• 4 week old male entire Cavalier King Charles Spaniel

• Presented for investigation of heart murmur

Left ventricular dilatation Turbulent flow in pulmonary artery

Visualisation of PDA

• Important part of foetal circulation • Shunt between pulmonary trunk and aorta (RL)• Allows deoxygenated blood to bypass the lungs and

enter the aorta

• When first breath is taken: Aortic pressure increases Blood flows back into ductus arteriosus Ductus arteriosus pressure increases Walls of ductus arteriosus collapse Ductus arteriosus closes

• Left sided heart failure • LV dilatation and mitral regurgitation• LV myocardial failure• LA enlargement• Atrial fibrillation

• Maltese• Pomeranian • Shetland Sheepdog • English Springer Spaniel • Bichon frise• Poodle • Yorkshire Terrier • German Shepherd

• “triple knuckle” • Cardiomegaly • Distended pulmonary vessels • +/- pulmonary oedema

• Vascular occlusion coils

• Amplatz Canine Duct Occluder (ACDO)

• Furosemide

• Pimobendan

• (ACE inhibitors)

• (Spironolactone)

• Catheter passed via femoral artery aorta ductus arteriosus• Suitable size of occluder chosen • Occluder released in DA • Encourage embolus formation ductus occlusion• Referral procedure

• Left ventricular systolic dysfunction

• Cardiomegaly/enlarged chamber size

• Mitral regurgitation

o Confirmed CHF

o Age: > 2 years old?

o Weight: >23kg ?

• Methadone

• Meloxicam

• Synulox

• Frusemide

• Pimobendan