Terbutaline Responsiveness in a Cat with Sinus Arrest
Keywords:
Sinus arrest, Terbutaline, Feline nonspecific phenotype cardiomyopathyAbstract
An 8-year-old neutered male Persian breed cat presented at the private practice for investigation of seizure-like episodes. An echocardiography revealed mild enlargement of the left atrium (La/AO: 1.73) with spontaneous echo contrast and mitral regurgitation. A left anterior fascicular block was also detected in the electrocardiogram. The cat had no response to the atropine response test. Aminophylline, pimobendan, clopidogrel, and furosemide were initially prescribed at the private clinic, and then the cat was referred to Prasu Arthon Animal Hospital, Faculty of Veterinary Science, Mahidol University, Thailand. Repeated echocardiogram and electrocardiogram demonstrated left atrium enlargement (La/AO: 1.85) and sinus arrest, respectively. The cat was diagnosed with feline nonspecific phenotype cardiomyopathy. As the cat has no improvement after aminophylline administration and the owners declined further management with pacemaker implantation, therefore, terbutaline at 0.625 mg/cat PO q12h was given to replace aminophylline. The cat responded well to this prescription. The mean interval of each syncope episode was markedly increased. Terbutaline increased the mean syncopal episode interval from 8.4 days of aminophylline treatment to 15.5 days. In this case, terbutaline could increase the mean heart rate (MHR) to 190 bpm, which might be an advantage over aminophylline, which increased the MHR to 165 bpm. Unfortunately, the cat died 62 days after starting a new medication. The objective of this case report is to describe medical management in a cat with sinus arrest without atropine responsiveness by using oral terbutaline.
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