I really do not know whats wrong :(

Hi, I really hope you can help me? bare with me though as this is a long story but I could really do with some advice right now

My cavalier king charles kaytee is 7, she has never been very well, she has syringmelia (sorry cant spell) Dry eye well thats just the ones I am certain she has but nothing makes sense to me anymore.

It all started when i first got her, she was never right, if i offered her food she would gag and it sounded like she had to clear her throat before she could eat, and then there was constant sickness she was sick at least four days out of a week, I took her to my vet and she was sent to a specialist vet in newmarket (UK) to work it all out.

Well they discovered she has a elongated soft pallet, also she has IBD (irritable bowel disease) which would explain the sickness and occasional diarrhea, so we changed her food to Walthams Sensitivity control, she was put on Zantac syrup for a while and some special tablets (sorry forgot what they were) but they were used to take the inflammation down in her stomach.
She was also put on prednisolone 5mg every other day which they say she has to be on for life

But the thing that bothers me is at the time they did this test where they fill her lungs with air, i cant really remember why but I remember they said she had a slight infection in her lungs, they said could even possibly be lung worm and they put her on some wormers and a course of synulox.

But when I returned to them months later they never did check the lungs to see if the infection had gone?

Her sickness is alot better, I have even managed to take her off the walthams and feed her on James wellbeloved, so far so good.

But what worries me now is she has a cough, has had it for a hell of a long time now when I spoke to my vet she said it could be bronchitis, but the steroids she was already on hadn't helped the cough and my vet said that maybe the cough is caused by her heart as she could hear a murmur on the right side she said a grade two

Right so you can probably see how confused I am, I havent a clue what she has im so mixed up, I have lost all faith in vets now, I have asked for the specialist vets to send me a print out of all the treatment she had and results to try and understand better.

I hate tablets I worry about giving them to her as my last cavalier was on heart pills and prednisolone and died of liver failure I cant help but worry that the tablets may have caused it?

At the moment kaytee is on
Fortekor 5mg once a day
Frusemide 20mg once aday
and prednisolone 5mg every other day.

So far she has been on the heart pills and water tablets a week and her cough is no better in fact it seems to be getting worse.

I must add before I go that the thing I do not get about this cough is that it is worse when kaytee goes to bed at night, I know cavaliers with bad hearts cough more at night but I don't get it as when I take her into the living room the cough eases, and tonight I was massaging her throat either side of the middle bit and it calmed it down...Yet sometimes in the day if she gets stressed she coughs...I DONT GET IT one minute i think its the heart then the bronchitis then the soft pallet...I seem to be getting no where with the vets...any advice? xxx

my first cav had the same sort of problems he lived until he was six but his lungs kept filling up so i had to have him put down in the end i could whatch him suffer anymore (it broke my heart) it felt so wrong at the time but when i look back now i know i did the right thing.The most important thing is not to let your dog suffer. i know its not what you want to here which im sorry but it what i would be thinking about.:xfngr:

I'm sorry Kaytee has had so many difficulties to deal with but you have done very good work in getting her tummy problems resolved.

The heart tablets wouldn't have caused liver failure, as far as I know -- I have never heard of that and these particular tablets are very well documented for their use not just in dogs but in humans.

To be honest I would take her to a dfferent vet for a second opinion. I would explain her background and

1) ask about the lungworm and to have this tested for (BTW did you ask your original vet about whether this should still be a concern? It can be quite serious and youd want to make sure she doesn't have this). Usually if it is mild, a course of wormers would have solved the problem.

2) ask to check for other possible sources of the cough, from asthma to kennel cough. The latter is very common and sounds far worse than it actually is.

3) ask for a referral to a cardiac specialist. A vet is really not going to be able to give you the information you need on Kaytee's heart condition (and she may not even have one! Vets often hear murmurs where there aren't any, and miss early murmurs as well). Most dogs are not given medication at only a grade two murmur because it would be unusual for the dog to go into congestive heart failure (eg have that cough) at only a grade 2! Vets are also extremely poor at hearing and diagnosing such early murmurs. This set of posts has extremely detailed information on MVD and what to ask a cardiac specialist to do, tests that can be done, etc:

http://board.cavaliertalk.com/showthread.php?t=9214

Normally the vet would have taken an xray to see her heart to see if it is getting enlarged and therefore if she is likely to be going into CHF, for example. If these things weren't done, I'd want to get then done but by a cardiaologist.

That said: KEEP HER ON MEDICATION if she needs it and until you find out more about what is wrong if anything, with her. ALL the heart meds have very few side effects, if any at all, and can add YEARS of comfortable life to a dog with a severe murmur/CHF. They NEED those tablets. Please don;t decide not to give something that is so hugely beneficial because of concern about giving tablets. If she has CHF, they will all be really helping her.

