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Gillian
30th May 2006, 07:33 PM
Poor Kayla is sick. She hasnt been feeling well for two days. Sleeping all day. Not eating and just generally not feeling like doing anything. So when she threw up, today we took her to the vet. She has an infection in her uterus. Dont know how she got it. She just was in heat. But the worst is that the vet, who was a different one to the one we usually go to, same clinic, found a heart murmur :yikes Our worst nightmare. she is only 1 year one month old. You can imagine how worried we are. The vet said not to let her do any vigorous excersise , like chasing a ball, which she loves doing. Of course right now she is sick so she wouldnt feel like anyway. :(

RodRussell
30th May 2006, 09:24 PM
Did the vet who found the murmur tell you what grade of murmur he thinks it is? They are graded from 1 to 6. Anything is possible, but for a 13 month old female Cavalier, I would be surprised if it is a high grade murmur, if any at all. Statistically, the likelihood of her having a real MVD murmur at her age are about 1 out of 10.

You definitely ought to get her to a cardiologist soon. If you live in the US, there is a list of heart clinics on this webpage: http://www.cavalierhealth.org/health_clinics.htm and the cost of having a cardiologist examine her at one of these clinics will be very reasonably priced.

Also, a young Cavalier with a low grade murmur usually does not have any significant exercise restrictions. We run Cavaliers with low to moderate grade murmurs in agility practices and trials. Of course, follow the vet's advice, but the vet giving the advice in a case like this ought to be a cardiologist (or at the very least a board certified internal medicine specialist). I have found that, with some general practice vets, a little bit of knowledge about MVD can be a dangerous thing. Some find MVD murmurs where there are none, and some immediately start prescribing medications usually reserved for dogs facing congestive heart failure.

Rod Russell
Orlando, Florida USA

Nicki
30th May 2006, 09:41 PM
Gillian, the infection in the uterus sounds like a Pyometra - there is more information here:

http://www.iol.ie/~pjmathew/faqpyo.htm

If so, then at present this is the most urgent problem to worry about. Did the vet prescribe antibiotics? Have they mentioned surgery?

It is unusual for a young dog to have a Pyo, but have heard of two recently.

With regard to teh murmur, these are always more obvious when a dog is poorly. Rod's advice is good, not sure if you'd have access to a cardiologist there, but that is the best route if at all possible. Wait anyway until she is through the infection and then take her back and get the vet to check her heart again.

If it's only a Grade 1 murmur, they can't be heard all the time and may only be apparent due to her current illness.

The main thing with that is to watch her weight.

judy
31st May 2006, 02:02 AM
i'm really sorry to hear kayla is sick. it's really hard to see a dog be sick like that, one who is normally so fully of energy and antics. I hope she will heal fast. Is she refusing food and water?

Cathy T
31st May 2006, 04:40 AM
If you have access to a cardiologist I would definitely get her heart checked that way rather than relying on a vet's interpretation. Shelby was diagnosed with a mild murmur at 2 years old. Having two of them and knowing the statistics I wasn't surprised. Disappointed but not surprised. We weren't given any restrictions for her activity. I think it would be interesting to find out how many cavaliers on this board alone have any kind of heart issue. I think the numbers may surprise you. The nice thing about the heart issue (I try to look on the good side when I hear things like this!) is that there is a lot of data and lots of good treatment options.

Jay
31st May 2006, 05:34 AM
Both of my dogs have heart murmurs, Monty's is congenital due to a pulmonary stenosis. Gem's was diagnosed recently (at 2 years) as a grade 1 murmur. Both have been evaluated by board certified cardiologists. Neither has any activity restrictions. We are currently training in agility with both dogs. You would never know there was anything wrong with either dog. I take them to the cardiologist for annual check ups and will follow their direction regarding meds and activity. So far so good. I know that at some time, it may (and probably will) be different but we take things one day at a time. Sending good wishes your way that Kayla starts feeling better really soon.
J.

Gillian
31st May 2006, 06:36 AM
Thank you all for your replies and advice. Unfortunatly I dont think there are any Vet cardiologists in Malta. In fact when we mentioned the problems that Cavs get and the tests they do in England and USA on these dogs , she laughed and said { We havent had these machines and tests for people longer than a few years let alone dogs} So I will wait and see how infection goes. Yes she gave us antibiotics for 20 days and also some kind of vitamins that is like a food supplement.
Kayla did eat her supper last night. thank God.
Thanks again

Claire
31st May 2006, 10:26 AM
Hope she is feeling better very soon - it's a shame that you don't have the facilities for animals in Malta like we do in US, Ireland and UK.... :(

Karlin
31st May 2006, 10:46 AM
Oh I hope she improves quickly! And I am so sorry to hear you also had a heart murmur diagnosis.

