Download Reversible congestive right sided heart failure in a

Companion Animal
Voorjaarsdagen Clinical Cases Award
Reversible congestive right sided heart
failure in a cat
Mark J. Dirven1,2
Ictuscordis veterinary
services, Wevershof 15,
5126 VW Gilze, The
Netherlands
1
Department of Clinical
Sciences of Companion
Animals, Faculty of
Veterinary Medicine,
Utrecht University, Yalelaan
108, 3508 TD, Utrecht,
The Netherlands
2
[email protected]
A six months old male entire domestic shorthaired was presented as a second opinion
for assessment of congestive right sided heart failure secondary to congenital tricuspid
valve dysplasia diagnosed several weeks earlier in a referral centre.
The presenting complaints had been cough and dyspnoea for a couple months.
Physical examination findings consisted of the following: dyspnoea, tachypnea, jugular
vein pulsation and abdominal distension suggestive of congestive right sided heart
failure, harsh respiratory sounds over all lung fields and a grade III/VI heart murmur on
the right hemithorax. Right sided congestive heart failure cannot explain the dyspnoea
and harsh lung sounds, so thoracic radiographs were made to determine the cause of
dyspnoea. Thoracic radiography showed a mixed pattern of interstitial, alveolar and
bronchial changes and right sided cardiomegaly. Echocardiography confirmed right
ventricular and atrial enlargement, pulmonary artery dilation and severe tricuspid valve
regurgitation with evidence of moderate to severe pulmonary hypertension. Clinical,
radiographic and echocardiographic abnormalities were hypothesised to be caused by
primary pulmonary disease. As a first step in the work-up of primary pulmonary disease,
a direct smear of a rectal swab was evaluated to diagnose parasitic lung disease.
Many Aelurostrongylus abstrusus L1 larvae were found. Diagnosis was confirmed with
Baermann. A single dose of spot on broad spectrum anthelminthic with moxidectine
was applied. Two months later the cat had made a complete clinical recovery, thoracic
radiographs showed no abnormalities and echocardiography showed a completely
normal heart without any pulmonary hypertension.
This case report shows Aelurostrongylus abstrusus can cause significant morbidity and
mortality, might be underdiagnosed and should be considered a differential diagnosis
not only in cats with dyspnoea and cough but also in cats with pulmonary hypertension
and congestive right sided heart failure.
Abstracts | European Veterinary Conference Voorjaarsdagen 2015
www.voorjaarsdagen.eu