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Love my Cavaliers
16th January 2009, 06:23 PM
At 4 months of age Oz was diagnosed with a Grade 1 murmur caused by leaking across the mitral valve. Are there any therapies that others have tried to slow down or prevent the progression of MVD in dogs with a diagnosed murmur? CoQ10 has been mentioned, but I don't know the dose to use. Also I have heard about using Calcium Carbonate and there is supposedly a rosemary protocol. Anyone know of any of these? Since his murmur is only a grade 1 right now, his cardiologist has not put him on any meds and he is just to go in yearly for a cardiac follow-up unless there are worrisome signs - thankfully there are none right now. He is active, playful, and just a lot of fun.

ilsamom
16th January 2009, 08:41 PM
I am so sorry, I had a dog with mvd before, and it's sad to see it so young.

The best advise I received ( though she was medicated at the time) was to feed her HD dog food, which is for heart disease, and keep her to a heart healthy, low fat, low sodium diet. I was also told to feed her bananas, but that may have been because she was on lasex. I think it helped, she had a good quality of life until she was 12. I never gave her supplements, the medications worked very well and she had no side effects. It's great that you caught it early, if it advances even a bit you'll know and early treatment makes a great deal of difference.


Jen and Ilsa

rhiannasmom
16th January 2009, 11:27 PM
I've been reading a fantastic book... The Veterinarians' Guide to Natural Remedies for Dogs by Martin Zucker. This is a compilation of advice from many holistic-minded vets. The advice for supporting the cardiovascular system is this...
CoEnzymeQ10 (can lessen your dog's dependenceon medication when used long term) - 10 milligrams, twice daily for small dogs
Vitamin E (antioxidant/anti-inflammatory)- 200 IU daily for small dogs
L-Carnitine (an amino acid that improves the strength of the heart muscle and helps burn fat) - 250 milligrams daily for small dogs
Powedered Kelp (excellent source of minerals for the nervous system which keeps the heart pumping) - 1/2 teaspoon per meal, mixed into food
Selenium Methionate - 100 micrograms daily
Also a helathy diet and exercise, of course!

Talk to your vet about these before administering!!!

Hope this helps ;)
Melissa

Pat
17th January 2009, 12:40 AM
At 4 months of age Oz was diagnosed with a Grade 1 murmur caused by leaking across the mitral valve
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Whoa, this is really significant info for me. I've never before heard of a dog younger than about a year diagnosed with endocardiosis (acquired valvular disease, the problem so common in Cavaliers). I've been studying this for about 20 years. At the Heart Symposium in Atlanta in 1996 (where the MVD Cavalier breeding protocol was announced), Dr. Beardow was asked the question of how old the youngest diagnosed Cavaliers were, and he replied that they were about one year old. One of my personal Cavaliers was diagnosed at 18 months, which was pretty young. (And by the way, he lived to 15 and never went into CHF which was rather remarkable. Cardiologist - Gil Jacobs in Athens, GA - and I have no idea how that happened.) The reason that the disease doesn't manifest until about a year is because it is a DEGENERATIVE disease which obviously means that the disease takes some time to develop versus a congenital defect which is something present at birth.

There is a condition known as mitral valve dysplasia, and this is a congenital malformation of the mitral valve. But this is different from the degenerative valve disease that Cavaliers typically have. Lance Armstrong's golden retriever had mitral valve dysplasia and Chris Orten at CSU vet school is the vet who pioneered the surgery to repair congenital mitral valve dysplasia. More below that I copied from Merck Veterinary Manual site:

Congenital malformation of the mitral valve complex (mitral valve dysplasia) is a common congenital cardiac defect in cats. Canine breeds predisposed are Bull Terriers, German Shepherds, and Great Danes. Mitral valve dysplasia results in mitral insufficiency and systolic regurgitation of blood into the left atrium. Any component of the mitral valve complex (valve leaflets, chordae tendineae, papillary muscles) may be malformed, and often more than one component is defective.

