Case 31 — Enlarged Heart

Boris, a 13-year-old domestic shorthair cat.
Boris

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

Signalment

  • Species: Feline
  • Breed: Domestic Shorthair
  • Age: 13 years
  • Sex: Male neutered
  • Weight: 4.3 kg
  • Name: Boris

Presenting Complaint

Enlarged heart

Pertinent History

  • Boris presented today for further workup of heart disease diagnosed by the referring veterinarian.
  • Boris presented to the referring veterinarian for vomiting. The referring veterinarian took thoracic radiographs and found an enlarged heart. He then found a positive heartworm antibody test at 100 AbU/ml.
  • The owner also reports lethargy of 3 weeks duration.
  • The animal originally presented to the referring veterinarian for urinating outside the litter box and the owners observing one area of urine that was dark brown in color. A urinalysis was performed, but the results are unknown. The animal was started on tetracycline, which was completed yesterday. The owner reports that clinical signs of lethargy and urinating inappropriately have resolved.
  • The owners have recently moved back to northern California from Texas. During the year that the owners lived in Texas the cat was not on heartworm preventative.

Physical Examination

  • Wt 4.3 kg, T 100, HR 156, RR 42. BAR hydrated by skin turgor. Full coat; clear skin.
  • Ears free of erythema thickening, discharge. Eyes – anterior chamber, cornea, conjunctiva clear OU. PLR intact OU. No nasal discharge. Teeth clean.
  • BS 5/9. Small thyroid nodule palpable.
  • Normal rhythm, pulses adequate, mm pink, CRT 1 sec. A jugular pulse is present to the level of the angle of the jaw; distension is also present. A soft grade 2/6 sternal systolic heart murmur is present.
  • Inspiratory breath sounds bilaterally dorsally and ventrally.
  • No organomegaly or abdominal masses.
  • Bladder smooth.
  • NE. WNL.

Problems

  • Cardiomegaly with jugular distension/pulsation
  • Positive heartworm antibody test
  • Dark colored urine

Quiz

1. How would you interpret the positive heartworm antibody test?

↑