Pulmonary Hypertension As Cause Of Collapses

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Pulmonary Hypertension As Cause Of Collapses

Moe is a 13 1/2 year old poodle cross with ~5 episodes of collapse over the past 2 weeks. Gets weak and collapses, breathes slightly heavier and a little disoriented. Has urinated a couple of time in these episodes. Could be seizure but could be collapse…

Physical exam revealed mild to moderate tachypnea/dyspnea. No obvious murmur osculated.

Labs were normal except hi globulin @ 5.5

Radiographs suggest liver enlargement and a prominent bulge in the area of the pulmonary artery?

Moe is a 13 1/2 year old poodle cross with ~5 episodes of collapse over the past 2 weeks. Gets weak and collapses, breathes slightly heavier and a little disoriented. Has urinated a couple of time in these episodes. Could be seizure but could be collapse…

Physical exam revealed mild to moderate tachypnea/dyspnea. No obvious murmur osculated.

Labs were normal except hi globulin @ 5.5

Radiographs suggest liver enlargement and a prominent bulge in the area of the pulmonary artery?

On ultrasound I see a normal left side, but the right side looks…not right: the RA is dilated and I feel like the RV free wall is thickened. the septum looks thickened also but seems in proportion with the LV free wall. There seems to be a prominent TR and, if my measurements are correct, a moderate to severe regurgitation velocity. In the short axis I can convince myself that the inter ventricular septum is flattened. Subjectively on the RPST short axis I feel the pulmonary artery is dilated as it exits the RV.

All of which makes me think this is pulmonary hypertension…Except no ascites (yet) and no to minimal enlargement of the hepatic veins.

My other DDx’s are seizure/CNS neoplasia.

I’d appreciate a second opinion on the heart side of this…I think it’s PH but I may have diagnostic blinders on…

Thanks, 
Sam

Comments

EL

TR velocity approaching 4

TR velocity approaching 4 m/sec is fair game for exercise induced collapse/hypoxia. I don’t think there is any wrong here in doing a sildenafil trial and see if improvement even if only minimal dilation of the HV which means not full right failure yet and compensating but why not try helping out the compensation process?

franklinanimalclinic

Thanks for the thoughts
Sam
 

Thanks for the thoughts

Sam

 

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