1. A CASE OF L EFT V ENTRICULAR ENDOCARDIAL FIBROSIS IN A CAT Leonardo Susta, DVM Janildo Ludolf Reis, DVM Elizabeth W. Howerth, DVM, Ph.D A8-034732 Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

2. S IGNALMENT AND H ISTORY 5 yr, female, DSH cat Acute onset of illness Respiratory distress Died soon after presentation at the veterinary clinic Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

3. G ROSS F INDINGS Petechiation on the lung Pulmonary edema Mottled liver with accentuation of lobular pattern Heart was moderately enlarged and rounded Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

4. M ICROSCOPIC FINDINGS Heart The left ventricular endocardium is severely expanded by a thick layer of fibrosis Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

6. M ICROSCOPIC FINDINGS The underlying myocardium shows: extensive myofiber loss replacement by fibrosis increased number of small vessels scattered infiltrating lymphocytes and macrophages are present Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

8. Masson Trichrome Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

9. In the remaining parenchyma, there are multiple foci of fibrosis Multifocally, the myocardial fibers show disarray M ICROSCOPIC FINDINGS Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

11. M ICROSCOPIC F INDINGS Lungs: Multifocally, the alveolar septa are thickened by a moderate amount of fibrous tissue and type II cells hyperplasia. Rare bronchioles and alveolar ducts are filled by foamy macrophages which give to the lung a patchy consolidated appearance. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

14. A NATOMIC D IAGNOSIS Heart: Left ventricular endocardial fibrosis and hypertrophic cardiomyopathy. Lung: multifocal to coalescing interstitial pneumonia with type cell II hyperplasia and fibrosis Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

15. D ISCUSSION Left endocardial ventricular fibrosis (LEVF) was previously named as restrictive cardiomyopathy It is the less common cardiomyopathy in cats It cause diastolic deficit with decreased cardiac output Two forms of restrictive cardiomyopathy are present: - Subendocardial fibrosis - Eccess of moderator bands that trasverse the left chamber o The subendocardial fibrosis has been associated with endomyocarditis Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

16. In an extensive survey, 28% of cats suffering from LEVF had interstitial pneumonia Causation or concomitant underlying cause for both the lesions? In our case LEVF was associated with histological lesions of cardiac hypertrophy. D ISCUSSION Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

17. Acknowledgment: Dr. Janildo L. Reis Dr. Raquel Rech Dr. Elizabeth W. Howerth Dr. Corrie Brown Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

18. Q UESTIONS ? Thank you! Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only