Background:
Aortic stenosis refers to several types of anatomic and functional obstructions of the left ventricular outflow tract. In small
animals, this anomaly is most commonly documented as either a
congenital lesion or an obstruction that develops soon after
birth. It is a
hereditary disease, caused by a dominant autosomal
gene and modifying
genes that interfere with
phenotype expression. Even though aortic
thromboembolism may be a potential complication in
cats with
cardiac diseases,
aortic stenosis is deemed rare in that species. In this
paper, we
report an unusual case of a Persian kitten with
aortic stenosis that eventually developed arterial
thromboembolism.Case A 7-month-old Persian kitten (3.1 kg) was admitted to a
Veterinary Teaching Hospital with a
history of
hindlimbs paralysis over the past 48 h, as well as excessive vocalization. Also, the
cat presented with inappetence, adipsia,
urine incontinence, and
hematuria. On
physical examination, we observed
hypothermia and
cold paws. The footpads were cyanotic and there were no palpable femoral
pulses.
Cardiac auscultation disclosed a regular fast pace (200 bpm) and a grade 2/6 murmur heard best over the left cardiac base, but irradiating to the contralateral hemithorax.
Prothrombin time and
activated partial thromboplastin time were within the normal
reference range, but the
complete blood count showed microcytosis,
lymphopenia, and hyperproteinemia. Also, elevated
alanine aminotransferase and
BUN were identified. On the echocardiogram, we observed a
subvalvular aortic stenosis, which resulted in concentric
remodeling of the
left ventricle and a mild left atrial
dilation. The stenotic lesion was classified as mild. Also, the
thoracic radiography unveiled
cardiomegaly. The recommended
therapy included
atenolol(6.25 mg/
cat PO, q24h),
clopidogrel (18.7 mg/
cat PO, q24h),
enoxaparin (1 mg/kg SC, q24 h),
methadone (0.2 mg/kg IM, q8h) and
amoxicillin +
potassium clavulanate (20 mg/kg SC, q12h).[...]