Case 20 — Heart Failure

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

Signalment

  • Species: Canine
  • Breed: Labrador retriever
  • Age: 10 weeks
  • Sex: Male
  • Weight: 4.6 kg
  • Name: Stubs

Presenting Complaint

  • Congestive heart failure

Pertinent History

  • Last of twelve puppies; discovered still in amniotic sac. Breathed and nursed normally after sac cleared.
  • Three weeks ago: trouble breathing, lethargy, weakness. Referring DVM found pulmonary abnormalities on radiographs. Started on amoxicillin; seemed to respond.
  • Ten days ago: another episode of respiratory distress with T = 96°F. Rewarmed. Radiographs revealed markedly enlarged heart. Given diuretic injection and referred to VMTH.
  • Good appetite but not gaining weight like litter mates. No vomiting/sneezing/diarrhea. Owner noted “moist” sounds during respiratory distress but no coughing.
  • Lives with mother and 7 healthy litter mates. Dewormed at 3 and 6 weeks. No immunizations. Diet: lamb and rice kibble.

Physical Examination

  • T = 101°F; P = 204 bpm; R = 72. BAR. Full soft coat. Thin; BCS 2/9.
  • Eyes, ears, nose clean. No tracheal cough.
  • Grade 5/6 left apical systolic murmur; gallop rhythm; weak femoral pulses. MM pink; CRT 2 sec. Possible soft diastolic murmur (difficult to discern). No jugular pulses.
  • Tachypneic; harsh lung sounds; moderate inspiratory effort. No crackles or wheezes.
  • Smooth gut loops; no masses. Small smooth bladder. CN intact; PLRs normal. LN WNL.

Problems

  • Respiratory distress
  • Grade V/VI left apical systolic murmur with gallop rhythm and possible soft diastolic murmur
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