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عدد المساهمات : 275 نقاط : 726 السٌّمعَة : 10 تاريخ التسجيل : 25/01/2010 العمر : 31 الموقع : l2vevet.ahlamontada.com
| موضوع: Pleural effusion الإثنين يناير 17, 2011 4:40 pm | |
| Pleural effusion
Signalment
| Five-year-old MC Labrador retriever weighing 56 kg ("Monty") |
Presenting Complaint
Pertinent History
| Monty presented on emergency for management of a pleural effusion. |
| The owners noticed that Monty was panting more than usual about 6 days ago. |
| He has always been a finicky eater but they felt that his appetite had decreased in the past few days. |
| He has been less active for the past few days and was unwilling/unable to go running with the owner three days ago (he usually goes running about once a week). |
| In the last few days he has had difficulty breathing when laying on his side but seems comfortable when sternal or standing. |
| He was presented to the referring DVM two days ago. Radiographs were taken which showed an enlarged liver and pleural effusion. The heart could not be evaluated because it was obscured by the fluid. Blood work was done. It was unremarkable except for a mild monocytosis of 1296. |
| The chest was tapped and 70ml of fluid was removed. The fluid was submitted for analysis which showed a lymphocytic plasmacytic modified transudate, SpGr 1.026, WBC 2,950/ul, RBC 20,000/ul, protein 4.1 gm/dl. |
| Heart disease was suspected and Monty was referred to the VMTH for further evaluation. |
| The owners have had Monty since he was a puppy. He was neutered at six months of age. He has had foxtails in the past but his medical history is unremarkable otherwise. |
| He is current on his vaccinations. |
| He is a yard dog who is allowed to roam freely (he usually remains in his yard). |
| He is fed a Pedigree kibble and canned food diet. |
| The owners have not noticed coughing, sneezing, vomiting or diarrhea. |
| Current medication: Clavamox 375mg 2 tablets PO BID (started two days ago). |
Physical Examination
Alert. Hydrated. T=100.5, P=115, R=pant. | Clean full coat. Eyes clear bilaterally. | Ears clean. | Nose moist. | Symmetrically muscled with no gait abnormalities. | Heart sounds muffled. Weak femoral pulses. Jugular pulses present. Mucous membranes pink. CRT 1 second. | Increased lung sounds in dorsal lung fields. Diminished lung sounds ventral to the costochondral junction. | Abdomen full ventrally. Palpably enlarged liver. No fluid wave to indicate ascites. | No peripheral lymphadenopathy. |
Problems
| Pleural effusion |
| Hepatomegaly with jugular pulsation
RadiographsLateral DV VDTwo-dimensional EchocardiogramsRight parasternal long-axis view Right parasternal short-axis view The echocardiograms show a small amount of pericardial effusion (PE) and a moderate amount of pleural effusion (PL). The heart itself appears normal. The hepatic veins were distended on an abdominal ultrasound exam meaning that systemic venous pressure is increased. LV - left ventricular cavity; RV - right ventricular cavity; LA - left atrial cavity; RA - right atrial cavity.
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