Case 36

Primary clinician: Patrizia Knafelz, DVM, DACVIM (Cardiology)
Supervising clinician: Mark D. Kittleson, DVM, PhD, DACVIM (Cardiology)

Newman was referred to the VMTH Emergency Service three days ago after his veterinarian diagnosed a partial saddle aortic thromboembolus. Three days ago he was knuckling his right hind leg and dragging it. The right caudal foot was cool and the femoral pulse was weak in this leg. He is back for a recheck examination today. The client says the foot has now warmed up and Newman is walking better, although his right hind leg has been stiff.
A murmur was first noted 3 months ago by a veterinarian in Pennsylvania.
Newman has seemed less active for the last couple of weeks. He has panted when stressed (at veterinarian's office; after bath) for a long time. He has never been seen panting after exercise. No coughing.
No other known problems. No surgery since neuter. Vaccinated for travel in April.
TRAVEL: Newman has lived in Portland and Spokane. He has been in Philadelphia for the last four years and recently moved to Fairfield, CA.
ENVIRONMENT: He lives with one other cat (Newman's brother) and one dog - both healthy. Cats are mostly outdoors.
DIET: Science Diet hairball adult. Recently some wet food.
No C/S/V/D/PU/PD.

GEN: BAR, hydrated by skin turgor. T=102.5, HR=220, RR=72. Wt=6.1kg.
INT: Full coat, no masses or lesions noted. Small amount of flea dirt.
EENT: Ears: Mild wax. Eyes: Sclera, cornea and anterior chamber clear, no discharge. Nose: No discharge. Mouth: mm pink, CRT~1sec. Mild tartar.
MS: Symmetric musculature, BCS 6/9. Ambulatory x 4. No knuckling. Walk is symmetric; hind feet stay very close to floor during walk. Able to jump to counter easily.
CV: III-IV/VI left apical systolic murmur. No arrhythmia ausculted. Femoral pulses strong and synchronous.
RESP: No crackles or wheezes ausculted.
GI: Bowel loops smooth with no thickening. No masses or organomegaly palpated.
GU: No discharge.
NS: Grossly normal; full neuro exam not performed.
LN: Axillary LNs~1cm, popliteal~1.5cm.