Subclinical Subaortic Stenosis in a Golden Retriever
Kursten Pierce, DVM, DACVIM (Cardiology), Colorado State University
THE CASE
A 12-month-old intact female golden retriever is presented for a wellness examination and to discuss the pros and cons of breeding the patient versus pursuing ovariohysterectomy. The owner would like her to produce one litter of puppies prior to being spayed.
On physical examination, the patient is bright, alert, and responsive. She is extremely energetic with a good BCS (4/9) and appropriate musculature. Cardiovascular examination reveals pink mucous membranes, no obvious jugular venous distension, and a normal heart rate and rhythm with normal synchronous femoral pulses. Auscultation is difficult and brief because the patient is rambunctious and panting. Despite the panting, she is eupneic with clear bronchovesicular sounds. A grade II/VI left basilar systolic heart murmur is auscultated. A murmur had not previously been documented at her puppy wellness visits. The owner has not observed any coughing, trouble breathing, exercise intolerance, or syncope at home, and the patient appears subclinically affected.
Diagnostic investigation of the heart murmur via echocardiography is discussed with the owner but declined due to the patient’s lack of clinical signs and the costs associated with additional testing.
What are the next steps?
CHF = congestive heart failure, LVOT = left ventricular outflow tract, SAS = subaortic stenosis