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Signalment: 14 year old, MC, Shih Tzu
Presenting Complaint: Collapsing daily.
Grade III/IV murmur, mildly harsh lung sounds, mild cough on tracheal pressure.
Presenting History
This dog collapsed while on a walk two weeks previously, then again one week later, now occurring daily. Episodes last about a minute, he remains conscious, with no urination or defecation. Seems normal afterwards, but has increased breathing. Thirst is increased, appetite is good, no vomiting or diarrhea. Does honk when he coughs, but has done so his whole life when excited, and there has been no increase in coughing. Sneezes occasionally, has bubbles from the nose which has been occurring for 2-3 years. Energy and exercise tolerance were good until the episodes began. He has marked dental disease, a cataract in the left eye, pigmentation in the right eye from a previous cataract, and chronic growths on the eyelids.
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Radiographs
Lateral view 
DV view
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