Would you be willing to share details such as the name of the cardiologist who diagnosed this and whether this was confirmed by an echocardiogram? A murmur in a dog who is 16 weeks old is generally either an innocent flow murmur or a congenital heart defect such as a PDA or aortic stenosis or similar. The mitral valve dysplasia that I described above is not one of the most common congenital heart defects and it is not a Cavalier breed issue. Do you have a written discharge summary or report? If so, does the diagnosis read endocardiosis or mitral valve dysplasia or something else? If this is truly mitral valve dysplasia, you should read about the surgical repair options.

This is really very significant info to me. Rod - if you are out there, have you ever heard about this or read any veterinary papers about it?

I'll address diet and supplements later after I leave the office.

Pat Beman
Atlanta

Pat
17th January 2009, 12:46 AM
I just looked at your signature and saw that Oz was born in July of 2007, so this diagnosis happened over a year ago? Murmur auscultated at four months by cardiologist or regular vet? Echo done at four months or recently? I'm trying to make sense of this. Wondering if it was an innocent flow murmur at four months but is now an MVD murmur???? If this had been mitral valve dysplasia, likely the condition would have worsened.

Pat

Love my Cavaliers
17th January 2009, 05:44 AM
Hi Pat,

Oz had an episode of what I think now was probably Episodic Falling syndrome when he was 4 months old. His regular vet heard a murmur when I took him in that day and referred me to Dr. Eva Sikorska, a cardiologist at the Animal Emergency and Referral Center in Northbrook, IL. She works with Dr. Leuthy. His diagnosis was mild degenerative valve disease and intermittent second degree AV block, confirmed by echocardiogram. I can fax you the discharge summary if you would like which includes a lot of information which I don't understand. By the way, although the murmur was picked up at 4 months of age, he didn't see the cardiologist until he was almost 6 months old. He also wore a holter monitor for 24 hours. I took him back to the cardiologist last week for a follow-up because his regular vet could not hear the murmur. Dr. Sikorska confirmed that it is still present. She called it a soft murmur and said that it hadn't changed from a year ago. Please let me know if you want a copy of his paperwork. Thanks for your concern. By the way, he has not had another instance of episodic falling syndrome, so I don't really know if that's what it was.

Love my Cavaliers
17th January 2009, 05:47 AM
Thanks Melissa. I am going to look for that book. Sounds like it has a lot of good information.

petcrazyme
17th January 2009, 06:44 PM
This is a very interesting thread. Although my 10 month old has not yet been diagnosed with MVD (regular vet does not hear any murmur) I often wonder what I can do NOW even before it happens (as it sounds like its more a matter of 'when' it happens rather then 'if' it happens to any particular cavalier).

For the natural/holistic approach I wonder if a dog as young as mine would have any adverse effects from preventative supplementation ..??

frecklesmom
17th January 2009, 07:01 PM
Regarding your Vet hearing or not hearing a murmur, Petcrazyme, you have to take that with a "grain of salt". The general practitioner Vet is not "fine tuned" to the sound of murmurs. Example: Freckles-my Vet said he had a slight murmur-Cardiologist said no murmur but a "snap" which may or may not be precursor to murmur. Annie-my Vet said no murmur-Cardiologist rates her as 1+ murmur. Have not had an echo yet to verify as I keep dreaming there will be a Clinic within a day's driving-I'm a regular visitor to http://www.cavalierhealth.org/health_clinics.htm .

Love my Cavaliers
17th January 2009, 08:20 PM
Just to echo what Frecklesmom said - Oz's cardiologist jokingly said that she is paid the big bucks because she is trained to hear the Grade 1 and 2 murmurs that the majority of regular vets miss. She was truly amazed that Oz's regular vet picked up his Grade 1 at 4 months of age. But then, he didn't hear it on his last regular visit to the vet. However the cardiologist confirmed last week that the murmur is indeed still there.

petcrazyme
17th January 2009, 10:28 PM
Regarding your Vet hearing or not hearing a murmur, Petcrazyme, you have to take that with a "grain of salt".

