Case Studies

These case studies contain detailed information on the diagnostic and treatment process for each individual animal.

Kodiak

Case Background

Name: Kodiak
Age: 7 year old
Sex: Female, spayed
Breed: Siberian Husky

Clinical History

Please review Kodiak’s clinical history.

Patient presented 30 hours after an ovariohysterectomy. Patient is recumbent with pale MM, weak femoral pulse, a soft heart murmur, and fluid in the abdomen detected via ultrasound examination. Blood pressure was 80mmHg systolic.    

ECG

View Kodiak’s electrocardiogram (the black bar represents one second)
What abnormalities are present on this ECG?
Relevant Findings: Heart rate=200bpm. Sinus tachycardia is considered when the heart rate is greater that 140 bpm in dogs. There are easily identifiable P waves preceding each QRS complex and the QRS complexes are narrow, consistent with a supraventricular origin. The rhythm is regular, so atrial flutter or fibrillation can be ruled out. We do not see the tachycardia begin or end, so this cannot be easily differentiated from supraventricular/atrial tachycardia. However, given the history and the heart rate, sinus tachyardia is most likely. View an annotated image of Kodiak’s ECG highlighting the relevant findings.  

 

Discussion & Treatment

 
Discussion:  Sinus tachycardia is the logical diagnosis, given the recent history of abdominal surgery and fluid in the abdomen. The most likely cause of the sinus tachycardia is systemic hypotension secondary to arterial bleeing into the abdomen (hypovolemic shock). The natural response to hypotension is an increase in sympathetic tone which increases the sinus rate. Treatment/management: Administer shock dose of fluids, perform a cystocentesis to confirm the fluid in the abdomen is blood and perform emergency abdominal exploratory surgery, looking for a bleeding uterine or ovarian artery.

    The CEG is funded through an educational grant from Boehringer Ingelheim Vetmedica, Inc., IDEXX Laboratories, Inc. and Nestle Purina PetCare.

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