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Brian M
24th August 2011, 07:53 AM
HI

I am a bit lost ,hurt and disappointed this morning . I phoned Chestergates early yesterday to ask two questions ,firstly can I have a
copy of the xray mri images on a cd please and secondly I forgot to ask Mr Skerritt about Daisy's heart as I presume she was checked
before her G A .The nurse who was with Daisy phoned me at 5.45pm and said the part of their scanner that copies to cd is broken so for
now they cant do it but Mr S did give me on the xray sheet the most appropriate images ,OK I can live wthout that, so hows her heart as MR
S didnt mention it ,out of the blue she commented Daisy has a murmur.

That was like a kick in the bxxx I could feel myself go cold ,then next she said you can get another referral and come and see our cardiologist,
not now let me think .How could this not have been mentioned on Monday ,my opinion of Chestergates is severely dented .


So I have an appointment at my vets at 11.10 today and started thinking who is the best around I can take Daisy to ,so I phoned North
West Surgeons in Runcorn its another referral hospital the one Rosie was almost going to have her patella op and ther cardiologist is Mr Simon
Swift .When I phoned last night to see if hes available they were closed but open today at 8.30 when I will ring and see if Daisy can see him.

So my plan is phone NWS at 8.30 then phone my insurers AXA then go to my vets at 11.10 then if all works see Mr Swift today/tomorrow or Friday,
so I hope MR Swift is there .I dont know if I am doing right or wrong and tried to get some advice last night but unfortunately couldnt.


Will try and post as the day goes along ,also Dawn has got the docs at 9.10 and last night at the end of Lukes Karate lesson in L/pool the bxxxxx
car wouldnt start for the first time ever so I was pannicking over that as it was 10.00 pm and I had all 4 girls with me ,fortunately the AA turned up
and we got home at 11.30.Good ob I am on a weeks hols .Poor Daisy she is like a Russian Genera ie Daisy Murtagh SM ,SM,PSOM and poss MVD.:(

jasperpaw
24th August 2011, 08:26 AM
Brian I am really really sorry to read this, now you have concerns about Daisy`s heart, maybe they assumed that you already knew about her murmur, there was obviously a lot to take in on Monday and I know it`s often when to walk away that you suddenly realise that you should have asked certain questions, I know Daisy has other health issues but please don`t despair at her heart, not sure how old Daisy is now, but speaking from experience with a dog who was discovered to have heart problems at 8 yrs and knowing how I felt at the time, he is now 11 and a half and still has a good life with regular check ups, as least it`s good that you live in an area where you have a good choice of vets, living in a rural area we do not have this choice, although the vets I attend has hospital status and open 24 hours and excellent facilities. Thinking of you all.

Brian M
24th August 2011, 08:38 AM
Hi

Just phoned Nws and Mr Swift is available
Thurs or Fri ,next my vets and referral letter.

anniemac
24th August 2011, 09:24 AM
Hi

Just phoned Nws and Mr Swift is available
Thurs or Fri ,next my vets and referral letter.

Oh brian,

I'm so sorry to read this and can't believe that someone just happened to tell you when you called about images. When I think of hearts, simon swift comes to mind so I know you are seeing someone well known.

How old is Daisy? I know when ella was about 2 the vet said he thought he heard a murmer but is not something to be alarming and to check next visit since he wasn't sure and that sometimes it changes. (I think that is one reason it is recommended to have cardiologist exam b/c vets can't pick up as easily. Never heard anything about it for 3 yrs and completely normal. He said this sometimes happens.

I think this happened recently to shannon's holly but can't remember. I'm hoping this is the case with daisy. You have been through a lot but remember that a lot of this can be well managed.

She's the same dangerous daisy and hopefully new medication will get her back on track and dr. Swift says its a false alarm or something real mild.