4) If she has a problem with her palate this alone could cause the coughing and some gagging. It would be good to review this situation with a vet. A small operation could be the answer and restore her comfort in breathing. Also what is her weight like? Extra weight will make breathing far more difficult for her and could be adding significantly to her palate problem.

5) I'd review the need for the steroids and if she is showing pain from SM, get her on to gabapentin. The frusemide for the heart may also be helpful towards the SM. There's a treatment diagram from Clare Rusbridge for SM you can download and print out for your vet at www.smcavalier.com.

I hope you are able to find the cause of the cough and resolve these problems as it sounds like you have done a lot for her. :flwr:

PS How do you know she has SM? Has she been MRId and is she symptomatic? Has she ever been put on anything for it?

I would take her to a cardiologist, as recommended by Karlin. A regular vet cannot grade a heart murmur as well as a cardiologist can, and also might grade the murmur lower than a cardiologist would. If Kaytee's cough is related to her heart condition, her medication can be adjusted to help her improve.

I hope she feels better soon.:flwr::flwr::flwr:

Oh my goodness. I am so sorry to hear Kaytee's health is causing you and her such worry. Having never been in this situation myself, I am loathe to dispense advice. That said, Karlin's advice seems to make sense.

I just butted in to say for what it's worth that I'll be thinking of you both. :xfngr: :xfngr: this all works out well. Keep us posted on how the situation develops. :flwr: :flwr:

thanks to all of you I will take everything you say in mind, I spoke to my vet tonight as I dont know if I added but I asked for kaytee to have a full blood test just to see if there was anything more sinister going on as she also has (to add to her many other probs) a bald tail well thankfully that came back all clear i am now waiting for the last bit of it that got delayed that bits for a test on the pancreas.

I explained how i feel about kaytee and asked if my vet could refer kaytee to a heart specialist quite a few miles from us, she said she would be happy to but could we try a couple more things first, she wants me to increase the frusimide to two aday first to see if that helps if not she said they will do a xray there and they should be able to tell what the heart looks like, she says if we are still stuck she will refer kaytee.

fingers crossed, thanks again all, i hope kate will be ok xx

Some good news then! That's great!

On the heart issues: I'd still go to the cardiac specialist *right away*, not wait and try adjusting medications. They are the ONLY people who can deifinitely tell you if she actually even HAS a murmur, what grade it is, how advanced (if at all) CHF is, and the bext mixture of medications. I wouldnt be fiddling with medications withut even knowing what you are dealing with or if this cough is due to CHF.

If Kaytee has symptomatic SM she should also really, really be placed on gabapentin as this is excellent at stopping pain. It is also virtually side effect free. Most SM dogs that I know of with symtpoms of any kind are on this and it really helps including mine).

I would re-iterate what Karlin has said.

Kaytee needs a heart X-Ray to see what's going on. With MVD, the dog's heart enlarges and can affect their breathing, because the heart puts pressure on the windpipe.

Frusemide should clear the excess fluid hopefully. If it is MVD, there's an amazing drug called Vetmedin, which is well-reputed.

Dogs with MVD do tend to cough more at night, as the fluid settles.

Cailean is 7 years old and has advanced MVD, with a grade 5 murmur. He's on the following meds for his heart condition:

Vetmedin 2 per day
Fortekor 1 per day
Frusemide 2 per day (he wees 'lakes' - lol)
Corventyl 2 per day (this drug helps open up the airways)

I have to say it's took him about a year to be on all 4 drugs and there isn't an awful lot more he can take but he has fun and we take the good with the bad.

Oddly, when he's really poorly, a course of antibiotics sometimes helps, which the vet can't explain!

Good luck with kaytee.

thank you all again for your advice, i think i forgot to say that kaytee did have a MRI i think it was that confirmed she has SM that was a year or so ago. She dosent seem to be in pain with it I think it is not too bad at the mo so fingers crossed.

I really want her to see the specialist but my vet says she can Xray there and would rather do as much as she can there first, she says if we look at the Xray she will be able to see the heart, how large it is etc and then also look at the lungs and decide wether it is the heart making her cough, i do trust my vet and just want to get to the bottom of all this really.

Misty mentioned vetmedin, apparently my dog Siouxie who I sadly lost a few years back was one of the first Cavaliers to try that drug in the UK, I agree it was amazing and i know it gave her a few more extra years of life and since then her son Bracken my mums dog is on it, history is sadly repeating itself

As for Kaytee we had a horrible day I took my vets advice and put the frusemide up to two tablets aday which in all is 40 mg, I gave her one then a few hours later I gave her the second as i wasnt sure whether to give both at the same time...I took her to the loo then we went for a cuddle on the bed, she wasnt asking for the toilet she snuggled with her head on my neck as always but when we got up I realise she had wet herself whilst she was sleeping
I took her downstairs and she did a massive wee

It had only been two hours since I gave her the second tab, since then i have been taking her down every hour and she has been weeing.

