Otto Sven, Höpfner Robert
Tierklinik Panitzsch, Carl-Benz-Straße 2, 04451 Borsdorf, Germany.
Kleintierspezialisten Berlin, Wittestraße 30 Haus P, 13509 Berlin, Germany.
Case Rep Vet Med. 2020 Oct 22;2020:8848627. doi: 10.1155/2020/8848627. eCollection 2020.
Intracardiac thrombi are rare in dogs. If they occur, they are mostly seen in the right atrium while only two case reports describing a mural left atrial thrombus in dogs are available. This case report describes a 14-year-old mixed-breed bitch that was presented at the clinic because of dyspnoea. The dog suffered from alopecia for about three years and displayed polyuria and polydipsia for a number of months. Clinical examination revealed intensified inspiratory and expiratory respiratory sounds and various heart sounds. Chest X-ray showed cardiomegaly (VHS 11) and a mixed bronchoalveolar lung pattern of the caudal lung. A transthoracic echocardiography was performed and showed a moderate mitral regurgitation, a highly dilated left atrium, a low-grade pulmonary insufficiency, and a minimal aortic and tricuspid insufficiency. Additionally, a free-floating ball thrombus was found in the left atrium. Hyperadrenocorticism was indicated by an ACTH stimulation test. The previous medical therapy of the referring veterinarian consisted of benazepril and furosemide and was complemented by clopidogrel. The pet owners declined any further clinical diagnostics and therapy. The dog died 19 days later. This is the first reported case of a dog with a free-floating left atrial thrombus. Specific therapeutic strategies for intracardiac thrombi in the dog are currently not available, and therefore, every patient should be treated individually.
心内血栓在犬类中较为罕见。若发生心内血栓,大多见于右心房,而仅有两篇病例报告描述了犬类左心房壁血栓。本病例报告描述了一只14岁的混血母犬,因呼吸困难就诊于诊所。该犬患有约三年的脱毛症,并出现了数月的多尿和烦渴症状。临床检查发现吸气和呼气时呼吸音增强以及多种心音。胸部X光显示心脏肥大(VHS 11)以及肺尾叶的混合性支气管肺泡肺模式。进行了经胸超声心动图检查,结果显示中度二尖瓣反流、左心房高度扩张、轻度肺动脉瓣关闭不全以及轻微的主动脉瓣和三尖瓣关闭不全。此外,在左心房发现了一个游离的球形血栓。促肾上腺皮质激素刺激试验表明患有肾上腺皮质功能亢进。转诊兽医之前的药物治疗包括贝那普利和呋塞米,并辅以氯吡格雷。宠物主人拒绝进一步的临床诊断和治疗。该犬19天后死亡。这是首例报告的患有游离性左心房血栓的犬类病例。目前尚无针对犬类心内血栓的特定治疗策略,因此,每个患者都应进行个体化治疗。