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Sabby
24th August 2011, 09:46 AM
Oh Brian
Another shock for you I am so sorry. I must agree with you that you should have been told this at the consultation after the MRI. When Ebony was diagnosed at 2 by my old vet he just said very casual she got a murmur, when he saw the shock on my face he just said “Well it’s a Cavalier” You are seeing a good cardiologist. I know what you are going through, I think I seen my vet more then I seen my husband this year. God you must be glad when life gets backs to a bit of normality.

Margaret C
24th August 2011, 10:20 AM
Poor Brian,
I'm sure you have been so worried.

This is really not a life sentence, most cavaliers will develop a murmur at some time and most of them live for years without any symptoms, so don't despair too soon.

Simon Swift is about the best known cardiologist in the cavalier world because he has been the 'Cavalier Club Cardiologist' and involved in the club heart testing scheme for years. So you could not be taking Daisy to anyone better qualified to give advice.

When you do pluck up the courage to watch PDE you will see Simon being interviewed at a cavalier show.

Give Daisy a big hug from me

Brian M
24th August 2011, 10:34 AM
Hi Sabby

And thanks .Just back from the docs and Dawn was told come back in two weeks as the doctor is concerned about her weight loss
she has lost 7 lb in three weeks and is now 9 st 7 lb ,she has had severe migraine attacks for years but now has stomach problems
so she was prescribe Lansoprazole 30mg once daily and if no improvement in two weeks it will be the camera down to see whats happening.


Back to Daisy I phoned AXA and they were fine and no objection at all about going to North West Surgeons ,about 30 mins by car ,and
AXA have already emailed another claim form so we now see my vets at 11.10 today for another referral letter which should be no problem and
then Mr Simon Swift on either Thurs or Friday of this week . I suppose in a way all this should happen when I am off for a week which
is ideal and its amazing that the people I wanted Daisy to see have all been available so I have been very lucky there.

http://www.nwsurgeons.co.uk/services-cardiology.php N.W.S.

http://www.nwsurgeons.co.uk/specialists/40/simon-swift.php Mr Simon Swift

My car is fine it was me .I sit outside The Red Triangle Karate Club every Tues and Thurs from 6.30 till Luke comes out about 9.45 and of course I
had the radio on and was checking the SatNav for directions and when we came to to go home the battery was flat and so I phoned Honda Care and
within an hour the AA turned up put jump leads on and it started straight off ,he checked the battery and its charging rate and even said thats fine
no need for a new battery just dont use all the electric gadgets while I am sitting waiting with the engine off .Initially I did think xxxxxxxxxxx hell
what will I do now stuck in the middle of L/Pool in a not so good area with Luke and four Cavaliers ,but alls well in the end.The car is a CRV which
I bought from new as Honda have a superb reliabilty record and its nice and big to take four Cavaliers and three humans and its never ever
let me down before ,its just on 4 years old and has done aout 60 k so will prob keep for another 12 months or so then get another one

http://www.kugb.org/kugb-instructor-sensei-profiles.php Sensi Sherry 8th Dan ,Luke's instructor last night the highest and best in Europe


Hope I am doing right for Daisy as I have never been through all this before so If I am doing wrong please HELP and tell me.

Sabby
24th August 2011, 10:41 AM
God you had a lot to deal with this week. I just hope Dawn will be ok as well.
And of course you doing things right for Daisy, she has the best dad a Cavalier could have.

meljoy
24th August 2011, 11:25 AM
Oh Brian it never rains but it pours!!! What a terrible week you've had. In my humble little opinion you are doing everything that an owner of 4 beautiful cavaliers should do. Like Margaret said a murmur isnt necessarily a death sentance so dont panic just yet, its just on top of everything else this week you must be think what next!

Sending my very best wishes to you and Dawn, hope she improves soon.

Leo sends kisses to your 4 girls....keep your chin up....you'll get there
:hug:

Brian M
24th August 2011, 01:46 PM
Hi

Been home about an hour after our Vet visit which was fine saw Laura and she promised to fax the referral letter by 1.00 pm I then
took Dawn and Luke for a bite to eat to eat then the park with the girls for a walk and the inevitable game of ball with Rosie then home
to wait .1.20 came and no call so just started to put NWS phone number in the iphone got to 01 then the house phone rang and of course
it was them .Appointment made with Mr Simon Swift for 9.30 tomorrow,so a big thanks to Laura and of course all our members here on CT.


