Amy

 Signalment

 10 year old, spayed female

 Cocker spaniel-cross

 Past pertinent history

 Vax current, on HW preventative

 Murmur for 1 year

 CXR: Cardiomegaly

 Presenting history

 Cough, Tachypnea, P. Anorexia

 HR = 180, RR > 100 per minute

 No GI, PU/PD

 rDVM: Furosemide prior to referral

 Physical examination

 T = 38.5, P = 160/wk, R = 64, 7.5kg

 CRT = 1.5–2 sec, MM = pink

 5/6 L apical, plateau-shaped murmur & S3 gallop

 No Adventitial lung sounds

 Problems

 Partial anorexia

 Cough, tachypnea

 Cardiomegaly (historical)

 Murmur & S3 gallop

 Differential diagnoses?

 Plan?

 Diagnostic?

 Therapeutic?

 Client education?

Swayze

 Signalment

 8 year-old male, Doberman pinscher

 History

 Wobbler - surgical candidate

 Cardiovascular - asymptomatic

 Cardiac consult requested due to breed

 Physical exam (12/20/96)

 TPR = 101.5/120/30; BW: 35 kg

 MM = pink, CRT < 2 sec

 Pulses = good and regular

 S₃ gallop

 Posterior ataxia, CP deficits

 ECG - NSR

 Echo - SF = 13%, thin-walled LV

 CV problem list:

 Compensated DCM

 Myocardial failure?

 Remodeling?

 Heart rate/arrhythmia?

 Heart failure?

 Hypo-, hypertension?

 Loading (pre-, after-)?

 Electrolytes?

 Oxygenation?

 Neurohumoral activation (RAAS, SNS)?

 Plan

 Therapeutic options - What would you do?

 Furosemide

 Spironolactone

 Sodium restriction

 Digoxin

 Dobutamine

 Ca channel blocker (Amlodipine, Diltiazem)

 Beta blocker (Carvedilol, Atenolol)

 Nitroglycerin

 Hydralazine

 Enalapril

 Carnitine, taurine

 Fish oils

 CoQ10

 Oxygen

 Euthanasia

Gabby

 Signalment

 West Highland White Terrier

 12 year old, spayed female

 History - past

 Good vaccination and HW preventative history (recent negative test)

 Non-productive cough r/t steroids, antibiotics

 1 period of syncope (8–10 months ago)

 Cough returned; n/r to steroids, antibiotics

 Another syncopal episode, f/b 2 more with exercise

 History - current

 Arrhythmia) and crackles audible

 CXR: cardiomegaly & bronchointerstitial dz

 Diagnosed with L-CHF

 Treated with Lasix (25 mg BID) and theophylline (100 mg BID)

 Referred to NCSU

 Physical exam/MDB

 TPRWt = 38.7°C, 80 bpm, 40 rpm, 7.8kg

 NSA, + Arrhythmia (dropped beats), loud S2

 Coarse crackles audible + expiratory effort

 CBC: mild, mature neutrophilia; thrombocytosis

 Chemistry: WNL

 UA: NA

 Problem list?

 Cough

 Syncope

 Cardiomegaly

 Arrhythmia

 Loud S2

 Differential DIagnoses?

 Plan?

 Diagnostic

 Therapeutic

 Client education

Tiger

 Signalment

 6 year old, neutered male, Domestic short-hair, 4.5kg

 Presenting complaint

 Routine visit

 Examination and vaccination

 On no heartworm preventative

 Physical exam

 TPR = 36/220/32

 4/6 right sternal border, pansystolic murmur

 Normal respiration

 Problem list

 Murmur

 Tachycardia

 Differential diagnoses

 Plan?

 Diagnostic

 Therapeutic

 Client Education