Medical and surgical management of multiple organ infarctions secondary to bacterial endocarditis in a dog

A 6-year-old male Doberman Pinscher developed multiple organ infarctions secondary to vegetative endocarditis. Clinical signs included fever, nystagmus, head-tilt, inappetence, dehydration, hematuria, and dysuria. The dog was azotemic and anemic and had a high WBC count and high liver enzyme activities. Disseminated intravascular coagulation was diagnosed on the basis of thrombocytopenia and prolonged activated clotting times. Vegetative mitral valvular lesions were evident on M-mode echocardiography. The dog underwent diuresis with physiologic saline solution and was treated parenterally with antibacterial and anticoagulant agents. Surgery was performed to remove an infarcted kidney and an infarcted spleen and to relieve urethral obstruction caused by a large blood clot. Gram-positive cocci were noticed in the biopsy specimens. Mortality associated with organ infarctions secondary to bacterial endocarditis is high, and combined medical and surgical therapy is rarely reported. This dog survived and was alive 38 months after surgery.