Yes exactly Frecklesmom! That's why I said 'regular' vet ..meaning what that vet heard or didn't hear doesn't mean squat. I went on to say that "it's not a matter of 'if' MVD appears but 'when'". I fully expect that my cavalier will at some point in time suffer from symptoms due to MVD. That is known. What I don't know is what I can do now for preventative measures. I'll keep my eye on this post to see what other's are doing. I'm interested in the CoEnzymeQ10 supplement that was mentioned but hesitate to supplement a young dog with anything until I know more.

rhiannasmom
18th January 2009, 05:41 AM
Just to give some peace of mind to anyone thinking about supplemention with CoQ10 it is generally well tolerated, and all of my studies and research on this particular supplement has yielded favorable results (for humans and canines!). From the advice in the book I mentioned earlier, many vets are using this supplement as a preventative in dogs who are prone to cardio and valvular issues.
It's important not only to talk with your vet about this, but also to make sure that your vet will be knowledgeable about nutritional therapy. In my hometown, only one of the 5 vets would consider speaking with me about herbal & nutritional medicine, and she wasn't a certified Holistic Veterinarian. I've run across vets who are willing to give treatments like this a shot, but that doesn't leave me with a warm and fuzzy feeling... I'd rather find someone who has experience with this sort of therapy.

Good luck!

Melissa

RodRussell
18th January 2009, 05:22 PM
At 4 months of age Oz was diagnosed with a Grade 1 murmur caused by leaking across the mitral valve
---------------------
Whoa, this is really significant info for me. I've never before heard of a dog younger than about a year diagnosed with endocardiosis (acquired valvular disease, the problem so common in Cavaliers). ...

Rod - if you are out there, have you ever heard about this or read any veterinary papers about it?

This is a real shock to me. I don't doubt its accuracy, because I know the cardiologists who are involved. I have never heard of a Cavalier that young with a confirmed MVD murmur. It would not surprise me if the cardiologists publish a case study of this dog.

As for supplements, I suggest these basic ones, which would be good for any Cavalier, even those without MVD murmurs:

-- Vitamin C (300 to 400 mg. daily)

-- Vitamin E -- Tocopherol (100 I.U. daily)

-- CoQ10 (30 mg. daily)

-- Fish oils high in Omegas 3 and 6 -- such as wild salmon oil -- (about 400 mg. daily)

Since the dog already has a murmur, you might conisder a general cardiac supplement like:

-- Bio-Cardio, by Thorne Veterinary Products.

-- Canine Cardiac Support, by Standard Process, Inc.

I think that these products are obtainable only through a veterinarian, but you could ask your vet to order them for you. These are holistic supplements, so some conventional vets will think these things are a waste of time. Their usual response is: "There are no peer-reviewed, double-blind studies finding that these supplements are of any value."

Nicki
18th January 2009, 06:08 PM
Be careful with vitamin C though - you shouldn't give it in conjunction with prednisolone {or Medrone - Methyprednisolone} or Frusemide {lasix} as it can give rise to calcium oxalate crystals in the urine, as these drugs affect the way it is broken down and excreted.

COQ10 only actually has an effect on heart muscle - so there isn't really any point {in MVD} in giving it until there is muscle involvement - ie the heart is enlarged. However it is supposed to help with dental health, so it may be worth starting it earlier for that reason as bacteria from dirty teeth can cause a deterioration in heart condition.

Cathy Moon
18th January 2009, 07:12 PM
I have been giving Geordie CoQ10 30mg daily since his cardiologist started him on Enalapril in 2008.

Pat
18th January 2009, 10:34 PM
Sorry it's taken awhile for me to get back - my 13 1/2 year old is in the midst of a vestibular episode that started last night so I've been preoccupied with that. And it takes me a long time to do posts because of the time I spend checking the literature, etc. I'll break the post into comments about MVD age of onset, food and supplements. I wish I could just scan pages and post but these forums don't allow for posting attachments and I'd be a little concerned about copyright laws also.