I agree with others that if you want to correctly treat her heart condition, she needs to see a cardiologist for a proper assessment of what is actually going on -- vets are not able to make a very thorough or precise diagnosis on this condition. You should consider taking her over to the UK for a cardio exam if that is at all possible. Also be sure inform her breeder -- this is very early onset for MVD and he should not repeat the mating and should not breed either the dam or stud again, full stop, unless they have very good cardio histories themselves and there are VERY strong outweighing factors to not breed.

Also you will probably strongly want to consider spaying her as soon as she is able (not just because of pyometra, but because of the high risk of any puppies having early onset heart murmurs as well -- you don't want to pass those genes on, at any cost). I am sure the vet probably mentioned this and the possibility of recurrence and that you have lots of information. You can read background info here on the condition and why spaying is very important now -- there is often a recurrence in a dog and every incidence of it is a life or death matter. Did your vet say why she decided to treat with antibiotics rather than spay?

From http://www.marvistavet.com/html/body_pyometra.html


WHAT IS A PYOMETRA?

The word “pyometra” is derived from latin “pyo” meaning pus and “metra” meaning uterus. The pyometra is an abscessed, pus-filled infected uterus. Toxins and bacteria leak across the uterine walls and into the bloodstream causing life-threatening toxic effects, Without treatment death is inevitable.



WHAT MIGHT MAKE THE VET SUSPECT THIS INFECTION?

Classically, the patient is an older female dog. (Pyometra can occur in the cat but its not nearly as common.) Usually, she has finished a heat cycle in the previousl 1-2 months. She has a poor appetite and may be vomiting or drinking an excessive amount of water. In the more usual “open pyometra” the cervix is open and the purulent uterine contents is able to drip out thus a smelly vaginal discharge is usually apparent.

There is also a form of pyometra called a “closed pyometra” where the cervix is closed. In these cases, there is no vaginal discharge and the clinical presentation is more difficult to diagnose. These patients also tend to be sicker than those with open pyometra due to retention of the toxic uterine contents.

Lab work shows a pattern typical of widespread infection which is often helpful in narrowing down the diagnosis. Radiographs may show a gigantic distended uterus though sometimes this is not obvious and ultrasound is needed to confirm the diagnosis.

HOW DOES THIS INFECTION COME ABOUT?

With each heat cycle, the uterine lining engorges in preparation for pregnancy. Eventually, some tissue engorgement becomes excessive or persistent (a condition called “cystic endometrial hyperplasia”). This lush glandular tissue is ripe for infectionf (recall that while thei inside of the uterus is sterile, the vagina below is normally loaded with bacteria.). Bacteria ascend from the vagina and the uterus becomes infected and ultimately pus filled.

WHAT IS THE USUAL TREATMENT?

The usual treatment for pyometra is surgical removal of the uterus and ovaries. It is crucial that the infected uterine contents do not spill and that no excess hemorrhage occurs. The surgery is challenging especially if the patient is toxic. Antibiotics are given at the time of surgery and may or may not be continued after the uterus is removed. Pain relievers are often needed post-operatively. A few days of hospitalization are typically needed after the surgery is performed.

It is especially important that the ovaries be removed to remove future hormonal influence from any small stumps of uterus that might be left behind. If any ovary is left, the patient will continue to experience heat cycles and be vulnerable to recurrence.

While this surgery amounts to the same end result as routine spaying, there is nothing routine about a pyometra spay. As noted, the surgery is challenging and the patient is in a life-threatening situation. For these reasons, the pyometra spay typically costs five to ten times as much as a routine spay.

PROS:

The infected uterus is resolved rapidly (in an hour or two of surgery). No possibility of disease recurrence.

CONS:

Surgery must be performed on a patient that could be unstable.

IS THERE AN ALTERNATIVE TO SURGERY?

In the late 1980’s another treatment protocol became available that might be able to spare a valuable animal’s reproductive capacity. Here, special hormones called “prostaglandins” are given as injections to cause the uterus to contract and expel its pus. A week or so of hospitalization is necessary and some cramping discomfort is often experienced. The treatment takes place over the course of a week. This form of treatment is not an option in the event of a “closed” pyometra as described above.

