Myxomatous Mitral Valve Disease in a German Shepherd Dog

Abstract

A four-year-old male German Shepherd dog was presented to the Small Animal Clinics, GADVASU, with the primary complaint of exercise intolerance for the past 3-4 days and chronic weight loss. Physical examination revealed poor body condition and dull mentation, fever and tachycardia. Conjunctival mucous membranes and palpation of lymph nodes were normal. The animal was subjected to blood sampling, thoracic radiography, electrocardiography and echocardiography. Haemoglobin was 14.7g% and TLC was 13,900 cu mm, showing absolute neutrophilia. Thoracic radiography showed heart occupying 83% of chest in ventral-dorsal view, suggestive of cardiac enlargement. Electrocardiography revealed an extremely rapid rhythm with a heart rate of 300 beats per minute, indicating emergency condition. Echocardiography revealed left atrium and ventricle enlargement, along with mild flattening of mitral valve and mitral regurgitation. Values of Ao, LA and their ratio (LA/Ao) were 1.80, 4.99 and 2.72 respectively. Based on the findings, the case was diagnosed for Myxomatous Mitral Valve Disease. The dog was treated with digoxin 250mcg and diltiazem 45 mg twice a day for first two days to control arrythmia. Further treatment was continued with tab pimobendan and enalapril at the dose of 5mg twice a day.  The dog was telephonically reported to be stable after 14 days.