For those who want to do research for themselves, I highly recommend these texts (not terribly expensive and found on Amazon and other places):

Manual of Canine and Feline Cardiology (Saunders) - I have the third edition edited by Goodwin and Tilley (2001) and I just purchased the fourth edition (2008) edited by Tilley, Smith, Oyama and Sleeper (Dr. Goodwin, a wonderful man, has sadly died).

Small Animal Cardiology Secrets, Jonathan A. Abbott, DVM (2000) (this book is really inexpensive and is fairly easy to understand). However, it is now somewhat dated since there has been much progression in treatment options.

Notes on Cardiorespiratory Diseases of the Dog and Cat - Mike Martin, Brendan Corcoran (Blackwell Publishing - 2006) These clinicians are from the UK so it was interesting for me to compare with the US vet texts

Kirk's Current Veterinary Therapy XIV (edited by John Bonagura and David Twedt - 2008) This text is the "Bible" of cutting edge diagnosis and therapy. I have the last three volumes. It is published about every ten years and covers the latest and greatest "stuff" in the vet world. There is one chapter on endocardiosis here. I just purchased this about a week ago. I've been intending to do a long post about the chapter on SM (which was not mentioned in the previous editions), and I'll get to that eventually. I've already transcribed a good bit of info about some of the recent topics on various boards such as brain/skull size, etc., etc.

Back to the above texts, the first two I highly recommend for anyone. Price is about $80 and $40 (not bad compared to other vet texts). The pertinent sections for Cavalier owners are really pretty easy to understand, and the more you read, the more familiar you become with terms and the more you will understand. This gives a wonderful education so that you can talk more intelligently with your GP vet and your cardio about diagnosis and treatment planning. Professionals give much more information to clients who "speak the language"!
-----------------
First topic - age of onset.

Bev, I would love to have a copy of the various reports you have. I have a filing cabinet full of 20 years of reports written by various cardios on many dogs, mine and others. I should be able to understand most of the report by virtue of having read so many for so long. I'll pm my street address to you, or you could scan and email to patbeman@comcast.net

As Rod said, those are excellent clinicians and I do not doubt the findings, which makes Oz rather extraordinary so I'm eager to learn more about him.

I did a long search of the literature. Every text said "middle aged to older dogs" and every text mentioned that CKCS were an exception as "clinical evidence" of the disease was found in "younger" dogs than the norm with more rapid progression. The only references I've found that mention a specific age are:

My notes from the 1996 seminar, as I mentioned (and Rod was sitting near me taking his own notes!) where Dr. Beardow (who with Dr. Buchanan had done a U.S. study of Cavaliers noting ages of dogs and grades of murmurs) said that one year of age was "about the youngest" where an MVD murmur was heard.

Dr. Abbott in Small Animal Cardiology Secrets - Chapter 34 - "Degenerative Valvular Disease" page 213..." Point#7 - "What is distinctive about MVD that affects the Cavalier King Charles Spaniel?"....." "In the CKCS, murmurs of mitral valve regurgitation are occasionally encountered in dogs as young as 2 and 3 years."

Somewhere in my attic are newsletters that I did as editor for COS way back in the early 90's that include data from Gil Jacobs' (bd. cert. cardio) heart clinics. He listed ages 1-10 and numbers of Cavaliers with murmurs. There were never any dogs younger than 1 included and as I recall very few or no dogs with a murmur at age 1 but there were some dogs at age 2.

That sums up age of onset info. I'll post again later about food and supplements.

Oh - someone used the term "snap" - that would be a systolic or mid-systolic "click" which is the proper terminology. Clicks are thought to be a precursor to a murmur and could represent a prolapsed valve (This is where the two valve leaflets are deformed, bowed inward, but still close pretty tightly so there is not yet any regurgitant jet and so not yet a murmur. A prolapsed valve, though, can go on to become an incompetent valve which starts leaking).

Pat
Atlanta, GA

Pat
18th January 2009, 10:36 PM
I don't understand the "cool" icon where I typed the number eight!! I typed the year of publication - two thousand and eight - and got the icon.

Sigh.......

