Swimmer puppy syndrome, pectus excavatum, and cardiac dextroposition in two American Akitas: management and successful long-term outcome.

Swimmer puppy syndrome (SPS), also known as splay leg, splay weak, or myofibrillar hypoplasia, is an uncommon condition with poorly understood pathogenesis. It affects neonates and is characterized by sternal flattening, limb abduction, and an inability to stand or ambulate properly. This report describes two American Akita littermates diagnosed with SPS. The condition was associated with pectus excavatum and cardiac dextroposition, identified through clinical examination and thoracic imaging. Both puppies presented with persistent sternal recumbency, respiratory distress, and restricted mobility during the first weeks of life. Radiographic evaluation revealed thoracic flattening, rightward cardiac displacement, and mild pectus excavatum. A therapeutic protocol including intensive physiotherapy, active positioning, and a custom-made external thoracic splint was implemented. Marked improvement in locomotion and thoracic conformation was observed within 30 days. Long-term follow-up (two years in one case) demonstrated a successful functional outcome despite persistent, mild, rightward cardiac displacement. These observations highlight the importance of early recognition and conservative management of SPS and associated thoracic deformities.