I think the biggest shock and upset was the heart murmur advice probaly because I wasnt looking for it and the way it was given and that
with Daisy's SM diagnosis it was maybe what I expected and had therefore already accepted that .In hindsight I was maybe wrong to be critical or think
bad of Chestergates as what has already been pointed out to me is that I went to Chestergates for a neurology exam and an MRI scan if
needed from one of the best in the business Mr G Skerritt and that is exactly what I got so have no reason whatsoever to complain there
and of course if the need arises with any of my other girls for an MRI it would be Cherstergates again for me . Just like I would not expect
Mr Swift to discuss in depth anthing other than Daisy's murmur.


Any advice as to what to expect and especially advice please on questions to ask .

GraciesMom
24th August 2011, 03:38 PM
So glad you have an appointment this week, but am angered for you that this did not come up!!! are neurologists too focused on their area that they would forget it or think it is not worth noting?? my goodness!!


Hi

Just phoned Nws and Mr Swift is available
Thurs or Fri ,next my vets and referral letter.

Sabby
24th August 2011, 05:35 PM
Glad you have got an appointment so quick. Look at the two of us. You at the Cardioligist and Harley and Me for an MRI.

HollyDolly
24th August 2011, 06:11 PM
Oh Brian how awful to find out like that, it has certainly been a rotten week.

Sins and myself were only saying the other night how medication for heart
problems has improved, although I am sure you would rather not read that
this now does not have to be a death sentence. My Cassie lived for several
years with MVD well managed on tablets. This was not the case several
years ago and many of my Cavaliers died soon after diagnosis.

Sending hugs to you all.

Nanette

Brian M
24th August 2011, 09:18 PM
Tks Nan

One bit of good news we weighed her at the vets and she was 8.15 kilo so getting near breed std weight
of 8.00 but I want her down to 7.25 now I know about the mumur ,I used the coat king on her after a
bath as she has a very heavy coat that must be at least 5 kilo:) Tks
for all your help you are brill ,going to ring Babs in a minute just for some guidance

rgds

bri

Karen and Ruby
24th August 2011, 10:31 PM
Hello Brian

So sorry to read your news about Daisy- unfortunately its kind of a given these days that a Cavalier will have SM or a Murmor and there are quite a large percentage that have both so you aren't alone

For a start the Cardiologist may just liten to her heart and grade the murmor and feel no further action is needed at this point.
As you know murmors don't require medication so fingers crossed its just a low grade murmor that will just need monitoring over time.
At the same time if they listened to Daisys heart before she went under for her GA and she was slightly stressed or nervous about her situation this could make the murmor sound worse than it actually is so the Cardio may not grade very highly.
Things you can give Daisy in these situations is Vitamin E and Co-Enzye Q10 which are both naturaal blood thinners available at any health shop or chemist.


As you may know Charlie is under close supervision with his Grade 6 murmor that the Cardio said is probably worse than most grade 6's but there isn't a Grade 7 so we can't have that BUT he doesn't need any meds and he lives perfectly normally.

Best you can do for her on the heart front is get her weight at a slightly lean state and see what the Cardio says xx

Sorry again Brian and gentle hugs for the Dangerous Daisy!!!

Zumie05
24th August 2011, 10:35 PM
What a roller coaster ride :(!! Hoping the best for you and your little Daisy.

mommytoClaire
25th August 2011, 03:26 AM
Brian, so sorry to hear about the continuing issues with Daisy. Stay strong, and hugs to the girls from Claire and I.

lovecavaliers
25th August 2011, 03:46 AM
Sorry to hear another thing has been added to your already overflowing plate of worries. Your a great dad and Daisy is a strong girl. Sending you both my best.

