- 10 year old FN Lab with 1-2 week history of panting rapidly/heavil
- Initially put down to warm weather but not herself, not exercising and more recently reduced appetite
- 10 year old FN Lab with 1-2 week history of panting rapidly/heavil
- Initially put down to warm weather but not herself, not exercising and more recently reduced appetite
- Single lead ECG seems like regular rhythm (sinus tachycardia
, VT?), which was >260, ECG was not recording rate - After intial echocardiogram, patient was given 0.2mg/kg butorphanol iv and heart rate normalised
- No structural cardiac disease evident
- Subtle hypoechoic liver nodules, suspect nodular hyperplasia, no other significant abdominal disease, adrenals normal
- No BP assessment yet
- Bloods one month ago, elevated ALP
- Can you make out the fast rhythm?
- What do you think may be causing this?
- How would you go about treating the tachycardia?
Comments
Hi!
This seems to be a
Hi!
This seems to be a pathological (supraventricular) tachycardia and it is dangerous! It carries the risk of syncope, pulmonary edema or tachycardia induced cardiomyopathy. (sudden cardiac death less likely). Since it is a Labrador, a AV- reentry tachycardia is most likely and a Holter-ECG is STRONGLY recommended. These tachycardias can appear and disappear – so the observation that butorphanol helped can be incidental.
If the AV reentry tachycardia is confirmed, medical treatement can be tried (e.g. Diltiazem or propafenone, sotalol for an attempt to control the rhythm, otherwise a comb of Diltiazem and Digoxine) but is likely to be unsuccessful – in this case, catheter ablation is a realistic option to cure the patient (Dr. Santilli, Cornell).
Thanks for posting this really interesting and instructional case!!!
PEter
Thank you so much Peter. I am
Thank you so much Peter. I am aware of this disease in Labradors but have not knowingly had a case. Can it occur later in life?