PROS:

There is a possibilityof future pregnancy for the patient (though often there is too much uterine scarring). Surgery can be avoided in a patient with concurrent problems that pose extra anesthetic risk

CONS:

Pyometra can recur. The disease is resolved more slowly (over a week or so). There is a possibility of uterine rupture with the contractions. This would cause peritonitis and escalates the life-threatening nature of the disease.

PREVENTION

Spaying represents complete prevention for this condition. Spaying cannot be over-emphasized. Often an owner plans to breed their pet or is undecided, time passes, and then they fear she is too old to be spayed. The female dog or cat can benefit from spaying at any age. The best approach is to figure that pyometra will eventually occur if the female pet is left unspayed; any perceived risks of surgery are very much out-weighed by the risk of pyometra.

Jen114
31st May 2006, 11:03 AM
HELLO everyone thank you for your concern for Kayla as you can imagine i have been going crazy... Gillian is my MOM and i am the owner of Kayla....... after hearing all these things.... and knowing the lack of facilities we have in malta i decided to call the vet straight away to see if the infection is called PYOMETRA ..................

NOOOOO she said thank gooodnessssssssss

She said it is a hint of Endometriosis or something like that?????

Do you know anything about it?

Karlin
31st May 2006, 11:20 AM
That's good that it isn't pyo, but not good that it is endo. :(

I know endo well as I have it!

This is a potentially very painful condition where the uterine tissue begins to grow all around the internal organs -- typically it attaches to the stomach, diaphragm, bladder, bowel, intestines... it can even penetrate thru the diaphragm and enter the lungs where it can cause a collapsed lung (my father, a respiratory specialist, was actually the first person to describe and name the lung aspect of this very strange condition in the 1970s).

Every time Kayla goes into a heat the uterine tissue will behave just like the uterine lining and swell in preparation for the possibility of puppies, which can be very painful in itself and is almost certainly why she has been off colour. Then, when the lining is shed all the tissue within the abdomen ALSO bleeds which causes cramping and discomfort at best and more serious problems requiring surgery, at worst.

In humans the effects are most noticeable during menstrual cycles and can require hospitalisation. The abdomen is very unhappy when there are fluids like blood seeping inside and the reaction is the body tries to fight off what it thinks is a foreign body. Infections are possible.

The human treatment is either full hysterectomy or the surgical removal of the endometrial tissue, which can be a major or minor operation depending on how much tissue and how many adhesions there are (where the tissue is attacjed to internal organs). Hysterectomy (eg spaying in a dog) removes the cause of the endometriosis -- eg the heat cycle.

Endometriosis tends to increase in severity over time as those of us with it can unfortunately testify. If she is already showing signs of it now you would probably want to act to remove the cause (eg have her spayed as soon as you can so she doesn;t go into another cycle and go through all of this again).

Most of us with endo find doctors do not know very much about the condition and even some specialists are unaware of it and what the symptoms are. Endo often acccompanies ovarian cysts in humans; I don't know about dogs. These are sacs that form around the ovary and fill with fluid and can become very large. If they burst, they can be life-threatening (like appendicitis), so doctors tend to want to remove the cysts when they occur. Again this requires abdominal surgery.

Jen114
31st May 2006, 11:30 AM
Thank you very much for your quick reply........ it is very informative and i guess i will be spaying Kayla sooner than i wanted too...

You would be very disgusted to hear about the ONLY cav breeder in Malta.......

1) first of all there are roumors that she doctors the pedigree bec she has soo many cavs in her house she is not sure which one is the dad so she just invents it.....

2) the dad of KAYLA is the dad of every single cav which comes to the dog show in malta ie... 10 cavs

3) seeing there is not health checking at all in MALTA.... No scans....no cardiologists..... not mri's.... ect.............. (IN MALTA WE JUST GOT THESE THINGS FOR HUMANS LESS THAN 10 YEARS AGO)

4) The breeder is really really not caring at all and i am sure that if i tell her which i will anyway about the condition of Kayla so will not give a dam... because she is a cold hearted ******** i better not continue what i think she is as i will be bleeeeeepped out.... but as you can see i am upset about this......

Now is there anything we can do about her and the way she breeds her animals ...... NO...... is there anything at all we can do ...... NO as in Malta they are so far behind and to be honest it does not seem as if they care...


I know alot of Cavs in Malta who have MVD and are on medication therefore that shows that the breeding is not done properly here.....

I really want to get another Cav in the next few years or so but i have no idea what i am going to do to get one......

