Case Presentation by:  Sean Jennett, Todd Dawson, Denise Dawson and Christine Fain

Patient Profile: "Woodrow", a 9-year old, castrated male Great Dane.

History: "Woodrow" presented to the emergency room in a very weak state.  He was experiencing some respiratory distress.  His medical history included a left forelimb amputation for osteosarcoma over 6 months ago and a two-year history of dilated cardiomyopathy.  He was being treated with digoxin 0.25 mg twice a day.

Physical Examination:  Heart rate = 190/minute.  Pulse rate = 65/minute.  Respiratory rate = 60 breaths/minute.  Body weight = 63.63 kg. "Woodrow's" attitude and gait were abnormal. Capillary refill time and hydration status were normal.  There were no apparent murmurs but there were pulse deficits.  Crackles were heard on chest auscultation.  Abdominal palpation was normal.

Laboratory Findings:   Stress leukogram (Nucleated cells = 48,800; Segmented neutrophils = 42,900; Band neutrophils = 1,500; Lymphocytes = 1,000), monocytosis (3,400).  PCV = 28, albumin = 2.0 g/dl, globulin = 3.9 g/dl, AST = 46 IU/L, ALP = 220 IU/L, glucose = 137 mg/dl, bicarbonate = 13.1 meq/L.  Azotemia (BUN = 52mg/dl, creatinine = 1.6 mg/dl, phosphorous = 8.5 mg/dl).

Electrocardiogram:
    The following electrocardiogram was recorded from "Woodrow".

Questions:   

• List the emergency treatments you would institute for "Woodrow".
• Describe the abnormalities you would expect to hear on auscultation of the heart and see on an EKG. 
• Describe what you see on the thoracic radiograph.
• Describe the pharmacologic agents used to chronically manage DCM.
• What is the prognosis for heart failure due to DCM?

Answers and Discussion:

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Copyright Wayne E. Wingfield, DVM and Brenda McClelland, DVM, Colorado State University, 1999. All rights reserved.
This page was last edited:  08/16/99