Case 11 — Ascites

Joey, an eleven-year-old male dachshund/terrier cross with a visibly distended abdomen.
Joey — 11-year-old male dachshund/terrier cross, 11 kg.

Primary clinician: Brad Gavaghan, DVM, DACVIM (Cardiology) and Darcy Adin, DVM, DACVIM (Cardiology)
Supervising clinician: Mark D. Kittleson, DVM, PhD, DACVIM (Cardiology)

Signalment

  • Species: Canine
  • Breed: Dachshund/terrier cross
  • Age: 11 years
  • Sex: Male
  • Weight: 11 kg
  • Name: Joey

Presenting Complaint

  • Ascites and Cough

Pertinent History

  • Joey was diagnosed with cardiomegaly a few years ago and the owner was told to watch for coughing, wheezing, or respiratory distress.
  • He started coughing two months ago and was put on furosemide 50 mg ½ tab SID and enalapril 10 mg ¼–½ tab BID.
  • One week ago the owner came home from a trip to find the dog’s abdomen severely distended.
  • After visiting the referring veterinarian, the dosages were changed to furosemide 50 mg 1 tab BID and enalapril 10 mg ¼ tab BID.
  • The dog was diagnosed with ascites.
  • The dog is still coughing, especially when on leash and in the mornings.
  • No vomiting or diarrhea.
  • Was on phenobarbital for seizures but owner discontinued. During one episode of respiratory distress, the owner gave a phenobarbital.
  • Seems uncomfortable.
  • Eating pasta, Purina kibble, boiled chicken and garlic, and occasionally a scrambled egg in the mornings. Seems to be eating well.

Physical Examination

  • T = 101.2°F; P = 144; R = 52
  • General: BARH. Weight 11.6 kg.
  • Integument: Skin clear, no palpable masses.
  • EENT: Right eye had mucous discharge. No pupillary response, nuclear sclerosis. Nose clear. Ears have a great amount of brown waxy exudate. Tonsils in crypts. Severe dental calculi.
  • Mucous membranes pink; CRT <2 sec.
  • Musculoskeletal: Asymmetry on right parietal region on head. Rest of body well-muscled and symmetrical. BCS 3/9.
  • Cardiovascular: V/VI left apical systolic murmur. V/VI right apical systolic murmur with palpable thrill. Gallop rhythm. Jugular distension. Positive hepatojugular reflux test. Weak femoral pulses.
  • Respiratory: No crackles or wheezes.
  • GI: Distended fluid-filled abdomen. No organomegaly.
  • Genitourinary: No secretions.
  • Nervous system: Not evaluated.
  • Lymph nodes: No lymphadenopathy.

Problems

  • V/VI left apical systolic murmur
  • V/VI right apical systolic murmur
  • Gallop rhythm
  • Ascites / Jugular vein distension

Chemistry Panel

  • Anion gap: 17 mM/L
  • Sodium: 150 mM/L
  • Potassium: 4.2 mM/L
  • Chloride: 114 mM/L
  • CO2 total: 23 mM/L
  • Calcium: 9.3 mg/dL
  • Phosphorus: 4.3 mg/dL
  • Creatinine: 0.8 mg/dL
  • Urea nitrogen: 17 mg/dL
  • Albumin: 3.1 g/dL
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