Anasarca in a neonatal bulldog puppy, secondary to a ventricular septal defect

A 2 year old primiparous English Bulldog presented for fetal monitoring prior to elective cesarean section. Bitch was bred via transcervical insemination and her singleton pregnancy was confirmed via transabdominal ultrasonography and radiographs. Due to risk of primary uterine inertia and fetal oversize with 1 fetus, and due to being a brachycephalic breed, a cesarean section was scheduled. First fetal monitoring was performed at 64 days post LH peak; at this visit, bitch had colostrum present within caudal mammary glands, and her progesterone concentration was 6.32 ng/ml. On ultrasonography, although the fetal heart rate was normal (226 - 232 bpm), fetus appeared to have pleural effusion and subcutaneous edema, consistent with an anasarca puppy. Cesarean section was performed on the following day. A single pup with severe subcutaneous edema (confirmed ultrasonography findings) was removed. Euthanasia was elected due to poor prognosis and necropsy followed. Gross examination revealed a ventricular septal defect, a finding that has been associated with hydrops fetalis in human and veterinary species. 1 Renal tubules and renal pelvis were mildly dilated, suggestive of urinary obstruction presumptively due to severe anasarca. On histologic examination, hepatocellular necrosis and congestion of various organs were noticed (lesions secondary to decreased left-sided cardiac output). In summary, ultrasonography was diagnostic (anasarca fetalis and pleural effusion) and findings enabled us to decide on a timely surgery.

Reference

1.Huggon IC, Cook AC, Smeeton NC, et al: Atrioventricular septal defects diagnosed in fetal life: associated cardiac and extra-cardiac abnormalities. J Am Coll Cardiol 2000 36:593-601.

This manuscript was originally published in the journal Clinical Theriogenology Vol 12(3) Sept 2020.  Clinical Theriogenology is the official journal of the Society for Theriogenology (SFT) and the American College of Theriogenologists (ACT).  This content has been reproduced on the IVIS website with the explicit permission of the SFT/ACT.