The strange thing is my sisters dog went on the same dose last week and he was weeing in his sleep every night, I dont know what to do with Kaytee now as I cant take her to the toilet when I go to sleep, i know it is normal for her to wee more but surly this isnt right?

Also SORRY but my other concern is if she hasnt got fluid on her chest will these tablets cause damage? we are using them to see how the cough goes but I am afraid of making her ill, I will ring my vet tomorrow but wondered what you think?

THANKS XX
This is Kaytee xx

Awwww...Kaytee is a sweetie. I am so sorry you are going through all of this with her, just breaks my heart reading your stories. I have no constructive advice, I'm just glad there are plenty of people on this board to give you guidance and support.

Cathy T said:

Awwww...Kaytee is a sweetie. I am so sorry you are going through all of this with her, just breaks my heart reading your stories. I have no constructive advice, I'm just glad there are plenty of people on this board to give you guidance and support.

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Thanks hun It is really hard, I sometimes think why do I always have poorly dogs?? Then I think that maybe the angels have sent the sick babies my way as they know I will do my up most to make them well? I just wish they had sent me something to calm my stress levels as I did it though! hehe xx

I had health issues with my two at the same time (luxating patella and carcinoma) and was lamenting my woes to my vet. Her response was "you were given these dogs because you can care for them....imagine if they were with someone who couldn't/wouldn't give them the proper care" and I felt a little better. Hang in there and come here for relief, care and big hugs.:luv:

We are thinking of you. Good luck and hugs and licks.
Pam

THANK YOU, Kates wee's seem to have calmed a little I hope we get to sleep through the night, I have been up with her a lot lately sitting up till 6-7am in the morning as she is coughing, I just love her so much and I wish she could talk mind you she would probably shout "STOP FUSSING!" hehe.
Will let you know how things go after I have rung about the frusemide take care all xxx

Thinking of you. Let us know how it goes with the phonecall.

hey all, just to let you know I spoke to the vet on the phone, kaytee's cough really improved on the frusemide, still I was unsure though wether it was as there has been a change in weather and still whether it is bronchitis but my vet said i should try lowering the dose now and see how she goes I am yet to do that.
I have requested an xray to have a closer look at kates heart and this is booked for this coming monday, do you think this is a good idea? i worry about the anesthetic as she has had a lot of it in the past but is it worth it to look at kates heart and see what the vet thinks? as always you amazing advice is always appreciated thanks xx

I have no help with your difficulties except I wonder what time of day she takes the furosimide? We always gave it ( to people) in the morning so that they could get rid of extra fluid during the day and rest at night. If we had to give it twice a day, we gave the second dose at noon or 4 pm depending upon the physician's wishes. If I remember correctly it is fast acting.

kaytee576 said:

I have requested an xray to have a closer look at kates heart and this is booked for this coming monday, do you think this is a good idea? i worry about the anesthetic as she has had a lot of it in the past but is it worth it to look at kates heart and see what the vet thinks? as always you amazing advice is always appreciated thanks xx

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My dogs have never had an anesthetic for x-rays. Geordie has had his lungs x-rayed, and India has had her knees and hips x-rayed - no anesthesia was needed.

I hope little Kaytee continues to improve!:xfngr:

Karlin said:

On the heart issues: I'd still go to the cardiac specialist *right away*, not wait and try adjusting medications. They are the ONLY people who can deifinitely tell you if she actually even HAS a murmur, what grade it is, how advanced (if at all) CHF is, and the bext mixture of medications. I wouldnt be fiddling with medications withut even knowing what you are dealing with or if this cough is due to CHF.

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Karlin have I read this correctly, are you saying that vets can't diagnose murmurs?

I can help with the Frusimide, now called Frusicare dosing, as Izzy was on it. I was told to give the tablet doses separately, giving the later one early enough to allow a good wee before bedtime, so he had one first thing, with his Vetmedin and Fortikor, then the other at about 6pm, with his dinner, the his second Vetmedin at bedtime.

I never went to a specialist with Izzy, as my vets served me very well, keeping him going, in relatively good condition for over two years, even when his heart was really bad. He didn't have Frusicare until his last 6 months, as he didn't have any significant fluid buildup (confirmed by at least 5 vets) and started on two half tablets. As many other cavalier owners have said, my vet then trusted me to temporarily increse his dose, if fluid became the obvious cause of coughing (His hernia used to go hard when fluid was present) so sometimes we went to a whole, in a morning and a half at dinner time. When he was onthis dose long term, we sometimes upped to two per day.

I asked if the extra, if there was no extra fluid would cause harm and the vet said it would not, but he would we more. He added that we were well within the safe dose and could more than double it without ill effect.