Severe heart failure with pericardial effusion, pleural effusion, and bilateral thoracic and abdominal echymosis

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Severe heart failure with pericardial effusion, pleural effusion, and bilateral thoracic and abdominal echymosis

  • 13 year old mn Italian Greyhound with presented yesterday to the rDVM with severe dyspnea and severe, bilateral echymosis along the thorax and abdomen.  O states dog was not hit by a car.

  • Chest radiographs showed pleural effusion and loss of the cardiac silhouette

  • Labwork done yesterday showed a mild anemia, and ALKP=200’s, normal platelets and clotting time

  • Pleural tap showed blood

    • 13 year old mn Italian Greyhound with presented yesterday to the rDVM with severe dyspnea and severe, bilateral echymosis along the thorax and abdomen.  O states dog was not hit by a car.

    • Chest radiographs showed pleural effusion and loss of the cardiac silhouette

    • Labwork done yesterday showed a mild anemia, and ALKP=200’s, normal platelets and clotting time

    • Pleural tap showed blood

    • Standing echocardiogram done today showed severe left atrial and left ventricular dilation, pleural and pericardial effusion.  No cardiac or pulmonary masses were seen.  Brief Doppler done on MVI showed velocity>6m/s.  Unable to do more Doppler as dog was rapidly decompensating.

    • Cardiac measurements (mm) were as follows:  IVSd=5.14, IVSs=19.61, LVIDd=53, LVIDs=26, LVPWd=5.8, LVPWs=14.5, FS=51%

    • Chest tap done after the echo showed frank blood.  The dog became moribund after the chest tap and died several minutes later.  The rDVM did his own post and thinks there was a right atrial rupture and a possible PDA. 
    • Owner reports that the dog had been showing respiratory signs for a while prior to presentation.  Also,  I later found out that the dog was diagnosed with a congenital (heart?) defect many years ago but owner was told not to worry.
    • What do you guys think?

Comments

EL

Tough to say other than lots

Tough to say other than lots of volume overload and valve disease. LA rupture possible since there is pericardial effusion on the first image…..

EL

Tough to say other than lots

Tough to say other than lots of volume overload and valve disease. LA rupture possible since there is pericardial effusion on the first image…..

Peter

difficult to say. a pda – if

difficult to say. a pda – if small – can be an incidental finding in an old dog. i don’t see one here, though.

re bleeding. bleeding times do not rule out willebrandt’s disease, so this is still possible. pericardial effusion increases central venous pressures and can “support” bleeding.

left atrial rupture usually causes clotting in the pericardial space, and this was not seen here. usually, blood does not clot when in contact with serosal surface but if severe bleeding starts acutely it still clots.

what i see on the clips and images is just what Eric mentioned

best regards

 

peter

Peter

difficult to say. a pda – if

difficult to say. a pda – if small – can be an incidental finding in an old dog. i don’t see one here, though.

re bleeding. bleeding times do not rule out willebrandt’s disease, so this is still possible. pericardial effusion increases central venous pressures and can “support” bleeding.

left atrial rupture usually causes clotting in the pericardial space, and this was not seen here. usually, blood does not clot when in contact with serosal surface but if severe bleeding starts acutely it still clots.

what i see on the clips and images is just what Eric mentioned

best regards

 

peter

Electrocute

So, my best guess is that

So, my best guess is that this dog was in heart failue and suffered left atrial rupture. Aside from the possibility of Von Willebrand’s disease or some unknown severe trauma, I really have no explanation for the severe bruising along the dog’s chest and abdomen.  

Electrocute

So, my best guess is that

So, my best guess is that this dog was in heart failue and suffered left atrial rupture. Aside from the possibility of Von Willebrand’s disease or some unknown severe trauma, I really have no explanation for the severe bruising along the dog’s chest and abdomen.  

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