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Care report for a Dogue De Bordeaux with congestive heart failure due to dilated cardiomyopathy

02 July 2016
11 mins read
Volume 7 · Issue 6
Figure 1. Electrocardiogram trace showing atrial fibrillation.
Figure 1. Electrocardiogram trace showing atrial fibrillation.

Abstract

Dilated cardiomyopathy (DCM) is the most common form of acquired myocardial disease in dogs. Congestive heart failure (CHF) is characterised by clinical signs of increased tissue water retention and/or decreased tissue perfusion caused by heart disease such as DCM. When clinical findings are severe sudden death is common. This patient presented in the overt clinical phase of DCM and displayed signs of CHF. The nursing care involves understanding the action of drug therapy and the pathophysiology of heart disease/failure. In conjunction with this, it is important for veterinary nurses (VNs) to consider the nutritional needs of a patient with CHF. Poor body condition score and distinct loss of fat and overall muscle mass are characteristics of cachexia, which is related to the poor prognosis in CHF patients. Good communication with the owner regarding the patient's normal eating habits, could allow the VN to re-create normal routines thus improving the response to food. The ability of the VN to communicate effectively with the owners can optimise patient care and enhance quality of life for the patient.

The patient presented with a history of rapid weight loss and lethargy. He was reported to have had hyporexia, progressing to anorexia over the past 5 to 7 days. The owner described his demeanour as poor and perceived him to be uninterested in his surroundings. He was fully vaccinated and had no previous clinical complaints.

The patient had pale, tacky mucus membranes (MM) and a capillary refill time of 1–2 seconds. He had a heart rate (HR) of 224 beats per minute (bpm), with an irregular rhythm and weak peripheral pulses. He had no audible heart murmur and no pulse deficits. His respiratory rate (RR) was 30 breaths per minute (brpm) and mild audible crackles could be heard over his lung fields. He had moderately increased respiratory effort and a distended abdomen. His body condition score (BCS) was 2/9.

Due to the presenting clinical signs of cardiovascular and respiratory compromise, congestive heart failure (CHF) was a potential differential diagnosis for this patient. CHF is characterised by clinical signs of increased tissue water retention and/or decreased tissue perfusion caused by heart disease (Jenkins and Pace, 2012).

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