NOW THESE PUPPIES HAVE TO BE LOVED AND JUST LIKE A DISABLED HUMAN WE CAN NOT ABANDON THESE PUPPIES ...... MY mom is going to buy one and so is my Sister in law and we will just have to love them and hope to be lucky that they are not sick

ITS A SAD SITUATION ISNT IT!!!!!!!!!!!

Karlin
31st May 2006, 11:30 AM
Can;t find anything on dogs having it except a 1966 study, but assume it will be very much the same as in humans.

Here's a background article on the condition:

http://news.bbc.co.uk/1/hi/health/1843962.stm

Jen114
31st May 2006, 11:35 AM
AND TO BE HONEST t

I DO NOT TRUST ANY VET ON THIS ISLAND


When ever she is sick..... they give her a few injections and saw now she will be ok....

Every time the vet sees her they listen to her heart and it always was fine.... now this vet said it is not..... HOw can this bee when another vet listened to her heart 2 weeks ago....

Does this new vet have a ringing in her ear...


I DON'T KNOW I AM JUST FED UP WITH THESE STUPIED VETS I WANT SOMEONE WHO KNOWS WHAT THERE DOING TO LOOK AT MY BABY

judy
31st May 2006, 05:25 PM
how did they diagnose endometriosis? In people, it's usually hard to diagnose for a time, and is similar to other possible diagnoses. I never heard of treating endometriosis with antibiotics before. I'm not saying they dont', i'm NO expert about this, but what tests or evidence did the vet base that diagnosis on? What antibiotic is she on? I can understand why you are feeling mistrusting about this vet. When will your usual vets be back?
Are you sure she doesn't have a worm infestation causing her symptoms?

Vets and doctors do make mistakes and then those can lead to treatments that are harmful. Once a couple of years ago my then 86 and somewhat demented mother went to the eye doctor for follow up on cataract surgery, on a Friday. I called the doctor just to stay on top of what was done. Her part time caregiver had said they gave her medicine to put in her eyes. I could not speak to the doctor and got very little info from the office staff.
The next day, my mom who lives alone woke up with some very bad pain in her eyes and head. The caregiver went over and put cold compresses on her head. I called the doctor but there was another doctor on call. He said that was pain was a common side effect of the medication which was for glaucoma. ???Why didn't anyone tell me when i called the day before about the glaucoma diagnosis? she never had that at all before? why didn't anyone tell me about the common side effect of the medication? the on call doctor stopped that medication and put her on a different one. Some time later, a few weeks i think, she had an appointment at the eye place, and i don't remember why but she saw the doctor who had been on call that day instead of her regular one. I went with her, which i usually don't have time to do. They used a machine to test her glaucoma. THERE WASN'T ANY FREAKING GLAUCOMA. Never was. they tested and retested. Good news. but scary that doctors can misdiagnos and treat accordingly. the doctor who did this is supposed to be among the very best in the field, he teaches at UCLA and is pioneering new kinds of cataract surgery, and thinks he's all that, wont' return your calls, etc. The other guy was very focused and caring and intelligent. took her off the glaucoma medication and just monitors her for signs of it.

So let the patient beware. If you can, i would get a second opinion. Endometriosis is not usually an emergency. And hopefully, fingers crossed, the vet misdiagnosed a heart murmur. It certainly seems possible. I was told i had mitral valve prolapse for years and years, had to take antibiotics for dental work, had an echocardiogram that showed "mild MVP" , they could hear a click when listening to my heart, not just one doctor, lots of them heard it over years. then one said i had a slight murmur. that was heard a few times over time. A couple years after that, i was told no murmur could be heard, and then, after a little while, i was told the MVP noise was not heard. Later on, i had another echo gram for another thing (slow heart beat) and was told there was no sign at all of MVP. I was told all those other doctors had been wrong. I don't know...

Karlin
31st May 2006, 11:45 PM
Vets will listen to hearts and should always give an opinion based on what they hear. Most vets are not nearly as good as a cardiologist at detencting and grading murmurs but that is normal -- cardios are specialists in this one area; while vets are general practitioners. Likewise your GP would likely pick up a bad human heart murmur with a stethoscope but might not hear a sensitive murmur at all. I have a chart in the health section that shows how unlikely vets are to pick up early stage murmurs compared to cardios but some can do this much better than others so it isn't at all surprising for one vet to hear and another not to, so don;t feel to disconcerted by that.

The problem is being certain of what is going on if there's no cardiologist to confirm the murmur.

If you want a heart-healthy cavalier, there's always the choice of seeking out a breeder outside Malta who breeds for health. Many people travel to get the right cavalier from the right breeder, including across or between continents, so maybe this is the right way to go.

