The appearance of a heart murmur at this time is likely due to vegetative endocarditis as a sequel to sepsis. Other rule outs for a sudden murmur include anemia, and ruptured chordae tendineae. Cardiac ultrasound necessary to define the underlying etiology of the heart murmur will not be pursued at this time given owner's desire to keep costs down and that answers to this question will not change our given course of therapy. Owner has again elected to care for Chimere at home this evening. Elbow is not painful to palpation.
Toes are warm, no edema except at the focal area described above.
Continue checking foot for increased swelling, pain and redness. Author's Note Because of the owner's reluctance to pursue further diagnostics, a cardiac consultation was not performed until 5 days later. The diagnostic test results are on the following pages. Back to the top Mark D. Kittleson, D.V.M., Ph.D. All rights reserved.