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Long-term management of congestive heart failure secondary to mitral stenosis in a ring-tailed lemur (Lemur catta)

Shane D. Murphy1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Jessica L. Ward1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Jodi D. Smith2Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

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Andrew J. Gall3Blank Park Zoo, Des Moines, IA 50315.

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June E. Olds1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
3Blank Park Zoo, Des Moines, IA 50315.

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Abstract

CASE DESCRIPTION

A 15-year-old sexually intact female ring-tailed lemur (Lemur catta) was evaluated for a heart murmur and progressive radiographic cardiomegaly.

CLINICAL FINDINGS

The lemur was clinically normal at the time of initial evaluation. Results of transthoracic echocardiography performed when the animal was anesthetized indicated mitral valve stenosis and severe left atrial dilation. Three months later, signs of left-sided congestive heart failure (CHF; coughing, exercise intolerance, and tachypnea) were observed and confirmed by the presence of radiographic pulmonary edema.

TREATMENT AND OUTCOME

Medical treatment that consisted of aspirin, benazepril, furosemide, pimobendan, spironolactone, and ultimately torsemide in lieu of furosemide successfully controlled the lemur's clinical signs for 33 months after the development of CHF. Euthanasia was then elected on the basis of perceived poor quality of life because tachypnea became refractory to progressively higher dosages of diuretic. Necropsy confirmed mitral stenosis with severe left atrial dilation and chronic pulmonary congestion.

CLINICAL RELEVANCE

The present report described the long-term medical management of CHF secondary to mitral stenosis in a lemur. Mitral stenosis was suspected to be a congenital defect, similar to the cause of mitral stenosis reported for dogs and cats, rather than to be an acquired change in association with rheumatic heart disease as commonly occurs for people. The lemur's CHF was well managed for 33 months with treatment, including pimobendan, which was well tolerated.

Abstract

CASE DESCRIPTION

A 15-year-old sexually intact female ring-tailed lemur (Lemur catta) was evaluated for a heart murmur and progressive radiographic cardiomegaly.

CLINICAL FINDINGS

The lemur was clinically normal at the time of initial evaluation. Results of transthoracic echocardiography performed when the animal was anesthetized indicated mitral valve stenosis and severe left atrial dilation. Three months later, signs of left-sided congestive heart failure (CHF; coughing, exercise intolerance, and tachypnea) were observed and confirmed by the presence of radiographic pulmonary edema.

TREATMENT AND OUTCOME

Medical treatment that consisted of aspirin, benazepril, furosemide, pimobendan, spironolactone, and ultimately torsemide in lieu of furosemide successfully controlled the lemur's clinical signs for 33 months after the development of CHF. Euthanasia was then elected on the basis of perceived poor quality of life because tachypnea became refractory to progressively higher dosages of diuretic. Necropsy confirmed mitral stenosis with severe left atrial dilation and chronic pulmonary congestion.

CLINICAL RELEVANCE

The present report described the long-term medical management of CHF secondary to mitral stenosis in a lemur. Mitral stenosis was suspected to be a congenital defect, similar to the cause of mitral stenosis reported for dogs and cats, rather than to be an acquired change in association with rheumatic heart disease as commonly occurs for people. The lemur's CHF was well managed for 33 months with treatment, including pimobendan, which was well tolerated.

Supplementary Materials

    • Supplementary Video S1 (MP4 285 kb)
    • Supplementary Video S2 (MP4 258 kb)

Contributor Notes

Address correspondence to Dr. Ward (jward@iastate.edu).