Hypertensive Cardiomyopathy in a Pomeranian Dog Complicated with Chronic Kidney Disease

포메라니언 개에서 발생한 만성 신장질환과 합병된 고혈압성 심근증

  • Lee, Joon-Seok (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University) ;
  • Hyun, Chang-Baig (Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University)
  • 이준석 (강원대학교 수의학과 소동물 내과교실) ;
  • 현창백 (강원대학교 수의학과 소동물 내과교실)
  • Published : 2009.04.30

Abstract

A 7-year-old, intact male Pomeranian(weighing 2.2 kg), was presented with clinical signs of prolonged anorexia, polydypsia/polyuria, severe azotemia, proteinuria and heart murmur. Diagnostic studies found chronic kidney disease, severe hypertension and hypertrophic cardiomyopathy. The dog was treated with 2-day peritoneal dialysis, blood transfusion, anti-hypertensive therapy with amlodipine and conservative therapies direct to chronic renal failure. This is a rare case of hypertensive cardiomyopathy complicated with chronic kidney disease in dogs.

7년생 중성화하지 않은 수컷 포메라니언(체중 2.2 kg)이 지속적인 식욕부진과 다음/다뇨, 심한 질소혈증 및 심잡음을 주증으로 내원하였다. 진단적 검사 결과 중증의 고혈압과 비대성 심근증을 동반한 만성 신장 질환이 확인 되었다. 2일 동안 복막투석과 수혈, 그리고 amlodipine을 이용한 항고혈압 치료를 실시하였고 동시에 만성신부전에 대한 보존 치료요법을 적용하였다. 본 증례는 만성 신장질환이 있는 개에서 병발한 고혈압성 심근증인 희귀 증례이다.

Keywords

References

  1. Artman M, Graham TP. Congestive heart failure in infancy: recognition and management. Am Heart J 1982; 103: 1040- 1055 https://doi.org/10.1016/0002-8703(82)90568-3
  2. Atkins CE, Rausch WP, Gardner SY, Defrancesco TC, Keene BW, Levine JF. The effect of amlodipine and the combination of amlodipine and enalapril on the reninangiotensin-aldosterone system in the dog. J Vet Pharmacol Ther 2007; 30: 394-400 https://doi.org/10.1111/j.1365-2885.2007.00894.x
  3. Brown SA. Pathophysiology of systemic hypertension. In: Textbook of veterinary internal medicine, 6th ed. Missouri: WB Saunders. 2005: 472-474
  4. Cooke KL, Snyder PS. Calcium channel blockers in veterinary medicine. J Vet Intern Med 1998; 12: 123-131 https://doi.org/10.1111/j.1939-1676.1998.tb02107.x
  5. Kobayashi DL, Peterson ME, Graves TK, Lesser M, Nichols CE. Hypertension in cats with chronic renal failure or hyperthyroidism. J Vet Intern Med 1990; 4: 58-62 https://doi.org/10.1111/j.1939-1676.1990.tb03104.x
  6. Kraft W, Egner B. Causes and effects of hypertension. In: Essential facts of blood pressure in dogs and cats, B Egner, A Carr, S Brown ed. BE-vetVerlag. 2003: 61-86
  7. Lewis BS, Miline FJ, Goldberg, B. Left ventricular function in chronic renal failure. Br Heart J 1976; 38: 1229-1239 https://doi.org/10.1136/hrt.38.12.1229
  8. Ortega TM, Feldman EC, Nelson RW, Willits N, Cowgill LD. Systemic arterial blood pressure and urine protein/ creatinine ratio in dogs with hyperadrenocorticism. J Am Vet Med Assoc 1996; 209: 1724-1729
  9. Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray DC, Barre PE. Outcome and risk factors for left ventricular disorders in chronic uraemia. Nephrol Dial Transplant 1996; 11: 1277-1285 https://doi.org/10.1093/ndt/11.7.1277
  10. Parfrey PS, Harnett JD, Barre PE. The natural history of myocardial disease in dialysis patients. J Am Soc Nephrol 1991; 2: 2-12
  11. Peterson AL, Frommelt PC, Mussatto K. Presentation and echocardiographic markers of neonatal hypertensive cardiomyopathy. Pediatrics 2006; 118: e782-785 https://doi.org/10.1542/peds.2006-0631
  12. Safar ME, Priollet P, Luizy F, Mourad JJ, Cacoub P, Levesque H, Benelbaz J, Michon P, Herrmann MA, Blacher J. Peripheral arterial disease and isolated systolic hypertension: The ATTEST Study. J Hum Hypertens 2008; 2: 1-6
  13. Saland JM, Mahony L, Baum M. Perinatal renal ischemia resulting in hypertensive cardiomyopathy. Pediatrics 2001; 107: 185-186 https://doi.org/10.1542/peds.107.1.185
  14. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ, Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension 2003; 42: 1050-1065 https://doi.org/10.1161/01.HYP.0000102971.85504.7c
  15. Snyder PS. Amlodipine: a randomized, blinded clinical trial in 9 cats with systemic hypertension J Vet Intern Med 1998; 12: 157-162 https://doi.org/10.1111/j.1939-1676.1998.tb02111.x
  16. Stepien RL, Elliott J. Measurement of blood pressure. In: BSAVA Manual of Canine and Feline Nephrology and Urology. 2nd ed. Gloucester: BSAVA. 2007: 186-190
  17. Ware WA. Systemic hypertension. In: cardiovascular disease in small animal medicine. London: Manson publishing. 2007: 372-373