Pat

RodRussell
19th January 2009, 03:36 AM
My notes from the 1996 seminar, as I mentioned (and Rod was sitting near me taking his own notes!) where Dr. Beardow (who with Dr. Buchanan had done a U.S. study of Cavaliers noting ages of dogs and grades of murmurs) said that one year of age was "about the youngest" where an MVD murmur was heard.

Dr. Abbott in Small Animal Cardiology Secrets - Chapter 34 - "Degenerative Valvular Disease" page 213..." Point#7 - "What is distinctive about MVD that affects the Cavalier King Charles Spaniel?"....." "In the CKCS, murmurs of mitral valve regurgitation are occasionally encountered in dogs as young as 2 and 3 years."

Yes, I was there in Atlanta, too. Although it actually was in May 1998 (I hope that eight comes out as a numeral and not an icon). I have a verbatim transcript of the symposium, and while it is not in front of me now, I recall that one of the cardiologists at the presentation -- I think it was Buchanan -- said that there are two distinctive things about MVD in Cavaliers. One is, as Dr. Abbott states in the quote above, that murmurs appear earlier in the CKCS than in the average dog. That is called "early-onset" MVD, with murmurs being heard as early as one year of age. The other is that MVD is about 20 times more prevalent in the CKCS than in other breeds.

Early-onset means having an MVD murmur before the fifth birthday.

While Oz having a murmur at such an early age -- under one year -- is not good news, hopefully it will be slow to progress. If it stays at grade one or two for several years, Oz may have a long and happy life even with MVD. But Oz certainly ought to have an ascultation by a cardiologist at least yearly and perhaps more frequently if recommended by the cardiologist.

Love my Cavaliers
19th January 2009, 04:49 AM
Thank you Rod, Pat, and everyone else. Rod, PM me if you would like a copy of his reports. I have sent an e-mail to Pat about sending them to her. Right now, Oz's cardiologist does not seem concerned about his murmur, but she does want to see him at least yearly and more frequently if he develops any signs of worsening disease. He is my little energizer bunny - he never seems to stop going. Just a real little pistol and such a love bug. I hope he stays this way for a very long time.

Love my Cavaliers
24th January 2009, 07:50 PM
Does anyone know where I can get CoQ10 in the 30 mg dose? The lowest dose I found is 50 mg. Thanks,

frecklesmom
24th January 2009, 08:06 PM
I order online at this site:

http://www.puritan.com/coenzyme-q-10-055

Cathy Moon
24th January 2009, 08:21 PM
CVS has 30mg CoQ10 on their website, but it costs nearly $15.00 for a bottle of 30. In Ohio I buy them at Discount Drug Mart; I pay $5.99 for a bottle of 30. I've checked at Sam's Club, but they don't carry 30mg. Keep looking - I'm sure you'll find some at a decent price.

Cathy Moon
24th January 2009, 08:24 PM
I order online at this site:

http://www.puritan.com/coenzyme-q-10-055

Great price on the Puritan's Pride brand!!! :thmbsup:

linderbelle
25th January 2009, 02:23 AM
We got our 3rd cavalier last night and the breeder sent this stuff home with us. Also, sent us some stuff like metamucil for the anal glands because of problems on cavaliers. I'm going to be getting this online as its much cheaper. I'd never heard of it until last night and then today there's a post on it.

Sophie08
29th January 2009, 12:59 AM
Jarrow makes an good quality CoQ10 30mg, one of the better brands on the market from what I am told. You can order it on vitacost.com. Take Care

Sophie08
30th January 2009, 05:43 PM
I just wanted to also add that not all vitamins and supplements are created equal. Although the price may be reasonable, many of the cheaper brands have fillers and lack the purity and quality to have any positive effect if the supplements will help. I got 150 capsules of 30mg Jarrow at $11.87 on vitacost.com much cheaper then if you where to buy it at a store where the price is doubled. Also with the vitamin E look for d-alpha tocopherol, the natural form of E not the dl-alpha tocopheral(synthetic). Sophie's mom