A 6-year-old 1.86-kg (4.1-lb) spayed female Chihuahua mix was evaluated because of vomiting of 2 days' duration. When the owner arrived home on the day of the evaluation, the dog was hesitant to ambulate out of its indoor crate. The owner subsequently carried the dog outdoors where it stumbled, vomited, and collapsed. The dog had no history of medical problems and no sudden diet changes. The dog was not receiving any medications, except heartworm preventative, and had no known exposure to toxic agents or human medications; its vaccination status was current.
A 3-year-old neutered male Labrador Retriever was evaluated at the emergency service for rapid onset of hind limb paralysis. The referring veterinarian had treated the dog for 2 previous episodes of hind limb dysfunction; the first episode occurred 2 months ago and resolved completely with the administration of carprofen. The second episode did not respond to the administration of NSAIDs, diazepam, or doxycycline; the dog was then treated with prednisone, and the paresis resolved. The dog had no history of travel or tick exposure.
Two days before evaluation at the emergency service, paresis reoccurred and became progressively worse, leading
An 11-year-old 33.6-kg (73.9-lb) neutered male chocolate Labrador Retriever was referred to a veterinary teaching hospital for evaluation of a newly diagnosed paroxysmal arrhythmia, lethargy of 3 days' duration, and a single episode of emesis. Four days prior to the referral evaluation, the dog developed gastric dilatation volvulus and consequently underwent exploratory laparotomy and gastropexy performed at another emergency hospital. Two days after discharge from that hospital, inappetence and lethargy prompted readmission. Electrocardiography reportedly revealed paroxysms of a narrow-complex tachycardia (NCT) with instantaneous rates of 280 to 300 beats/min as well as wide-complex premature beats (no ECG tracings available). Lidocaine
Objective—To report the outcome of minimally invasive surgical treatment of heartworm caval syndrome in a series of dogs and to provide information on long-term survival of patients with this condition.
Design—Retrospective case series.
Animals—42 client-owned dogs with a diagnosis of heartworm caval syndrome.
Procedures—Information on history, clinical, laboratory, and diagnostic imaging findings and treatment was obtained from medical records. When possible, additional follow-up information was obtained through telephone interviews with referring veterinarians and owners.
Results—Of the 42 dogs with caval syndrome, 21 underwent minimally invasive surgical treatment consisting of transvenous heartworm extraction. Two of the 21 dogs died during the procedure, and after surgery, 4 died. Following induction of anesthesia, heartworms migrated into the distal portion of the pulmonary artery in 1 dog; therefore, extraction was not attempted. Transvenous heartworm extraction was completed successfully in 14 dogs, and all 14 of these dogs were discharged from the hospital. Mean follow-up time in these 14 dogs was 24.4 ± 17.7 months with a range of 2 to 56 months. At the time of final follow-up, 10 of these 14 dogs had survived at least 18 months and 7 had survived > 24 months. By the end of the study, 1 dog was lost to follow-up and 3 had been euthanatized for unrelated reasons.
Conclusions and Clinical Relevance—Results of the study reported here suggest that dogs with caval syndrome that undergo successful transvenous heartworm extraction and survive to discharge have a good long-term prognosis.