case_images: PMC10170463_01
case_images: Radiographic findings in case 1. A) Lateral, and B) dorsoventral views at the first presentation showing alveolar patterns in all lobes (yellow arrowheads). The diffuse alveolar pattern obscured the cardiac silhouette, however, it appeared large compared to the thorax (red arrows). C) The alveolar pattern was improved on the following day after management with furosemide. The cardiothoracic ratio was 59.10% and the heart size was normal
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case_images: F1
case_images: A radiographic examination within 10 min after oxygen administration to confirm the lung status revealed a diffuse alveolar pattern in all lung lobes (Fig. 1A). The respiratory status was improved andradiographic examination revealed improvement in the radiolucency of the lung with heart size reduction (cardio-thoracic ratio [CTR]: 59.10%) on the following day (Fig. 1B). Since the heart size seemed normal (Fig. 1C), furosemide was withdrawn and pimobendan was administered at a dose of 0.28 mg kg-1 twice daily.
case_images: Echocardiographic findings in case 1. A) Marked left atrial enlargement at the initial visit, B) which normalized 2 weeks after management with furosemide and pimobendan. LA: Left atrium, Ao: Aorta, and PV: Pulmonary vein
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case_images: F2
case_images: Tokyo, Japan) revealed a markedly enlarged left atrium. The left atrial-to-aortic ratio (LA/Ao) was 2.21 (Fig. 2A), left ventricular internal diameter in diastole (LVIDd) 1.58 cm, and left ventricular internal diameter in systole (LVIDs) 1.01 cm. On echocardiography, LA/Ao was 1.49 (Fig. 2B), LVIDd 1.86 cm, LVIDs 1.36 cm, and FS% 26.90%.
case_images: PMC10170463_02
case_images: Radiographic findings in case 2. A) A mixed interstitial-alveolar pattern in the right lung field on the dorsoventral view (yellow arrowhead) was found. B) Marked cardiomegaly and enlargement of the caudal vena cava (*) in lateral view were observed. C) The cardiac size and caudal vena cava were improved after two weeks of management with pimobendan, furosemide, and diltiazem
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case_images: F3
case_images: The LA/Ao, LVIDd and LVIDs were 1.36, 1.99 cm and 1.54 cm, respectively, and FS% was improved to 22.60% (Fig. 3C).
case_images: Echocardiographic findings in Case 2. A) The biatrial and biventricular enlargement with valve regurgitation improved to B) Only mild mitral regurgitation 2 weeks after management with furosemide, pimobendan, and diltiazem. C) The left atrium was also markedly dilated; D) It was normalized after the same treatment. LA: Left atrium, LV: Left ventricle, RA: Right atrium, RV: Right ventricle, and Ao: Aorta
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case_images: F4
case_images: Tokyo, Japan) revealed biatrial and bi-ventricular enlargement with valve regurgitation (Fig. 4).
case_images: Ultrasonographic findings in Case 2. Respiratory variation in the caudal vena cava was absent with an enlarged hepatic vein. The ascites (*) was present
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case_images: F5
case_images: Mild mitral and tricuspid regurgitation were observed, respiratory variation in the caudal vena cava was absent and ascites was present (Fig. 5).
case_images: A) Electrocardiographic and echocardiographic findings in case 2. Supraventricular tachycardia of 375 bpm was detected on electrocardiogram (1.00 mV cm-1, 25.00 mm sec-1). B) At sinus rhythm, electrocardiographic examination (1.00 mV cm-1, 50.00 mm sec-1) revealed splinted QRS complexes with R' morphology. C) Supraventricular tachycardia was present during echocardio-graphy 8 days after the first presentation which suddenly was resolved with intravenous diltiazem
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case_images: F6
case_images: An electrocardiogram (ECG, Cardisuny D700; Fukuda M-E Kogyo, Tokyo, Japan) revealed tachycardia at 375 bpm, thus, supraventricular tachycardia was suspected (Figs. 6A and 6B). Tanabe Pharma, Osaka, Japan). The tachycardia suddenly was resolved with a return to sinus rhythm (Fig. 6C). Tokyo, Japan) twice daily. After five weeks, there was no obvious supraventricular tachycardia and only a splintered QRS complex with R' morphology was noted (Figs. 6A and 6B).
case_images: PMC10170463_03
case_images: Radiographic findings in case 2. A) A mixed interstitial-alveolar pattern in the right lung field on the dorsoventral view (yellow arrowhead) was found. B) Marked cardiomegaly and enlargement of the caudal vena cava (*) in lateral view were observed. C) The cardiac size and caudal vena cava were improved after two weeks of management with pimobendan, furosemide, and diltiazem
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case_images: PMC10170463_03_vrf-14-237-g003.jpg
case_images: F3
case_images: The LA/Ao, LVIDd and LVIDs were 1.36, 1.99 cm and 1.54 cm, respectively, and FS% was improved to 22.60% (Fig. 3C).