Case 23 — Cough

Max, a 2-year-old male castrated Labrador retriever.
Max — 2-year-old MC Labrador retriever, 31 kg.

Primary clinician: Kris MacDonald, DVM, DACVIM (Cardiology)
Supervising clinician: Mark D. Kittleson, DVM, PhD, DACVIM (Cardiology)

Signalment

  • Species: Canine
  • Breed: Labrador retriever
  • Age: 2 years
  • Sex: Male castrated
  • Weight: 31 kg
  • Name: Max

Presenting Complaint

  • Cough

Pertinent History

  • Max was brought to the referring DVM one week ago for a dry nonproductive cough.
  • The referring DVM on physical exam found an irregular heart rhythm and pulse deficits. An ECG revealed tachycardia.
  • Radiographs revealed severe cardiomegaly.
  • There was apparently an echocardiogram performed, but the owner was not informed of those results.
  • Max was placed on enalapril 20 mg PO BID. The owner also administered one aspirin a day since he had heard this was a treatment in human heart failure.
  • A second veterinarian was consulted and on physical exam he found hepatomegaly, weak femoral pulses, and an arrhythmia. After reviewing the radiographs and ECG he felt that a further work-up should be performed and sent Max to the VMTH.
  • Max is a narcotics detection dog in training and leads an active life. He doesn’t seem to have any energy loss or exercise intolerance. He has always been very thin and is a fastidious eater. His only clinical sign is the dry nonproductive cough.
  • He is not receiving any medications at this time.

Physical Examination

  • General: BARH, acts like a healthy 2-year-old Lab. T = 102°F; P = 140; R = panting; Wt = 31.2 kg.
  • Integument: Coat clean, salivary staining on all four paws.
  • EENT: Eyes — cornea and anterior chamber clear, no discharge. Ears — clean. Nose — clean and moist, no discharge. Mouth — no tartar or gingivitis.
  • Musculoskeletal: Thin, BCS = 4/9.
  • Cardiovascular: V/VI systolic murmur heard over the right apex; irregularly irregular arrhythmia; jugular pulses extend 3 inches above the thoracic inlet; mm = pale pink, CRT = 1.5 s, peripheral pulses poor with deficits.
  • Respiratory: No crackles or wheezes. Decreased lung sounds ventrally.
  • Gastrointestinal: Moderate hepatomegaly, all other organs within normal limits; no ascites, no masses, gut loops smooth.
  • Genitourinary: Intact male; both testicles descended.
  • Nervous: Not examined.
  • Lymph nodes: Within normal limits.

Problems

  • Systolic heart murmur heard best over right apex
  • Arrhythmia (auscultatory)
  • Jugular pulses
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