Brian M
25th August 2011, 09:06 AM
Hi
just arrived to book in,lets hope on this occasion
It is no stars.

Sandrac
25th August 2011, 10:12 AM
Brian, have just got back from holiday and catching up with all what has been going on with you and Daisy. Fingers crossed for good news today. You have all our support. :hug:

Brian M
25th August 2011, 10:57 AM
Hi

Back home but they are keeping Daisy there to check her blood pressure, and echocardiogram and an electrocardiogram and with no need for sedtion
but to shave her chest a bit to enable items to be stuck on, and I go back and collect her at 4.00 pm .

Mr Swifts initial diagnosis is a Grade 2 murmur and it is MVD ,so we wait till 4 pm for details.


What a blxxxxx week but Luke.s just back from school and he's happy enough with his A's and B's in his exams so these results
give him what he needs to progress onto his A Levels in Maths,Eng Lang,History and Geography with his aim in life so far of
career teaching History.


PS What a lovely man Mr Swift is ,very impressed.

Sabby
25th August 2011, 12:20 PM
Glad things are going ok for Luke and he got the grades he needs.

Yes Mr Swift is a very nice man. I meet him once when he checked Ebony at a Cavaliers Club day.

Fingers crossed for you. Looks like we are both waiting.

Brian M
25th August 2011, 01:16 PM
Hi Sabby

What time are you going back for Harley .

Nicki
25th August 2011, 01:37 PM
Sorry to hear this Brian - I think Daisy is 5 now, and 50% of Cavaliers will have a murmur at that age. Don't forget though that the grade of murmur is not hte most significant issue - symptoms are far more important - such as panting, reluctance to exercise, coughing accumulation of fluid.

This the best explanation I've seen of how the canine heart works
http://www.heartydog.co.uk/healthy/en/index.shtml

[the diagram is small but if you press the CTRL and plus keys together on the keyboard, that enlarges it - CTRL and minus to reduce again] - it will help you to understand when you go back for the results.


You are doing the right thing seeing a cardiologist - and you have probably the best man in the UK there in Simon Swift!! He can take baseline measruements today so will have those for the future to compare for changes.

Yes a murmur may be more apparent when a dog is stressed and sometimes if they are ill - it "disappears" again when they recover, but actually there are still issues there, it's just that a murmur is not apparent.

Cardiologists can hear murmurs at least 6 months before a vet would recognise it - due to their experience and training.


Things you can give Daisy in these situations is Vitamin E and Co-Enzye Q10 which are both naturaal blood thinners available at any health shop or chemist.


Mine go on to Vit E 200iu daily from the age of 5 - there are no studies proving its efficiacy but it is believed to help the circulation. It has to be natural source Vit E though - NOT the ones you can buy in the supermarket. There is no point in giving Co-Enzyme Q10 for the heart until there is muscle involvement ie the heart is enlarged, however it is believed to help with dental healthy and reducing bacteria which *may* also affect the heart - this is sometimes disputed.

The MOST important thing you can do is reduce Daisy's weight - bred standard weights don't really mean anything, she needs to be the right weight for her.

This is from Laura Lang [Roycroft Cavaliers] website:

Due to MVD, being overweight is nearly a death sentence for a Cavalier. I guarantee you the best way to prolong your Cavalier's life is to keep its weight to a MINIMUM! Not overweight even a little bit. THIN! If your Cavalier is even a little bit overweight, it will hasten the onset of MVD and death. Do not allow this to happen.

Strong words but the message is SO important.

