The Dion’s ten year old Boston Terrier Dash became acutely lethargic one night in early May, and his behavior was alarming enough to prompt him being brought to TPHCS’s ER. Once there, baseline testing included labwork and x-rays were unremarkable, but he was admitted for observation and support. He was given some basic intestinal support in the hospital after he developed diarrhea, but then at four in the morning his nurses found he was becoming very quiet and lethargic again. Listening to his heart, Dr. Doran found his heart rate was very elevated and irregular. The team got an EKG to assess Dash’s heart which revealed ventricular tachycardia, a potentially life-threatening arrhythmia. Just as treatment was initiated, the worst happened: Dash died.
Lucky for Dash he was surrounded by an emergency veterinary team that was prepared, and they jumped right in to action. CPR was initiated, and when the EKG showed ventricular fibrillation Dash was given defibrillation shocks. After a couple minutes of CPR, Dash was alive again.
Unlike in the movies or on TV shows, it was not all smooth sailing from there. Dash was still having arrhythmias, and was started on continuous monitoring of both blood pressure and his heart rate while medications were started to stop his arrhythmia. Dash responded well, and two days later was discharged with his new heart medication to try to prevent this from ever happening again.
While Dash’s case is rare and atypical, ventricular arrhythmias are not uncommon in certain dog and cat patients. Various heart and systemic illnesses can cause the heart to beat erratically, and ventricular arrhythmias are ones that put the heart at risk for stopping suddenly. They are the reason that airports, schools, and other public places often have defibrillators available to try to save a person if they were to unexpectedly die.
These arrhythmias are the ones that scare veterinarians the most, especially since dogs and cats with them can be acting completely normal one second, and then fall over dead the next. While we can never completely eliminate this risk, depending on the cause we can treat the arrhythmia and lower the risk of it happening, and we can give these patients a good quality of life in the meantime.
Signs of arrhythmias can be intermittent collapse/fainting, severe lethargy or trouble breathing, and exercise intolerance. Breeds at a higher risk compared to others include Boxers, Dobermans, and Bulldogs. Diseases that can predispose your patient to this type of arrhythmia include severe heart disease, cancers, and internal bleeding in dogs, and heart disease or urinary obstructions in cats.
The most important thing to know is that those of us at TPHCS are here 24/7 if you have a question or see concerning signs in your dog or cat. Conditions like these can go south very quickly, and it’s better to be safe and bring your patient in to the ER when you see concerning changes in their behavior or any of the above clinical signs.