vtx logo

request clinical advice

vtx logo sticky

Reply To: Another interesting case

Liz Bode

Replying to Anna Deen 24/09/2021 - 07:28

Hi both,

Great answers, it is a tricky one as this could be an MMVD lesion on the posterior valve. The murmur had not been noticed before, CRP was >70 mg/l (very high). I thought that this was most likely an endocarditis lesion – it oscillates separately to the valve and flails into the LA, it is very echodense and organised (almost polypoid). The posterior leaflet is not usually as affected as the anterior leaflet in MMVD, which increased my suspicions more. There was MR associated with it, although the anterior leaflet is also thickened and does display some evidence of MMVD.

The lameness localised to the carpus, this was tapped and appeared septic. Blood cultures and joint fluid cultures were submitted. CT was performed. Urine cultures also. Then the dog was started on IV antibiotics including potentiated amoxicillin and enrofloxacin. In the literature they say to hospitalise for at least 7 days, but with financial considerations this was not possible. Therefore, she was discharged following normothermia and when she was eating on oral equivalents.

She is currently doing well and I will re-echo in 4-6 weeks and recheck CRP. If CRP normal then I will stop antibiotics.