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Nathalie Cunha

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  • Nathalie Cunha
    Participant
    11:27 24/05/21

    Hi Liz,

    Do we note down our response here? Or do we keep our thoughts to ourselves and wait for further information on the case?

    Nathalie Cunha
    Participant
    06:46 22/05/21

    Hi everyone,

    Somehow I missed this post.
    My name is Nathalie and I work in a veterinary clinic in Belgium. I am a general practitioner but my intersest mainly goes out to cardiology. I just started the ESAVS cardiology certificate program this last February and I have my first 3 exams on the 25th of June …. so I am very happy with this course since Liz explains everything so clearly.

    Nathalie Cunha
    Participant
    06:13 13/05/21

    Hi Liz,

    Thank you for the response and the suggested reading material.
    The reason I asked the question is that I had a Chihuahua-Shiz-Tsu mix 7 months old on consultation this week. Main complaint: exercise intolerance since 12 weeks. The puppy runs for a little while and then it lays down. There is never loss of conciousness. (if it would be helpfull then I can e mail you a video of an event)
    The puppy does not show stunted growth and there is no murmer. Owner states a murmer was never heard.
    I did echo and ECG. Echo showed only that left ventricle was a bit larger in diastole than the Cornell values and contractility FS was 30% (I would have expected this to be higher). For the rest echo seemed normal to me. ECG showed sinus rythm with normal MEA but slower rythm than expected (90 bpm).
    My collegue is convinced there is a neurological explanation for these episodes (paroxysmal dyskenesia) and that therefore there is some vagal stimulation leading to slower heart rate?
    But now that I learned that shunt reversal can happen very early ( so never an audible murmer) I am concerned that maybe I missed an early reversed shunt?
    Is this still possible in this puppy or would there have been stunted growth and would there have been prominent ECG changes (right axis deviation) and prominent echo changes?

    Nathalie Cunha
    Participant
    16:20 05/05/21

    Thank you Liz, for that explanation. It is very helpfull.
    The problem I have with transmitral flow in cats however is E and A fusion so in a lot of cases I can’t confirm diastolic failure due to imaired relaxtation because I don’t have an E and A wave. I tried to let my assistent stroke the cat’s nose to try to induce a vagal response but it only made the cats even moren mad (whoops …. ). I have tried to use gabapentin 20 mg/kg 2hours before echo but still there is E and A fusion in most of my cat patients …

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