Do read through this page in particular
http://www.roycroftinformationcenter.com/Roycroft%20Cavaliers/Roycroft%20Cavalier%20Care%20Feeding%20new.html

Brian M
25th August 2011, 01:57 PM
Hi

Tks Nicki ,as I wrote yesterday at the vets on Monday she weighed in at 8.15 k ut I want her at max 7.25 then a review.I hardly feed her she has been having 18 gramme only of raw rabbit meat n fat with veg and fruit twice daily ,shes looks at her dish then at me "Is THAT it " I can hear.From what I know there are no smptoms yet such as you say panting ,reluctance to walk/run or coughing but I get his full repost at 4 .She was very relaxed with him and enjoying the attention and even on her back so he could rub her tummy and then went off and sat between his legs while we were talking .She is already on VIT e together with Omega3 (600 mg EPA/DHA ) and a 50mg softgel of Ubiquinol.

Tks

brian

anniemac
25th August 2011, 03:11 PM
This is from Laura Lang [Roycroft Cavaliers] website:

Due to MVD, being overweight is nearly a death sentence for a Cavalier. I guarantee you the best way to prolong your Cavalier's life is to keep its weight to a MINIMUM! Not overweight even a little bit. THIN! If your Cavalier is even a little bit overweight, it will hasten the onset of MVD and death. Do not allow this to happen.

Strong words but the message is SO important.

Do read through this page in particular
http://www.roycroftinformationcenter.com/Roycroft%20Cavaliers/Roycroft%20Cavalier%20Care%20Feeding%20new.html

Very good words of advice, if not just for MVD but for overall health.

GraciesMom
25th August 2011, 10:09 PM
And you already have started on the diet. I am having to cut back food for Gracie as her inactivity after surgery has had more impact on her metabolizing food than expected. So she is now giving me that look... "is that ALL?? REALLY???"

Gracie is doing so well after surgery so far. It is amazing. She has bounced back so much in the past few days. I hope this gives you some hope. I can just see in her eyes how much BETTER she feels.

Brian M
25th August 2011, 10:26 PM
Hi Annie


I asked Simon what Daisy's weight was on their scales and he said 8.00 Kilo ,then I asked his comments about her was she over weight,
he looked her over from top to bottom from above and fom the side and said "she looks Ideal " though I still want her down a bit maybe
7.25 to 7.50 .We have a conundrum over medication he commented that she needs no medication but he is not happy she is on frusimide
as that stimulates certain hormones to over produce some items which may affect the heart so he is considering if he should prescribe an
Ace Inhibitor to counter act the frusimide but he doesnt know if that is the right thing to do .So he is going to approach many other cardiologists
both in the UK and the US to ask them and then arrive at a majority decision and then tell me which way we will go .Sounds good to me.He wants
her on a low sodium diet so is happy with my raw list I showed and wants Omega 3 supplementaion with a minimal level of 420 epa and 280 dha.
dMy Puritans Pride Omega 3 I give has a level of 600 epa and 600 dha so we should be ok there .Poss chg in 3-4 years but they vary so much and
to see me in 12 months .Lovely man ,great respect from me and the report is slightly better than I expected .

I will contact Dasiys breeder but only when I have all the reports which I will send copies of ,I do not know if her breeder scans if not I will suggest
she does all politely of course.I am greatly relieved now that Daisy "is overweight hints" have been quashed and I can confim Jackie Thompsons little girl Lily is not over weight either and nor are pops or rosie and neither am I or Dawn or Luke .the end .If anybody would like a copy of her cardiologist report pls ask /pm.

Teresa
25th August 2011, 10:47 PM
Barney is on Frusimide and as it's long term he is now on Fortekor to counteract the effect on his heart... I also have him on a strict diet...Recent studies show that dogs at the lighter end of normal live long in general...

I am currently filling out a tally chart for behaviours noted for him as I feel his symptoms are more apparent now (SM and he also has CM)My vet has asked me to do this. I am not keen to pump him full of drugs but I do believe in the philosophy of having an animal happy and comfortable today is good...They don't seem to give a fig about tomorrow...

