ALL ABOUT HIS CONDITION:
Gibbs has, Double chambered right ventricle (DCRV) is an uncommon congenital disease of dogs characterized by juvenile-onset right-sided congestive heart failure and sudden death. This congenital defect occurs primarily in large-breed dogs and has not been frequently categorized until recently and was previously described as a subvalvular pulmonic stenosis. Double-chambered right ventricle is a form of septated right ventricle caused by the presence of abnormally located or hypertrophied muscular bands which divide the right ventricle cavity into a proximal and a distal chamber. These bands can be located at the cardiac apex or attached to the right ventricle. The defect obstructs flow through the ventricle and causes hypertrophy of the inflow but not outflow portion of the right ventricle. The malformation is often accompanied by tricuspid regurgitation. Gibbs regurgitates throughout the day, it’s like watching reflux. Liquid and his food come up. Concurrent congenital disease also occur with this condition, including ventricular septal defect, tricuspid valve dysplasia, pulmonary valve stenosis and subaortic stenosis. The defect causes clinical and pathophysiologic signs similar to those of congenital pulmonic stenosis in dogs but has distinct diagnostic features. Affected dogs are asymptomatic, but clinical signs are commonly reported in young dogs (from 12 weeks of age) with generalized weakness, exercise intolerance, syncope, pale mucus membranes and progressive ascites. A cough may be present intermittently. Gibbs has white gums and his tongue is often blue in color. He does not know he has a defect. He is playful but drops off to sleep quickly. He takes frequent naps throughout the day. A tentative diagnosis can be established by auscultation of a holosystolic ejection murmur at the left base close to the sternum and radiographic evidence of cardiomegaly and pulmonary edema, but definitive diagnosis requires use of M-mode and Doppler echocardiography or angiocardiography. Echocardiographs usually shows right ventricular hypertrophy with an abrupt transition to normal-appearing ventricular outflow tract. Doppler echocardiography usually reveals turbulent flow in the right ventricular outflow tract and a pressure gradient across the defect. Treatment is usually conservative in cases with mild clinical signs, with management of the secondary congestive heart failure. Surgical correction can be performed at specialty referral centers via cardiopulmonary bypass to resect the fibromuscular bands via right ventriculotomy.
Special thanks to Cindy Clark and Dr. Terri DeFrancesco, Cardiology at NCSU.
- Eric Nilsson
- Diana Holladay
- Matthew Patton
- Lisa Ksta
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