with a stage B1 like this guy.

July 20, 2014 at 4:41 am -

I have only had one of these

randyhermandvm

July 20, 2014 at 8:57 pm -

If your mitral jet is

If your mitral jet is accurate and no indication of aortic stenosis – then systemic blood pressure should be 132 mmHg higher than L atrial pressure ( 5.75 X 5.75 X4). Since the L atrium is not enlarged I suspect L atrial pressure should be around 10 mmHg making systemic pressure around 142 mmHg. As EL suggested you may want to check the systemic pressure to make sure. Also a good way to check the accuracy of your spectral doppler. Does anyone see the mitral prolapse on the cine presented here?

randyhermandvm

July 20, 2014 at 8:57 pm -

If your mitral jet is

Electrocute

July 21, 2014 at 2:49 am -

Thanks Randy and Eric for

Thanks Randy and Eric for your comments. I did recommend a BP check. What I am calling mitral prolapse is very subtle and may be just because the tips of the mitral valves are so clubbed. Also, I am seeing some fluttering of the anterior mitral valve leaftlet during left ventricular filling.

Electrocute

July 21, 2014 at 2:49 am -

Thanks Randy and Eric for

July 21, 2014 at 1:54 pm -

Its a minor prolapse but its

Its a minor prolapse but its there. Sometimes changing the approach angle will maximize it as well but the anterior leaflet just moves behind th eposterior by a mm or 2 in the last clip.

July 21, 2014 at 1:54 pm -

Its a minor prolapse but its

Its a minor prolapse but its there. Sometimes changing the approach angle will maximize it as well but the anterior leaflet just moves behind th eposterior by a mm or 2 in the last clip.

Electrocute

July 21, 2014 at 3:18 pm -

Thanks Eric. I scrolled

Thanks Eric. I scrolled through the clip in slow motion multiple times to convince myself that it was there.

Electrocute

July 21, 2014 at 3:18 pm -

Thanks Eric. I scrolled

Thanks Eric. I scrolled through the clip in slow motion multiple times to convince myself that it was there.