Case series summary Two cats were presented for investigation of bradyarrhythmia detected by their referring veterinarians during routine examination. Both cats had extensive investigations, including haematology, serum biochemistry with electrolytes and thyroxine concentrations, systolic blood pressure measurement, echocardiography, electrocardiography and infectious disease testing. Infectious disease testing included serology for Toxoplasma gondii, Ehrlichia canis, Anaplasma phagocytophilum and Borrelia burgdorferi, and PCR for B burgdorferi antigen in both cats. Case 1 was also assessed by PCR for Bartonella henselae antigen and case 2 was assessed for Dirofilaria immitis by serology. All infectious disease tests, other than for B burgdorferi, were negative. Case 1 was diagnosed with Lyme carditis based on marked bradydysrhythmia, positive B burgdorferi serology, a structurally normal heart and clinical resolution with appropriate treatment with a 4-year follow-up. Case 2 was diagnosed with Lyme carditis based on marked bradydysrhythmia and positive B burgdorferi PCR; however, this cat had structural heart disease that did not resolve with treatment. Relevance and novel information This small case series describes two B burgdorferi positive cats presenting with newly diagnosed cardiac abnormalities consistent with those found in humans and dogs with Lyme carditis. Both cats were asymptomatic as perceived by their owners; the arrhythmia was detected by their veterinarians.
This case report describes the patient journey of a young Cockapoo with symptomatic bradycardia, from admission to a referral hospital, investigations and management with pacemaker implantation, until discharge from the hospital. The case describes the general physical examination findings specific to symptomatic bradycardia, as well as common investigative tests performed in cardiology cases such as indirect blood pressure measurement, biomarkers (in-house cardiac troponin I), six-lead electrocardiography and comprehensive echocardiography. This case also describes the specialist nursing role during pacemaker implantation, including pacemaker programming using telemetry, the use of fluoroscopy with a C-arm, and surgical pull list and theatre set up. The post-surgical follow-up and further optimisation of the pacemaker settings is also described. Third degree atrioventricular block is the most common reason for pacemaker implantation. Awareness of the patient journey during pacemaker implantation is important to provide adequate support and advice to owners of canine patients with symptomatic bradycardia before referral.
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