Complex Cardiology Case


Duke, a 9-year-old Pomeranian Spitz, was presented to the Veterinarium clinic several months ago. The primary complaints included respiratory distress, paroxysmal coughing, cyanotic mucous membranes, lethargy, and exercise intolerance.

On physical examination, a pathological heart murmur, arrhythmia, and dyspnea were identified. The patient’s vital parameters were outside normal limits, raising suspicion of cardiogenic pulmonary edema secondary to heart failure.

Thoracic radiography revealed cardiomegaly and pulmonary edema. Echocardiographic evaluation confirmed myxomatous mitral valve disease (MMVD), ACVIM Stage D, indicating a long-standing, progressive cardiac condition in its end stage.

Based on these findings, the clinic’s cardiologist and anesthesiologist, Natia Robakidze, made the decision to hospitalize Duke, as discharge in such a critical condition posed significant risk. Intensive therapy was initiated immediately, including oxygen therapy, cardiovascular support, management of pulmonary edema, and correction of arrhythmia.

Duke remained hospitalized for one day. Following clinical improvement, he was discharged later that evening with detailed recommendations. Intensive remote monitoring was then conducted under the supervision of Natia Robakidze. The owner, following provided instructions, regularly reported heart rate, respiratory rate, and overall clinical status to the veterinary team.

On March 19, Duke returned for a scheduled re-evaluation. A repeat physical examination, echocardiography, and laboratory testing were performed, including a complete blood count, serum biochemistry, and electrolyte profile.

Based on the follow-up assessment, Duke’s condition is currently stable. This indicates that, despite the end-stage nature of his disease, appropriate medical management has resulted in meaningful clinical improvement, representing a significant therapeutic achievement.