Spot Check Tests Veterinarians' Knowledge of Cardiac Emergencies

This Spot Check is based on information from drip.vet’s continuing education: Cardiac Emergencies.

Signalment

• 1 year old male neutered Labrador retriever, 27kg

Presenting Concerns

• Acute progressive lethargy over 24 hours

Physical Examination Abnormalities

• Depression
• Oral mucous membrane pallor
• Tachypnea (50 rpm)
• Tachycardia (178 bpm)
• Hyperkinetic synchronous femoral pulses
• Muffled heart sound

Initial Diagnostic Tests

• Blood pressure: 74 mmHg systolic via Doppler
• PCV/TS: 23% / 4.9 g/dL
• Manual platelet count: 7.1/hpf (estimate: 142 K/uL)
• Lactate: 3.8 mmol/L
• BG: 134 mg/dL (7.4 mmol/L)
• Abdominal POCUS: 0 abdominal fluid score
• Thoracic POCUS: pericardial effusion, no visible mass within pericardial space, no evidence of tamponade

C: Prothrombin time / activated partial thromboplastin time measurement

Rationale

The patient is a young adult dog with documented anemia, thrombocytopenia in a consumptive range, and hypoproteinemia. Physical examination findings are most consistent with hypovolemia and hypoperfusion causing early decompensatory shock and pericardial effusion contributing to obstructive shock. Neoplastic and idiopathic causes of pericardial effusion are uncommon in young dogs. Conversely, rodenticide-induced coagulopathy is very common and could readily explain all the patient’s clinical and biochemical abnormalities.