Case of the week 10.19.20
Publication Date: 2020-10-15
History
13 year old male castrated domestic shorthair. Labored breathing. History of mild asthma reported by the owner
3 images
Findings
Study: Opposite lateral and VD radiographs of the thorax were acquired by the emergency service.
Findings: There is moderate, generalized cardiomegaly. All of the pulmonary arteries and veins are moderately to severely enlarged. The caudal vena cava is mildly enlarged compared to the aorta. There is a diffuse bronchointerstitial to multifocal patchy alveolar pattern with multifocal peribronchial infiltrates. A few thin pleural fissure lines are present, with widening of the pleural space at the periphery. The mediastinum is normal. The liver is on the upper limits of normal in size. The serosal detail of the cranial abdomen is normal. The included small intestinal segments are diffusely gas-filled but are normal in diameter.
Diagnosis
- Generalized cardiomegaly, pulmonary pattern and suspect mild pleural effusion are consistent with a cardiomyopathy with secondary left-sided heart failure. Mildly enlarged caudal vena cava and the size of the liver may be patient variant, though current early right-sided heart failure cannot be excluded. Furosemide administration and echocardiography are recommended.
- Given the reported history of feline asthma, a component of concurrent chronic lower airway disease is possible.
- Gas-filled small intestines are most likely secondary to aerophagia.
Discussion
The cat underwent an echocardiography. The patient had a evidence of pericardial effusion, hypetrophic cardiomyopathy, a dilated left atrium, confirmatory evidence of left sided heart failure and high grade secondary A-V block.
The patient was medically managed.
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