Long-term Management of Ruptured Chordae Tendineae and Acute Pulmonary Edema in a Dog

Long-term Management of Ruptured Chordae Tendineae and Acute Pulmonary Edema in a Dog

An 8-year-old Maltese dog was presented due to exercise intolerance, tachycardia and dyspnea. Thoracic auscultation revealed grade IV/VI left systolic heart murmur and abnormal lung crackles sounds. Thoracic radiographs showed generalised cardiomegaly with alveolar infiltrate in both caudal lung lobes. Echocardiography revealed left-sided heart enlargement and thickened mitral valve with flail anterior mitral valve leaflet. Severe mitral regurgitation and mild tricuspid degeneration was also detected. Based on the general and cardiac examination, the dog was diagnosed as acute pulmonary edema due to degenerative valve disease with chordae tendineae rupture (CTR). The dog was initially treated with oxygen supplementation wth cage rest, furosemide, and nitroglycerine patch. After the dog has been stabilized, oral medication and long-term follow up was made for 678 days. CTR is known to have a poor long-term prognosis and survival. Long-term follow up of this dog through a series of cardiac examinations and detailed drug application could help predict disease progression. Although the occurrence of CTR in degenerative valvular disease is fatal, follow-up with appropriate evaluation and aggressive treatment has been effective in long-term patient management.