Case 31 — Fourth Visit

Four months after first visit

Pertinent history

  • Boris presents today for a recheck after his heartworm removal.

Physical examination

  • General: BARH. Weight 4.17 kg, T 101.3°F, P 116 bpm, R 36/minute.
  • Integument: The fur is slightly oily, with shaved patches of alopecia. There is a 3x2 cm healed crusted lesion over the sternum. There is a healed incision over the right jugular area, with suture material present.
  • EENT: The eyes are clear, the ears are clean and dry, the nose is clean and moist, the oral mucosa is pink and moist. Lentigo simplex is present on the lips, eyelids, nose, and eyebrows.
  • Musculoskeletal: Body condition score is 3/9. No deficits are seen.
  • CV: A soft I/VI systolic murmur is ausculted. A jugular pulse is present. CRT is 1 second.
  • Respiratory: No crackles are ausculted.
  • GI: The teeth are clean; the anus is clean and dry.
  • GU: About 60 ml of dark brown urine was present in his cage at 10:50 AM.

Comments

  • Echocardiogram: No adult heartworms were noted on exam. A laminar tricuspid regurgitant jet was present with a normal transvalvular gradient. The valve appears structurally normal but the echo signs of a markedly enlarged right heart, jugular pulses, and the presence of a large tricuspid regurgitant jet with a laminar pulsed wave Doppler is consistent with a significant valve abnormality. The hepatic veins were distended, but no ascites or pleural effusion were present.

Eight months after first visit

Echocardiogram of the right heart after heartworm extraction.

Specimen #1: BLOOD
Collection Method: VENIPUNCTURE
Comment: SYNBIOTICS DIROCHEK ANTIGEN TEST: NEGATIVE.

IDEXX ANTIGEN TEST: NEGATIVE.

ASSURE ANTIBODY: WEAK POSITIVE.

Comments

The echocardiogram now shows that there are no worms present. The right atrium and right ventricle were mildly enlarged. No tricuspid regurgitation was present. The heartworm antigen tests were negative while the heartworm antibody test was weakly positive. Boris went on to do very well.

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