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Cardiovascular Disease 759

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Figures 1A (above) and 1B (right). Lateral and ventrodorsal thoracic
radiographs taken on the day of admission to the hospital.
Generalized cardiomegaly with prominent left atrial and ventricular
enlargement is present. Pulmonary venous distention and air bron-
chograms typical of cardiogenic pulmonary edema are also visualized.

some end-inspiratory crackles over the lung fields. An addition-
al dose of 2 mg/kg body weight of furosemide was administered
subcutaneously. Serum urea nitrogen, creatinine and electrolyte
concentrations were within normal limits. The serum digoxin
concentration was 1.2 ng/ml.
The food was changed to moist Prescription Diet h/d Canine a
(583 kcal/can; 2,439 kJ/can), which is lower in sodium than the
food fed previously.Three days later, the owners reported that the
dog was feeling well. Its serum biochemistry values continued to
be normal.
Approximately 10 months later, another episode of severe pul-
monary edema occurred that was unassociated with any known
nutritional indiscretion. This condition was unresponsive to 12
hours of intensive preload and afterload reducing therapy (increas-
ing doses of furosemide, the arterial dilator hydralazine and nitro-
glycerine).The dog was euthanatized at an emergency clinic at the
owner’s request. Postmortem examination revealed a ruptured pri-
mary chorda tendinea to be the cause of the dramatically worsened
mitral regurgitation and unresponsive pulmonary edema.

Endnote
a. Hill’s Pet Nutrition Inc., Topeka, KS, USA.
Bibliography Figure 2. An echocardiogram obtained on the second day of hospi-
Keene BW, Bonagura JB. Management of heart failure in dogs. talization shows thickened mitral (MV) and tricuspid (TV) valve
In: Bonagura JD, Twedt DC, eds. Current Veterinary Therapy leaflets typical of endocardiosis.
XIV. Philadelphia, PA: Saunders Elsevier, 2009; 769-780.