Langford Vets, University of Bristol, Stock Lane, Lower Langford, North Somerset, BS40 5DU, United Kingdom; Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, Avon, BS14 9BE, United Kingdom.
Veterinary Diagnostic Imaging Ltd, Baytree Cottage, Dyrham, Chippenham, SN148EX, United Kingdom.
J Vet Cardiol. 2022 Jun;41:209-215. doi: 10.1016/j.jvc.2022.03.003. Epub 2022 Mar 23.
A six-year-seven-month-old female neutered Cavalier King Charles Spaniel was referred for the investigation of progressive dyspnea and hyphema in the right eye with secondary glaucoma. Previous medical history included a high-grade soft tissue spindle cell sarcoma removed from the cranial sternal region one year before. On presentation at the referral hospital, the dog was tachypneic and dyspneic. The heart rhythm was regular and there was a soft left-sided systolic murmur. Echocardiography identified the presence of a mass significantly occluding left heart inflow, with no other lesions identified. Thoracic radiographs documented a localized alveolar pattern within the left caudal lung lobe. The size of the heart and pulmonary vessels were within normal limits, indicating a non-cardiogenic alveolar pattern. Given the clinical presentation of dyspnea and high index of suspicion of intra-cardiac neoplasia, the dog was considered to have a grave prognosis and therefore euthanized. Post-mortem gross and histopathologic examination revealed the presence of a metastatic osteosarcoma tumor thrombus in the left atrium and pulmonary vein, metastatic osteosarcoma infiltrating the myocardium, lungs, the uveal tract of the right eye, and both adrenal glands. Whitney grade II myxomatous changes were noted on the mitral and tricuspid valve leaflets. This report describes an unusual intra-cardiac tumor thrombus in a dog presenting with dyspnea. Cavalier King Charles Spaniels presenting with dyspnea often raise suspicion for myxomatous mitral valve disease. However, as demonstrated in this case, other more unusual causes of dyspnea should also be considered in the absence of classic clinical findings.
一只六岁零七个月大、已绝育的雄性可卡颇犬，因右眼进行性呼吸困难和前房积血伴继发性青光眼而被转诊。该犬一年前曾在前胸部颅骨区域切除高级别软组织梭形细胞肉瘤。转诊医院就诊时，该犬呼吸急促和呼吸困难。心律规则，有柔和的左侧收缩期杂音。超声心动图发现有一个肿块显著阻塞左心流入道，但未发现其他病变。胸部 X 线片记录到左肺下叶局部肺泡模式。心脏和肺血管大小均在正常范围内，提示非心源性肺泡模式。鉴于呼吸困难的临床表现和高度怀疑心内肿瘤，该犬预后较差，因此被安乐死。尸检大体和组织病理学检查显示，左心房和肺静脉内存在骨肉瘤肿瘤栓子，心肌、肺、右眼葡萄膜和双侧肾上腺均有骨肉瘤浸润。二尖瓣和三尖瓣叶片上有 Whitney Ⅱ级黏液样变。本报告描述了一只出现呼吸困难的犬出现不常见的心内肿瘤栓子。出现呼吸困难的可卡颇犬常引起黏液样二尖瓣病变的怀疑。然而，如本例所示，在缺乏典型临床发现的情况下，也应考虑其他更不常见的呼吸困难原因。
