Persistent Accelerated Idioventricular Rhythm in a Shih Tzu with Central Neuropathy

초록

A 7-year-old neutered male Shih Tzu dog weighing 5.2 kg was presented because of severe neurological signs (paddling, unconsciousness, blindness, seizure). ECG revealed accelerated idioventricular rhythm (AIVR) with ~140 bpm ventricular rate. Based on magnetic resonance imaging (MRI) study and cerebrospinal fluid (CSF) analysis,the neurological condition was tentatively diagnosed as disseminated granulomatous meningoencephalomyelitis (GME). The neurological signs were managed with steroids, anticonvulsive drugs, diuretics and antibiotics with 20% mannitol infusion. The rhythm disturbance (AIVR) was managed with oral medication of mexiletine. Because the heart rhythms were unstable without anti-arrhythmic therapy in spite of improvement of clinical signs after emergency treatment for neurological problems, the anti-arrhythmic therapy was maintained till the neurological signs were abolished.

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