Suspected hypocortisolaemia‐induced cardiac dysfunction and congestive heart failure in a dog with hypoadrenocorticism

Abstract

AbstractA 3‐year‐old, female, neutered lurcher was presented with a 6‐day history of lethargy and hyporexia. Clinical examination documented evidence of dehydration and hypovolaemia, but was otherwise unremarkable, including cardiac and pulmonary auscultation. Clinicopathological results, thoracic radiography, abdominal ultrasound, electrocardiography and adrenocorticotropic hormone stimulation testing were consistent with hypoadrenocorticism and hypovolaemia. Following initial stabilisation with intravenous fluid therapy, mineralocorticoid and glucocorticoid replacement, the dog became acutely tachypnoeic, and repeat radiography revealed a marked, generalised alveolar lung pattern consistent with pulmonary oedema. Echocardiography documented left ventricular volume overload and mild left atrial enlargement with increased left ventricular filling pressures, suggestive of cardiac dysfunction and left‐sided congestive heart failure. Following initiation of furosemide and pimobendan, alongside desoxycortone pivalate and prednisolone therapy, left‐sided congestive heart failure resolved within 24 hours. Cardiac structure and function, and N‐terminal pro‐brain natriuretic peptide normalised over the following 2 months, enabling tapering and discontinuation of furosemide and pimobendan therapy.