Ruptured chordae in a 12 year old minature poodle

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Ruptured chordae in a 12 year old minature poodle

Hello

We have Samantha a 12 year old minature poodle who was diagnosed with mild to moderate MVD 1 year ago. Was placed on fortekor, pimobendan and occasional lasix as needed by their regular vet.

We saw Samantha tonight for sudden decompensation. We performed an echocargiogram on her and found a flail valve. I am reasonably certain of the diagnosis but no so certain about the prognosis.

Hello

We have Samantha a 12 year old minature poodle who was diagnosed with mild to moderate MVD 1 year ago. Was placed on fortekor, pimobendan and occasional lasix as needed by their regular vet.

We saw Samantha tonight for sudden decompensation. We performed an echocargiogram on her and found a flail valve. I am reasonably certain of the diagnosis but no so certain about the prognosis.

I have read that after an initial compensation period of adjusting to the increase in pressure of the LA with moderate to high lasix doses the pets can return to being controlled.

The La/Ao ratio is approaching 3. I was hoping for some feedback regarding prognosis. With the LA already markedly dilated can this pet be reasonably controlled and stabilize over the long-term.

The FS was 65%.

Thanks. Brent

 

 

 

 

 

 

 

 

 

 

Comments

tosullivan

May have answered my own

May have answered my own question overnight?

The Poodle is greatly improved overnight. I initially thought this was a grave prognosis but it appears that it can be treated more effectively than I thought.

I would still love other opinions. 

Brent.

tosullivan

May have answered my own

May have answered my own question overnight?

The Poodle is greatly improved overnight. I initially thought this was a grave prognosis but it appears that it can be treated more effectively than I thought.

I would still love other opinions. 

Brent.

EL

These are hit or miss but

These are hit or miss but very precarious. I dont know oif published prognosis but wiht a flail leaflet like this I typically see these crash beyond C1 VD over 6 months… heart has to work really hard all the time to compensate. Could consider goign to Austria to have Peter Modler repair iot like our case of the month 4 months ago:

http://sonopath.com/resources/cases-month/mitral-valve-repair-due-severe-dmvd-6-year-old-cavalier-king-charles-spaniel-o

trip[le therapy and cage resty for a few days maybe torbutrol to calm. Any hypertension… seems like I get a lot of systemic hypertension with MV prolapses but thats just a personal experience.

tosullivan

Thanks! BPs were WNL. I’ll

Thanks! BPs were WNL. I’ll repeat them with a different machine. I read the case of the month. Fantastic stuff.

Thanks.

EL

These are hit or miss but

These are hit or miss but very precarious. I dont know oif published prognosis but wiht a flail leaflet like this I typically see these crash beyond C1 VD over 6 months… heart has to work really hard all the time to compensate. Could consider goign to Austria to have Peter Modler repair iot like our case of the month 4 months ago:

http://sonopath.com/resources/cases-month/mitral-valve-repair-due-severe-dmvd-6-year-old-cavalier-king-charles-spaniel-o

trip[le therapy and cage resty for a few days maybe torbutrol to calm. Any hypertension… seems like I get a lot of systemic hypertension with MV prolapses but thats just a personal experience.

tosullivan

Thanks! BPs were WNL. I’ll

Thanks! BPs were WNL. I’ll repeat them with a different machine. I read the case of the month. Fantastic stuff.

Thanks.

Peter

This is a good  video clip of

This is a good  video clip of a flail leaflet! There is severe volume overload of the LV and severe LAE present.

Usually, patients like this one can be stabilized by use of Lasix (initially 1mg/kg/h IV), Pimobendan, rest and oxygen. Some need sedation (Butorphanol at 0.2 mg/kg)

The prognosis seems to be influenced by factors including clinical symptoms, LV volume overload, degree of valvular pathology, PHT, arrhythmias, and heart rate. Still, it is impossible to state an exact prognosis. Some patients can be treated quite long (> 1yr), others die within several months.

Unfortunataly, I do not know of anybody doing mitral repair surgery in the US 🙂

Regards from AUstria!

 

Peter

Peter

This is a good  video clip of

This is a good  video clip of a flail leaflet! There is severe volume overload of the LV and severe LAE present.

Usually, patients like this one can be stabilized by use of Lasix (initially 1mg/kg/h IV), Pimobendan, rest and oxygen. Some need sedation (Butorphanol at 0.2 mg/kg)

The prognosis seems to be influenced by factors including clinical symptoms, LV volume overload, degree of valvular pathology, PHT, arrhythmias, and heart rate. Still, it is impossible to state an exact prognosis. Some patients can be treated quite long (> 1yr), others die within several months.

Unfortunataly, I do not know of anybody doing mitral repair surgery in the US 🙂

Regards from AUstria!

 

Peter

EL

Thx TOS… we like trying to

Thx TOS… we like trying to do fantastic stuff:) SonoPath is a hobby that turned into a career:)

EL

Thx TOS… we like trying to

Thx TOS… we like trying to do fantastic stuff:) SonoPath is a hobby that turned into a career:)

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