Reply To: CASE OF THE MONTH APRIL 2023
Replying to Liz Bode 22/04/2023 - 20:14
Thanks for your thoughts Liz,
The history revealed no toxin or drug exposure that would cause episodic weakness, PUPD or cataract formation. The theophylline was started after all of these clinical signs had developed. Likewise, the dietary history was complete, balanced and calorie appropriate for the dog’s needs. The age of onset of the clinical signs would make a congenital problem less likely. Neither the cataracts of heart murmurs had been noted at the annual vaccination check one year previously. None of the physical examination findings were consistent with pain or a neuromuscular disorder. Systolic blood pressure was documented within the normal range making hypotension a more unlikely cause for the episodic weakness.
For all investigations to be carried out the dog was hospitalised for just over 48 hours. Due to the detection of the heart murmurs and the possibility of the episodic weakness being due to cardiac disease an echocardiogram (looking for structural heart disease) (results below) and ECG (results below) were carried out. No abnormalities were detected with standard ECG. Despite early, mild degenerative changes, no significant structural heart disease was detected. The mitral regurgitation explained the murmur auscultated. It was clear at this stage that there were potential significant co-morbidities, and therefore it was decided to investigate and stabilise underlying diseases before further investigating the possibility of an arrhythmia.
Haematology, biochemistry, blood gas analysis and urinalysis (results below) were analysed to identify underlying metabolic, electrolyte, acid-base disorder or indicators of another systemic disease.
Would love to hear your thoughts on these!