Paik Jooyae, Kang Ji-Houn, Chang Dongwoo, Yang Mhan-Pyo
From the Chungbuk National University College of Veterinary Medicine, Cheongju, South Korea.
J Am Anim Hosp Assoc. 2016 Nov/Dec;52(6):378-384. doi: 10.5326/JAAHA-MS-6225. Epub 2016 Sep 29.
A 5 yr old intact female cocker spaniel dog weighing 7.8 kg was referred with anorexia, vomiting, and depression. At referral, the dog was diagnosed initially with typical hypoadrenocorticism, and 2 d later, concurrent primary hypothyroidism was detected. Hormonal replacement therapies, including fludrocortisone, prednisolone, and levothyroxine, were initiated, but a few days later the dog became abruptly tachypneic, and thoracic radiographs indicated the development of pulmonary edema. Echocardiography showed that there were abnormalities indicating impaired left ventricular function, although the heart valves were normal. Following treatment with pimobendan and furosemide, the pulmonary edema resolved. The dog had no recurrence of the clinical signs after 10 mo of follow-up, despite being off all cardiac medications; consequently, the cardiac failure was transient or reversible in this dog. The case report describes the stepwise diagnosis and successful treatment of cardiogenic pulmonary edema after initiation of hormonal replacement therapy for concurrent hypoadrenocorticism and hypothyroidism in a dog.
一只5岁、体重7.8千克的未绝育雌性可卡犬因厌食、呕吐和精神沉郁前来就诊。初诊时，该犬被诊断为典型的肾上腺皮质功能减退症，2天后又检测出并发原发性甲状腺功能减退症。于是开始了包括氟氢可的松、泼尼松龙和左甲状腺素在内的激素替代疗法，但几天后该犬突然呼吸急促，胸部X光片显示出现了肺水肿。超声心动图显示，尽管心脏瓣膜正常，但存在提示左心室功能受损的异常情况。在用匹莫苯丹和呋塞米治疗后，肺水肿消退。随访10个月期间，尽管停用了所有心脏药物，该犬的临床症状未再复发；因此，这只犬的心力衰竭是短暂的或可逆的。该病例报告描述了一只犬在因并发肾上腺皮质功能减退症和甲状腺功能减退症开始激素替代治疗后，心源性肺水肿的逐步诊断和成功治疗过程。
