Bir Fransız Mastiff’te Ebstein Anomali

Yıl 2019, Cilt: 12 Sayı: 4, 469 - 473, 31.12.2019

Turan Civelek , Durmuş Fatih Başer , Z. Kadir Sarıtaş Ahmet Cihat Tunç

https://doi.org/10.30607/kvj.613494

Öz

Bu olgu sunumunun materyalini, Afyon Kocatepe
Üniversitesi Hayvan Hastanesine letarji, asites ve ekzersiz intöleransı
şikayetleriyle getirilen 1.5 yaşlı Fransız Mastiff köpek oluşturdu.
Oskültasyonda triküspit kapak seviyesinde şiddetli sistolik murmur ve aritmi
tespit edildi. Radyolojik incelemede pleural effüzyon, sağ atrial dilatasyon ve
total kalp büyümesi belirlendi. Sonrasında gerçekleştirilen ekokardiyografik
muayenede sağ atrial dilatasyon, triküspital maformasyona bağlı olarak orta
derecede triküspital kapak yetmezliği ve triküspit yaprakçıklarının mitral kapak
yaprakçıklarına göre, yaklaşık 2cm apekste yerleşim gösterdiği tespit edildi.
M-mod muayenede kalp yetmezliği bulguları belirlendi (EF=13, FS=6). Abdominal
USG’de ise hematomegali ve asites ana bulgulardı. Tedavi prosedüründe; asit ve
pleural effüzyon kontrollü bir şekilde boşaltıldı. Medikal olarak;
amoksisilin klavunik asit (25mg/kg/IM, bir hafta), furosemid (2mg/kg, PO),
enalapril (0.5mg/kg, PO), pimobendan (0,5mg/kg, PO) ve kardiyak diyet reçete
edildi. Aritmi için digoxin (0.008mg/kg) kullanıldı. Düzenli kontrolleri
gerçekleştirilen hasta tedavi başlangıcından sekiz ay sonra kaybedildi. Ebstein anomali sahip
olduğu tipik ekokardiyografik bulgular nedeniyle "uzman" bir
kardiyolog tarafından kolayca tanınabilir. Ancak çoğu zaman gözden kaçırıldığı
da bir gerçektir. Bu nedenle reel insidansı daha yüksek olabilir.

Anahtar Kelimeler

Ekokardiyografi, sağ kalp yetmezliği, pleural effüzyon, köpek, Ebstein anomali

Ebstein Anomaly in a French Mastiff

Öz

The
material of this case report was a 1.5-year-old French Mastiff dog who was
brought to Afyon Kocatepe University Animal Hospital with complaints of
latergia, ascites and exercise- intolerance. Auscultation revealed severe
systolic murmur and arrhythmia at tricuspid valve level. Radiological
examination revealed pleural effusion, right atrial dilatation and total heart
enlargement. After echocardiographic examination, right atrial dilatation,
moderate tricuspidal valve insufficiency due to tricuspidal maformation and
tricuspid leaflets were located in approximately 2cm apex according to mitral
valve leaflets. M-mode examination revealed signs of heart failure (EF = 13, FS
= 6). In abdominal USG, hematomegaly and ascites were the main findings. In the
treatment procedure, ascites and pleural effusion were evacuated in a controlled
manner. Medically; amoxicillin clavunic acid (25mg / kg / IM, one week),
furosemide (2mg / kg, PO), enalapril (0.5mg / kg, PO), pimobendan (0.5mg / kg,
PO) and cardiac diet were prescribed to the patient. Digoxin (0.008mg / kg) was
used for arrhythmia. The patient, who had regular controls, died eight months
after the start of treatment. Due to the typical echocardiographic findings,
Ebstein's anomaly can be easily recognized by a cardiologist. However, it is
also a fact that it is often overlooked. Therefore, the actual incidence may be
higher.

Anahtar Kelimeler

Echocardiography, right heart failure, ascites, pleural effusion, dog, Ebstein anomaly

Kaynakça

• Cave, T. What was your diagnosis? Congenital tricuspid dysplasia with concurrent Ebstein's anomaly. The Journal of small animal practice. 2001; 42(6):271-311.
• Choi R, Lee SK, Moon HS, Park IC, Hyun C. Ebstein’s anomaly with an atrial septal defect in a jindo dog. The Canadian Veterinary Journal. 2009; 50(4):405.
• Deprest C, French A, Chiers K. Congenital tricuspid valve malformation with Ebstein’s anomaly in a Golden Retriever. Vlaams Diergeneeskundig Tijdschrift. 2006; 75:380-384.
• Eyster GE, Anderson L, Evans AT, Chaffee A, Bender G, Johnston J, Blanchard G. Ebstein's anomaly: a report of 3 cases in the dog. Journal of the American Veterinary Medical Association. 1977; 170(7):709-713.
• MacDonald KA, Johnson LR. Pulmonary hypertension and pulmonary thromboembolism. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine, 5th ed. Philadelphia: WB Saunders. 2005; pp. 1284–1288.
• Narin N. Ebstein Anomalisi: Tanı, İzlem ve Tedavi. Turkiye Klinikleri Cardiology-Special Topics. 2008; 1(5):74-77.
• Neetu S, Kumar US, Rohit T, Singh RS, Arun A. A Rare Case of Ebstein Anomaly in a French Mastiff Dog. Cardiovasc Ther. 2017; 7(2):555-706.
• Pasławska U, Noszczyk-Nowak A, Janiszewski A, Nicpoń J. Tricuspid dysplasia in dogs. Bulletin of the Veterinary Institute in Pulawy. 2013; 57(1):123-126.
• Sousa MG, Gerardi DG, Alves RO, Camacho AA. Tricuspid valve dysplasia and Ebstein's anomaly in dogs: case report. Arquivo Brasileiro de Medicina Veterinária e Zootecnia. 2006; 58(5):762-767.
• Takemura N, Machida N, Nakagawa K, Amasaki H, Washizu M, Hirose H. Ebstein's anomaly in a beagle dog. Journal of veterinary medical science. 2003; 65(4):531-533.
• Tidholm A. Retrospective study of congenital heart defects in 151 dogs. Journal of Small Animal Practice. 1997; 38(3):94-98.
• Yılmaz Z, Levent P, Kocatürk M, CIHAN H, Pars E, Saim SAĞ. Chylothorax associated with Ebstein’s anomaly in a Golden Retriever dog. Ankara Unıversıtesı Veteriner Fakultesi Dergisi. 2015; 62(3):243-246.