I don't agree that one should get cavaliers from an unethical breeder because someone needs to take the puppies. Cutting off demand is the best way to deal with poor breeders. Paying to take their puppies simply maintains them in doing what they are doing and gives them the financial incentive to keep breeding. The puppies are unlikely to lack homes -- there's always someone who will take them but someone who knows the real situation needn't support the breeder.

Where does this person show their dogs (eg what club do they belong to) and what registry do the puppies have -- you can always file a complaint with whoever is registering the puppies for example as well as the club they belong to.

judy
1st June 2006, 05:41 AM
karlin--sorry you have endomeriosis. what a coincidence that you father is a pioneer in the specialty!

How is endometriosis diagnosed? Does it generally require a laparoscopy? I used to have undiagnosed pelvic pain so i read about everything that it could possibly be. As you said, a lot of people with this condition are not diagnosed because their doctors don't know enough. Can a knowledgeable doctor distinguish a patient with endo just by history and physical examination?

I was surprised to hear that Kayla was diagnosed with endometriosis--i didn't know it was that easy to diagnose. Maybe that vet has seen a lot of cases? Is there an blood test marker that's specific for it?

rory
1st June 2006, 10:45 PM
Dogs don't get endometriosis. I'm sure she said Kayla has endometrITIS, not endometriOSIS. Plus, endometriosis is NOT an infection, which is what your vet said she had. Endometriosis is endometrial (uterine) tissue that is in the wrong place (like, outside the uterus, along the fallopian tubes, etc.)

Hope the heart murmur is nothing. I have had 2 people say they "maybe heard a 1/6 murmur" on rory and I've had a bunch of others say they can't hear anything. So we'll be getting an echo to see what's really going on. At a very low level, murmurs can be very hard to detect. So either the two who heard it have very good ears, of they are just "hearing" it because he's a Cav and they expect to hear a murmur. Either way I am not too worried because if it's that slight it's not going to be causing any problems right now. Best to see what is really going on now and then monitor progression.

did you say your mom and sister are going to get dogs from this breeder?? why support this woman who you obviously do not trust or respect? it is not like supporting disabled people because this woman has teh choice to bring these dogs knowingly into the world under less than ideal circumstances and knowingly producing unhealthy dogs without caring. Can't you fly in a dog from another country?? can't you fly into another country and bring a dog back with you?

cleopatra
2nd June 2006, 06:25 PM
i pray that kayla gets better really soon, you must be going mad with worry, you have a lot of people thinking of you both and wishing her good health xoxoxox

Gillian
3rd June 2006, 09:21 AM
Now we are really confused. Got a second opinion! Kayla was not getting any better so called another vet who came home to see her.He said it wasnt her uterus but a intestinal infection. Advice was keep her on same antibiotics othe vet gave us and vitamin food supplement and call him on Monday if she is not any better. He also gave her two injections,One to settle her stomach and one for her appetite. icon_nwunsure :? These vets are going to drive us crazy.
Not sure how she is this morning as my daughter Jenny has her on weekends. I am sure she will call me soon.

Gillian
3rd June 2006, 09:22 AM
Forgot to say he also heard heart murmur and said it was very slight.

judy
3rd June 2006, 02:23 PM
good luck! I hope she's better today.
my puppy had diarrhea for three weeks off and on when i first got him, they treated it with antibiotics (flagyl), it would go away and always come back when the medication was done. then, he started vomiting, several times a day, also listless, quiet, not playing, every other day for about a week, that was such a long week. He was given two shots for nausea and appetite twice, it seemed to help the first time for acouple of days, then the illness came back and he had the shots again but it didnt' help. I went to different vets. Finally i went to a vet that gave him deworming pills and he immediately got better, has been better ever since, but he was sick for over a month until he had the deworming. I've ready of otherpeople having this happened, someone on the other cavalier forum said her dog was sick wiht gastrointestinal symptoms for over a year before they tried deworming and the dog got better. None of the first vets i went to even considered deworming. the stool samples were all negative.

sure is hard to have a sick dog. it feels so good when they are well again. I hope this happens for Kayla now.

Gillian
4th June 2006, 08:17 AM
Thanks for the advice. If she is still not well I will mention it to the next vet. Hopefully we will sort her out.

Harry & Heidi's mom
4th June 2006, 07:30 PM
sounds like kayla has colitis

Harry had it a few weeks ago, and he had an injection to settle his tummy, and antibiotics, plus a "special" diet which is a rip off.

he was better within a week or so.

hope kayla gets better soon.