I am hoping his SM won't progress too much :/ I am luck as at nine his murmour is a grade one and has been at that for ages...

anniemac
26th August 2011, 12:44 AM
Hi Annie


I asked Simon what Daisy's weight was on their scales and he said 8.00 Kilo ,then I asked his comments about her was she over weight,
he looked her over from top to bottom from above and fom the side and said "she looks Ideal " though I still want her down a bit maybe
7.25 to 7.50 .We have a conundrum over medication he commented that she needs no medication but he is not happy she is on frusimide
as that stimulates certain hormones to over produce some items which may affect the heart so he is considering if he should prescribe an
Ace Inhibitor to counter act the frusimide but he doesnt know if that is the right thing to do .So he is going to approach many other cardiologists
both in the UK and the US to ask them and then arrive at a majority decision and then tell me which way we will go .Sounds good to me.He wants
her on a low sodium diet so is happy with my raw list I showed and wants Omega 3 supplementaion with a minimal level of 420 epa and 280 dha.
dMy Puritans Pride Omega 3 I give has a level of 600 epa and 600 dha so we should be ok there .Poss chg in 3-4 years but they vary so much and
to see me in 12 months .Lovely man ,great respect from me and the report is slightly better than I expected .

I will contact Dasiys breeder but only when I have all the reports which I will send copies of ,I do not know if her breeder scans if not I will suggest
she does all politely of course.I am greatly relieved now that Daisy "is overweight hints" have been quashed and I can confim Jackie Thompsons little girl Lily is not over weight either and nor are pops or rosie and neither am I or Dawn or Luke .the end .If anybody would like a copy of her cardiologist report pls ask /pm.

Brian,

I can't do math but I was not saying daisy is overweight! Ella was morbidly overweight but I think it is hard to say a certain weight without looking at the cavalier. Elton is not quite 11 lb which is under standard but according to vet and others he is ideal to his structure. Put it this way, ella was 2X the size of elton.

You went the best cardiologist and I'm interested in what he said about the medication and heart increase.

Overall, how are you hanging in? Poor you and dangerous daisy.. you are lucky to have such great people close by and daisy is lucky to have you!

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Pat
26th August 2011, 01:00 AM
We have a conundrum over medication he commented that she needs no medication but he is not happy she is on frusimide as that stimulates certain hormones to over produce some items which may affect the heart so he is considering if he should prescribe an Ace Inhibitor to counteract the frusimide but he doesnt know if that is the right thing to do .So he is going to approach many other cardiologists both in the UK and the US to ask them and then arrive at a majority decision and then tell me which way we will go.

Well, thank you Simon Swift!!! I have long been concerned about dogs receiving furosemide (US spelling) long-term for SM. I have made a few mild comments here that I would never give this drug long term for SM because of the side effects. The drug activates the RAAS (renin-angiotensin-aldosterone system) - a very complex compensatory neuro-hormonal system that I'm not going to try to explain here. The RAAS is compensatory and helps with an acute problem but it becomes maladaptive over the long term so this is something that you don't want to activate. This is why furosemide alone is never given for dogs in heart failure but an ACE-I is always added. (Any vet that gives furosemide only to a dog in heart failure is sadly out of date.)

I personally would not want my dog on furosemide for SM, and I'd certainly not want to prematurely add an ACE-I simply to compensate for the furosemide for a dog that is in the early stages of MVD. Since cimetidine and omeprazole are also drugs given to reduce CSF, I would opt for one of those drugs and not use the furosemide. I also know what furosemide does to kidney function, so I would not use that drug long term unless it was necessary to control symptoms of CHF.

All of this is of course my own opinion, but I feel somewhat vindicated that Simon Swift has voiced the concerns that I've had for a long time about this drug in the SM treatment protocol. I've also not been happy with the monitoring recommendation for dogs on this drug - I'd monitor much more aggressively.

Brian - would you consider talking with the neurologist about using one of the other drugs that is reported to reduce CSF and just skip the furosemide and the ACE-I? Then you would start those drugs when necessary for CHF from MVD, but that may well be years down the road.

