Simon is a 16 year old Standard Poodle that came in for an exam. He has been experiencing some Ataxia (not noted so much on exam today) along with some staring off into space. He also has Anisocoria. I noticed an arrhythmia on exam along with a grade 2 HSM heard over the mitral valve. No history of syncope.
I did an EKG and it came back with multiple PVC’s. I wanted to start him on 5 mg/kg Mexilitine for the arrhythmia but decided I better do an echo to make sure his heart myocardium is not decompensating.
Simon is a 16 year old Standard Poodle that came in for an exam. He has been experiencing some Ataxia (not noted so much on exam today) along with some staring off into space. He also has Anisocoria. I noticed an arrhythmia on exam along with a grade 2 HSM heard over the mitral valve. No history of syncope.
I did an EKG and it came back with multiple PVC’s. I wanted to start him on 5 mg/kg Mexilitine for the arrhythmia but decided I better do an echo to make sure his heart myocardium is not decompensating.
On Echo I found a mild increase in LA/AO, myxomatous change to the Mitral valves and a large Mitral regurgitation with a velocity of 5.87 m/sec. I could not see any other abnormalites with CFI and Spectral doppler
I am going to attach a .jpg of the evaluation of the L ventricle. As you can see there are changes in the rhythm of IVS making placement of my measure a little tricky.
My ?
1. Is it safe to start the Mexilitine?
2. Would you start him on Pimobendan? He would not qualify IMO if I was going to use the standards of the Epic study. Yes I know he is not a small dog.
Owner is reluctant to do a cardio consult at 16 years of age.
Comments
I would need to see more
I would need to see more images but i dont see volume overload to justify Pimo as the a/ao is normal here amd the LV volume looks good based on your image.
Thank you EL.
Your advise is
Thank you EL.
Your advise is how I see it.
I started Simon on Mexlitine. I will keep all posted on response and any change in the Echo.
As the heart is +/- normal,
As the heart is +/- normal, would look in the abdomen for splenic disease as can result in PVC. With the age, staring into space, ataxia, and anisocoria would be concerned about intra-cranial pathology (neopalsia highly likley).
Thank you Riobetti- shall do.
Thank you Riobetti- shall do. Not sure how much further the owner wants to go on this 16 year old poodle. I appreciate all the feedback.
Fair enough.
Fair enough.