Case 2: Cough (Dilated Cardiomyopathy)

Case 2 — Cough

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

Monty is a 13-year-old male castrated Doberman pinscher weighing 38 kg (“Monty”)

The owner first noticed Monty’s coughing and shortness of breath about one and a half months ago.
Monty was seen by the referring DVM for this problem about 6 weeks ago. The referring DVM did a chemistry panel, CBC, ECG, thoracic radiographs, and a cardiac ultrasound. Results are not available.
Monty was put on Lasix 75 mg TID, Tussigon BID, and prednisone 10 mg EOD.
Monty is also on chondroitin sulfate for his arthritis.
Before starting the Lasix therapy, the owners report that Monty was coughing continuously, and that he would even wake up to cough while sleeping. Now Monty coughs when he lays down, approximately 10 times per day. The coughing lasts for about 15 seconds.
The owner reports that Monty gets short of breath when he walks, but also sometimes when he is just laying down.
Monty’s energy level has been much lower than usual since this problem began.
When he was coughing continuously Monty was anorexic. Now his appetite is almost back to normal.

T=100.2°F, P=180, R=48.
BAR. Severe dental calculus.
There is bilateral varus of the carpi. He has great difficulty moving and seems painful in all four limbs. The pelvic limbs splay out caudally when the dog attempts to rise.
There is a II/VI left apical systolic murmur and a regular tachycardia. Femoral pulses are weak.
Inspiratory and expiratory breath sounds are loud in all lung fields.
Hepatomegaly; pendulous abdomen with positive ascites wave (a fluid wave can be produced via ballottement).