Case 13 — Syncope

Daisy, a one-and-a-half-year-old female English bulldog.
Daisy — 1.5-year-old female English bulldog, 18.6 kg.

Clinicians

Mark D. Kittleson, D.V.M., Ph.D., DACVIM (Cardiology)

Signalment

  • Species: Canine
  • Breed: English bulldog
  • Age: 1.5 years
  • Sex: Female
  • Weight: 18.6 kg
  • Name: Daisy

Presenting Complaint

  • Heart Murmur
  • Syncope

History

  • Daisy was adopted about five months ago at which time the new owners knew she had been previously diagnosed with a heart murmur.
  • A couple months ago, Daisy had an episode beginning with a choking-like action followed by falling into lateral recumbency. She remained unconscious for about one minute without movement or defecation/urination. After regaining consciousness, it took about a day to fully recover.
  • A second episode occurred last week while going down stairs. Her front legs buckled and she remained unconscious for less than one minute. During this episode, her tongue went white, her body was cold, and she urinated. She perked up immediately afterward.
  • Daisy is fairly active and climbs a long set of stairs to the owner’s work every day without evidence of tiring. She is fed once a day.

Physical Examination

  • BARH; T = 102.4°F; P = 120; R = 72; Weight = 18.6 kg
  • Skin clean except for skin fold pyoderma on the nasal region. Small skin mass in the intrascapular region.
  • Teeth clean, ears clean.
  • Well-fleshed and symmetrical.
  • Femoral pulse strong; jugular pulse visible about 1/3 up the neck. A V/VI systolic murmur was auscultated at the left heart base.
  • Stertor was auscultated.
  • No abdominal abnormalities palpated.
  • Mandibular, prescapular, and popliteal lymph nodes all about 2 cm diameter.

Problems

  • V/VI systolic left basilar heart murmur
  • Syncopal episodes
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