Name: Fritz
Age: 6yr
Sex: Male, intact
Breed: Doberman Pinscher

Please review Fritz’s clinical history.

Fritz presented for acute onset of exercise intolerance and coughing.    

View Fritz’s electrocardiogram (the black bar represents one second)

 

 
Discussion:  The presence of atrial fibrillation in a Doberman presenting for exercise intolerance and coughing is very suggestive of underlying heart disease, with dilated cariomyopathy as the top differential consideration. Evaluation for heart disease is imperative in this case, and should include chest X-rays (at a minimum), echocardiography and blood pressure evaluation. Treatment/management: The treatments for atrial fibrillation can include heart rhythm control (cardioversion) or heart rate control (giving drugs that slows conduction down the AV node). In cases of structural heart disease, cardioversion is not recommended. Drugs that slow AV nodal conduction include beta blockers, calcium channel blockers, sodium channel blockers, and digoxin. Which drug(s) is/are chosen depends on a variety of factors, including the underlying disease process, cardiac size and function, blood pressure, and overall patient health. In general, a dog with CHF will be treated initially with diltiazem ans/or digoxin to better control ventricular rate. A cardiac workup is needed to identify the best treatment options.