C09986507 / invoice 10000

Reason: Echo GAP ONLY HISTORYFirst clinical signs - heart murmur first detected 14/2/2022 Summary - Grade IV/VI left sided systolic heart murmur, echo results indicate stage B1 MMVD Diagnosis - Stage B1 MMVD Treatment - No medication indicated currently, monitoring RRR, coughing, exercise intolerance etc, repeat echo in 12mths Presented for evaluation of a systolic heart murmur.Last echo 3/2025 MMVD stage B1  Clinical signs: nil coughing, RRR etc Cardiac exam: BAR. HR 124bpm, regular. Grade IV/VI left apical systolic heart murmur. Normal respiratory rate and effort, no crackles or other abnormal lung sounds detected.Echocardiogram 2-DAo Diam 12.3mmLA Diam 18mmLA/Ao 14.6 (Stage B2 criteria =1.6)M-ModeIVSd 9.7 mmLVIDd 31.9 mmLVPWd 8 mmIVSs 17.7 mmLVIDs 14 mmLVPWs 15.6 mm%FS 56.3 %Echo Findings Left Ventricle: Eccentric hypertrophy present (LVIDDn 1.6 Stage B2 =1.7 ). Right Ventricle: Normal size and function. Left Atrium: mild dilatation. Right Atrium: Normal size. Mitral Valve: Mitral valve is thickened with myxomatous degeneration,  moderate regurgitation. Pulmonic Valve: Structurally normal, no stenosis or regurgitation. Aortic Valve: Trileaflet, structurally normal, no stenosis or regurgitation. Tricuspid Valve: Structurally normal, mild regurgitation. Pericardium: The pericardium is normal. There is no pericardial effusion.Procedure:Views taken: right lateral Diaphragm: intact Pleural space: no air or fluid visualised. No evidence of pneumothorax, hydrothorax or pleural effusion Mediastinum: cranial mediastinum grossly normal with homogenous soft tissue appearance. Width is within normal limits with no masses or fluid identified.(* cranial mediastinal width = width of spine, or up to 3.5x width of spine in obese animals)Pulmonary: Normal pulmonary and parenchymal structures. No pathological pattern present Trachea/Bronchi: grossly normal, normal dorsal tracheal membrane Oesophagus: grossly normal with no air, dilation or foreign bodies identified Cardiac: mild cardiomegaly, no atrial enlargement, VLAS 2Extra-thoracic structures: no significant abnormalities identified. Normal skeletal and subcutaneous structures Interpretation:- mild cardiomegaly ASSESSMENT1. Mitral valve thickening and prolapse, moderate mitral regurgitation, consistent with myxomatous mitral valve disease2. MMVD stage B1 PLAN1. No medication required at this stage2. Monitor sleeping respiratory rates daily, should be <30bpm, if consistently increased then complete thoracic radiographs to assess for evidence of pulmonary oedema then commence Frusemide3. Avoid strenuous activity and avoid high salt dietary intake4. Repeat echo in 12 months time5. Moderate increase in anaesthetic risk. Avoid more than maintenance fluid rates if possible. Pre-medication with low dose acepromazine/opiod, induction with alfaxane and maintenance with isoflurane.## Monitor right eyelid lump, at this stage growing externally and no causing any abrasion to the cornea ## Rectal exam unremarkable, no palpable masses etc Trimmed nails    Vital Signs    Weight: 7.4;