Case 38: Heart Murmur

Case 38

Primary clinician: Fiona Campbell, DVM, DACVIM (Cardiology)
Supervising clinician: Mark D. Kittleson, DVM, PhD, DACVIM (Cardiology)

Brie, a 15 month old female Standard Poodle, presented to the UC Davis Cardiology Service for evaluation of a heart murmur identified following an exaggerated bradycardic response to sedation at the referring veterinarian's office 10 days ago.
NO C/S/V/D and no decrease in activity level or appetite.
Diet consists of a raw food diet consisting of approximately 1/2 lb of food grade beef, chicken, or pork. No supplementation.
Current medications include a topical saline wash applied to both eyes.
Traveled to Toronto, Canada for a 2 1/2 month period where he received Purina kibble diet. He lost 8 lb while on trip but has since gained it back while at home.

GEN: BAR, adequately hydrated based on skin turgor,
INTEG: clean, full coat, no masses, no ectoparasites, no odor, no scales, no mammary masses, no discharge,
HEAD: facial symmetry, temporal muscles not atrophied, nose clean, moist, no discharge,
THROAT: MM pink, moist, CRT 1.5sec, all teeth present, mild tartar, no gingivitis or calculi, tonsils in crypts
EYES: PLR intact OU, sclera mildly injected, conjunctiva slightly hyperemic, cornea clear, anterior chamber clear, no ocular discharge, protruding 3rd eyelid mildly hyperemic OU, trichiasis
EARS: clean, mild waxy debris, otic epithelium smooth, pink
MS: BCS: 5/9, lean, adequate muscling, gait symmetrical
CV: HR 88bpm, regular rhythm, grade I-II/VI left basilar systolic murmur, split S2 (fixed), femoral pulses strong and synchronous.
RR: Eupneic, normal bronchovesicular sounds all fields.
GI: abdomen not distended or painful, smooth bowel loops, liver not beyond caudal rib
GU: kidneys not palpated, bladder small, vulva not swollen, no discharge,
LN: mandibular, prescapular, popliteal less than 1.5cm