Document Type : Clinical Report
Authors
Department of Veterinary Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Punjab, India
Abstract
A one and a half years old male French bulldog weighing 9.50 kg was presented with the history of inappetence, lethargy, abdominal distension and exercise intolerance since last 2 days. The physical examination was done which revealed normal physiological parameters including temperature, mucus membrane color and capillary refill time except palpable precordial thrills, jugular distension on palpation, tachycardia and systolic murmurs on auscultation. Electrocardiography (ECG) was done which depicted ectopic foci with atrioventricular junctional tachycardia and right ventricular enlargement involving very small inverted P waves, deep S waves in leads I, II, III and augmented vector foot (aVF) and splintered QRS complexes. The dog was undergone chest radiography that revealed right atrial enlargement, increased sternal contact of heart on lateral view and a bulge at 9:00 o’clock to 11:00 o’clock depicted right atrial enlargement on dorso-ventral view. Lastly, echocardiography was done to arrive at a diagnosis confirming the Ebstein’s anomaly as a form of tricuspid valve dysplasia including apical displacement of tricuspid valve leaflets, division of right ventricle into atrialized and functional portions, increased displacement index, increased apex-mitral annulus to apex-tricuspid annulus ratio, severe right atrial dilatation and tricuspid regurgitation. The dog was medically treated with diuretics, angiotensin converting enzyme inhibitors and inotropes and the owner was advised to put the dog on low sodium diet for 2 weeks. The dog has resolved clinical signs of right sided heart affection; but, suddenly collapsed at home. The owner denied for the necropsy of dog.
Keywords
- Schrope DP. Prevalence of congenital heart disease in 76,301 mixed-breed dogs and 57,025 mixed-breed cats. J Vet Cardiol2015; 17(3): 192-202.
- Boon JA Congenital shunts and AV valve dysplasia. In: Boon JA (Ed). Veterinary echocardiography. 2nd West Sussex, UK: Wiley-Blackwell 2011; 468-472.
- Chetboul V, Charles V, Nicolle A, et al. Retrospective study of 156 atrial septal defects in dogs and cats (2001-2005). J Vet Med A Physiol Pathol Clin Med 2006; 53(4): 179-184.
- Dearani JA, Mora BN, Nelson TJ, et al. Ebstein anomaly review: what’s now, what’s next? Expert Rev Cardiovasc Ther 2015; 13(10): 1101-1109.
- Andelfinger G, Wright KN, Lee H, et al. Canine tricuspid valve malformation, a model of human Ebstein anomaly, maps to dog chromosome 9. J Med Genet 2003; 40(5): 320-324.
- Celermajer DS, Dodd SM, Greenwald SE, et al. Morbid anatomy in neonates with Ebstein’s anomaly of the tricuspid valve: pathophysiologic and clinical implications. J Am Coll Cardiol 1992;19 (5): 1049-1053.
- Tidholm A. Retrospective study of congenital heart defects in 151 dogs. J Small Anim Pract 1997; 38(3): 94-98.
- Garncarz M, Parzeniecka-Jaworska M, Szaluś-Jordanow O. Congenital heart defects in dogs: A retrospective study of 301 dogs. Med Weter 2017; 73(10): 651-656.
- Favril S, Broeckx BJ, de Rooster H, et al. Tricuspid valve dysplasia in dogs. Vlaams Diergeneeskd Tijdschr 2018; 87: 14-21.
- Kittleson MD. Congenital abnormalities of the atrioventricular valves. In: Kittleson MD, Kienle RD (eds). Small animal cardiovascular medicine. St. Louis, USA: Mosby 1998; 273-281.
- Holst KA, Connolly HM, Dearani J Ebstein's anomaly. Methodist DeBakey Cardiovascular J 2019; 15(2): 138-144.
- Kornreich BG, Moïse NS. Right atrioventricular valve malformation in dogs and cats: an electrocardiographic survey with emphasis on splintered QRS complexes. J Vet Intern Med 1997; 11(4):226-230.
- Chetboul V, Poissonnier C, Bomassi E et al. Epidemiological, clinical, and echocardiographic features, and outcome of dogs with Ebstein's anomaly: 32 cases (2002–2016). J Vet Cardio 2020; 29:11-21.
- Ammash NM, Warnes CA, Connolly HM, et al. Mimics of Ebstein’s anomaly. Am Heart J 1997; 134(3): 508-513.
- Lai WW, Mertens LL, Cohen MS, et al. Echocardio-graphy in pediatric and congenital heart disease: from fetus to adult. 2nd New Jersey, USA: Wiley Blackwell 2016; 231-242.
- Chetboul V, Tran D, Carlos C, et al. Congenital malformations of the tricuspid valve in domestic carnivores: a retrospective study of 50 cases [French]. Schweiz Arch Tierheilkd 2004; 146(6): 265-275.
)