Nando
DSH
CLEAR ALL LINES
FULL DIRECTIONS
Select Radiograph(s)
Radiographic Report
VHS = approximately 9.1 (severe cardiomegaly). Pulmonary infiltrates efface the cranial edge of the cardiac silhouette on lateral views, making the width measurement approximate. The caudal dorsal lung fields are relatively normal on the lateral view, but heavy alveolar infiltrates are present in the caudal ventral and cranial ventral lung fields. The DV view is not straight, and the sternum is visible on the left side of the spinal column, indicating that the left sided structures are likely to be overemphasized. Even taking this positioning artifact into account, the heart is severely enlarged and the left atrium is prominent in this view. There are moderate alveolar infiltrates present in all lung fields on this view. The pulmonary arteries and veins are difficult to discern. The stomach is distended with air, likely secondary to air-swallowing due to dyspnea.
The combination of cardiomegaly and alveolar infiltrates in a dyspneic feline patient with a history of diagnosis of HCM is suggestive of congestive heart failure (Stage C HCM). The sudden onset of Nando’s signs is not unusual; many cats are able to “hide” their developing congestive heart failure signs until the signs are very severe. Nando’s history of collapse with handling while he was dyspneic may reflect stress, hypoxia, arrhythmia or some combination of these. Immediate oxygen therapy was a good choice for a first therapy, and was immediately followed by administration of 2 mg/kg of furosemide IM, to begin definitive therapy for congestive heart failure.
Clinical History
Signalment: 10 years MN DSH
Nando was presented one year ago for investigation of gallop heart sound with NT-proBNP= 329 pmol/L. Hypertrophic cardiomyopathy was diagnosed, and no therapy was recommended at that time. Today, Nando was brought to the ER for respiratory distress. His owner noticed Nando in corner breathing heavily and when handled, Nando collapsed but maintained consciousness. Onset was sudden, Nando had been acting normally with a good appetite recently.
Physical examination: Nando was open-mouth breathing, with a marked increase in respiratory effort. He had bilateral pulmonary crackles, RR 64, gallop rhythm with HR = 220 bpm. Weak femoral pulses, pale pink MM brightened up to pink in oxygen cage.
We recommend you to use the application in a tablet, in landscape mode.
Subscribe to
