Bir Fransız Mastiff’te Ebstein Anomali
Bu olgu sunumunun materyalini, Afyon Kocatepe Üniversitesi Hayvan Hastanesine letarji, asites ve ekzersiz intöleransı şikayetleriyle getirilen 1.5 yaşlı Fransız Mastiff köpek oluşturdu. Oskültasyonda triküspit kapak seviyesinde şiddetli sistolik murmur ve aritmi tespit edildi. Radyolojik incelemede pleural effüzyon, sağ atrial dilatasyon ve total kalp büyümesi belirlendi. Sonrasında gerçekleştirilen ekokardiyografik muayenede sağ atrial dilatasyon, triküspital maformasyona bağlı olarak orta derecede triküspital kapak yetmezliği ve triküspit yaprakçıklarının mitral kapak yaprakçıklarına göre, yaklaşık 2cm apekste yerleşim gösterdiği tespit edildi. M-mod muayenede kalp yetmezliği bulguları belirlendi (EF=13, FS=6). Abdominal USG’de ise hematomegali ve asites ana bulgulardı. Tedavi prosedüründe; asit ve pleural effüzyon kontrollü bir şekilde boşaltıldı. Medikal olarak; amoksisilin klavunik asit (25mg/kg/IM, bir hafta), furosemid (2mg/kg, PO), enalapril (0.5mg/kg, PO), pimobendan (0,5mg/kg, PO) ve kardiyak diyet reçete edildi. Aritmi için digoxin (0.008mg/kg) kullanıldı. Düzenli kontrolleri gerçekleştirilen hasta tedavi başlangıcından sekiz ay sonra kaybedildi. Ebstein anomali sahip olduğu tipik ekokardiyografik bulgular nedeniyle "uzman" bir kardiyolog tarafından kolayca tanınabilir. Ancak çoğu zaman gözden kaçırıldığı da bir gerçektir. Bu nedenle reel insidansı daha yüksek olabilir.
Ebstein Anomaly in a French Mastiff
The material of this case report was a 1.5-year-old French Mastiff dog who was brought to Afyon Kocatepe University Animal Hospital with complaints of latergia, ascites and exercise- intolerance. Auscultation revealed severe systolic murmur and arrhythmia at tricuspid valve level. Radiological examination revealed pleural effusion, right atrial dilatation and total heart enlargement. After echocardiographic examination, right atrial dilatation, moderate tricuspidal valve insufficiency due to tricuspidal maformation and tricuspid leaflets were located in approximately 2cm apex according to mitral valve leaflets. M-mode examination revealed signs of heart failure (EF = 13, FS = 6). In abdominal USG, hematomegaly and ascites were the main findings. In the treatment procedure, ascites and pleural effusion were evacuated in a controlled manner. Medically; amoxicillin clavunic acid (25mg / kg / IM, one week), furosemide (2mg / kg, PO), enalapril (0.5mg / kg, PO), pimobendan (0.5mg / kg, PO) and cardiac diet were prescribed to the patient. Digoxin (0.008mg / kg) was used for arrhythmia. The patient, who had regular controls, died eight months after the start of treatment. Due to the typical echocardiographic findings, Ebstein's anomaly can be easily recognized by a cardiologist. However, it is also a fact that it is often overlooked. Therefore, the actual incidence may be higher.
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