Case 30 — Acute Collapse

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

Signalment

  • Species: Canine
  • Breed: Boxer
  • Age: 6 years
  • Sex: Male neutered
  • Name: Max

Presenting Complaint

  • Acute collapse

Pertinent History

  • Max had an episode of acute collapse 3 days ago. The episode was described as a seizure with tremors, paddling, urination, and loss of consciousness. The owner performed mouth-to-nose breathing for approximately 3 minutes. Max recovered and appeared normal.
  • An ECG at the referring veterinarian showed sinus tachycardia. Propranolol 10 mg TID was prescribed.
  • Max had another episode of collapse this morning.
  • A melanoma was removed from the right caudal thigh approximately 5 months ago.
  • Max is an indoor/outdoor dog.
  • The owner reports occasional dry cough.

Physical Examination

  • General: QAR. T = 101.8°F. P = 78. R = 60.
  • Integument: Surgical scar on the right flank.
  • EENT: Ectropion OU. Bilateral serous nasal discharge.
  • Musculoskeletal: No atrophy or ataxia.
  • Cardiovascular: II/VI systolic murmur, PMI left apex. Strong, synchronous femoral pulses. Marked sinus arrhythmia. Mucous membranes pink. CRT = 1 second. No jugular distension.
  • Respiratory: Lungs clear on auscultation.
  • GI: Abdomen unremarkable.
  • Lymph nodes: All WNL.

Problems

  • Two episodes of acute collapse in a Boxer dog

Echocardiogram

  • All measurements within normal limits: IVSd = 1.0 cm, LVFWd = 1.0 cm, LVDd = 4.0 cm, LVDs = 2.9 cm, FS = 27%, LA = 2.6 cm, Ao = 2.0 cm.
  • Trivial tricuspid insufficiency noted.
↑