From the Case Book presented in 2001 by Luca Ferasin (Department of Clinical Veterinary Science, University of Bristol Veterinary School)
Case details
| Patient
detail Six year old, 4.5 Kg, male, Japanese Chin |
| History The dog had been in the owner's possession since he was a puppy. He was exercised daily for approximately one hour on moderate runs and fed a maintenance commercial tinned dog food supplemented with fresh cooked beef meat. The dog was regularly vaccinated, wormed and treated for flea infestation. When the dog was three-years old, a heart murmur was detected at an annual check up for routine vaccination but there were apparently no associated clinical signs. Nevertheless, long term administration of frusemide (Frusemide BP Vet®, 10 mg/sid) was instituted. The dog did not show any remarkable clinical signs for approximately one year, thereafter he started to present occasional bouts of dry coughing that the owner described as "like a bone in the throat". At that time enalapril (Cardiovet®, 2.5mg/sid) was added to the current therapy. Four weeks prior to presentation, the dog had started coughing more frequently, 3-4 times daily initially progressing to 12-15 times daily, over the previous ten days. Ten days prior to presentation, the administration of both enalapril (2.5mg) and frusemide (10mg) was increased from once to twice daily. |
| Physical
examination At presentation, the dog was slightly thin, with palpably pronounced dorsal vertebral processes and intercostal spaces. However, he appeared bright, alert and fully responsive. Physical examination revealed the presence of a regular femoral pulse and the heart rate was within the normal range (170bpm). The oral mucous membranes appeared pink with a normal capillary refill time. The colour of the skin and the preputial and anal mucous membranes appeared also normal. Jugular vein distension or pulsation was not noted and the hepato-jugular reflex was negative. Palpation of the abdomen was unremarkable. A palpable precordial thrill could be appreciated over the cardiac area and auscultation of the thorax revealed a loud systolic murmur with a point of maximum intensity (PMI) over the left apex. The murmur seemed to radiate to the left base and could also be auscultated, less loudly, on the right side. On the basis of these findings, the murmur was classified as grade V/VI. Respiration rate was increased (tachypnoea) with some degree of abdominal effort (dyspnoea). Auscultation of the lungs revealed the presence of fine crackles, especially over the caudo-dorsal fields. Systolic blood pressure was within the normal range (150 mmHg). |
| Problem
list 1. cough 2. tachypnoea 3. systolic heart murmur |
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