C10002660 / invoice 10000

Bruno present collapsed and cyanotic was unable to hear his hear sounds at all and he was panting History - he was being treated for cardiac disease with pimobendan and Cushings disease with trilostane also on cobalazorb and denamarrinExamine:eyes - clean and clearears not examined teeth - not examined mm cyanotic and CRT >>>4 secsUnable to auscultate the heart but the lungs sound clearAbdomen is pendulous but owner reports is is normally like that ( due to Cushings Disease?)Femoral pulse present but weak and very inconsistent PR - 16-20?Admit for TFAST and assessment for pericardial infusionNo medication given - just flow by oxygenChest rads - enlarged globoid shaped heart but no obvious pulmonery edema or pleural effusionno peritoneal effusion, stomach full of gas and enlarged liverTFAST - no pericardial effusion but grossly dilated left and right side of heart and very slow flaccid heart - Heart beats about once every 5- 6 secondsECG attached appears now to have heart rate of 124 but this is not what we are seeing - I believe this dog has second degree heart block - Refer to specialist asap owner would like to take to SASH prospectPlan - send all history to SASH prospectThoracic Radiographs:Three view thoracic radiographs were performed- left lateral, right lateral and VD/DV projections. Findings:Visible body wall and skeletal system are within normal limits.Pleural space is unremarkable.Cranial mediastinum is normal in width on the VD/DV projection.Trachea is within normal limits.Cardiac silhouette is normal in size and shape.Pulmonary vasculature are within normal limits.Pulmonary parenchyma is normal in appearance.Diaphragm is unremarkable.Visible cranial abdomen is within normal limits, with normal serosal detail. Conclusions:    Vital Signs