Pat

anniemac
26th August 2011, 01:42 AM
brian,

It seems like you have done a really good job going over the different drugs etc and got a lot of information. What pat wrote, it seems like this might be something good to know for others too. Since simon swift is such a well known cardiologist (is he the breed clubs cardiologist?) anyway since SM and MVD are both concerns it seems like something that might be beneficial to address which it looks like he might do. Oh daisy and brian, you have had a tough week but you are in good hands

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Brian M
26th August 2011, 07:31 AM
Hello Ladies

And Good Morning to all ,How are You my good friend Sabby and Harley.

Pat I dearly hoped you would respond and your comments are what Ihoped for and I will be phoning Geoff Skerritt this morning to advise
what Simon Swift said and to ask for a change from frusemide to the negate the need for an Ace Inhibitor at this stage of Daisy's journey.
Your comments on frusemide activating her renin-angiotensin-aldpsterone system (RAAS) and that these are harmful hormones in the setting of
heart disease and that ACE Inhibitors such as Fortekor will help blunt this effect,are Simos words

Pat I will pm you and wish to ask you a confidential question which I think you will be interested in so pls look out for my PM .


I would also like to hear Rods comments if hes about .

PS Hello Annie ,yes Simon is the clubs cardio and deals with all the breeders.

anniemac
26th August 2011, 07:47 AM
For some reason I thought he was who rod always mentions that spoke to the ckcsc usa meeting in 98 about MVD and set forth the mvd protocol. I must have been wrong but I have heard many talk about him in good ways

I am sure he will be able to make sure she gets managed.

You got a double whammie and I'm so sorry

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Brian M
26th August 2011, 07:57 AM
Hi Annie

It could be the same as I know he spent some time in The US in Missouri with John Bonagura

http://www.thecavalierclub.co.uk/health/seminar_2010/swift_bio.html

What time is it there ,you should be in bed ,its gonna get windy tomorrow you stay safe .

anniemac
26th August 2011, 08:09 AM
3 am. I'm up. I'm always worry about these babies. I went through some old emails and read my blog going back in time. I have an 11 lb baby in my lap telling me its time to sleep.

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anniemac
26th August 2011, 08:10 AM
I looked at my calendar for some reason and it was on daisys photo. Maybe someone was telling me something ...

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Pat
26th August 2011, 11:47 AM
Your comments on frusemide activating her renin-angiotensin-aldpsterone system (RAAS) and that these are harmful hormones in the setting of heart disease and that ACE Inhibitors such as Fortekor will help blunt this effect,are Simos words.

The problem is that I believe that furosemide causes these unwanted side effects for ALL dogs, not just for dogs with heart disease. This is not a benign drug (probably no drug is entirely benign). There are always negative consequences that one must balance against the positive effects when giving any drug, especially long term.

Furosemide is an essential drug in the treatment of heart failure - in that situation the positive effects outweigh the potential harmful effects. It is also never used as monotherapy for heart failure but it is part of a multi drug treatment program.

For these reasons, if I had a dog with SM, I'd select one of the other drugs used for CSF reduction. I have not studied these other drugs in depth so I'd probably want to read up on them but I feel pretty certain I'd not want to use furosemide.

Pat

RodRussell
26th August 2011, 11:22 PM
I am not sure where we all are on this topic, but I want to jump in based upon what I think is going on, because I am in a rush and need to get out of here before being able to read all of the foregoing posts. I have read the two reports, one from Geoff Skerritt and the other from Simon Swift. This is what I think concerns Simon Swift:

From http://cavalierhealth.org/mitral_valve_disease.htm#--_moderate:

In a 2009 study report which did not include CKCSs, veterinary cardiologists observed a three-fold increase in RAAS activity using furosemide. Their conclusion was that "furosemide is not recommended for chronic use in the absence of concurrent therapy to blunt RAAS activity, such as ACE-I, aldosterone receptor blockers, or angiotensin II type I receptor blockers.

Here is a summary of that 2009 report (from http://cavalierhealth.org/mitral_valve_disease.htm#The_Effect_of_Furosemide_ and_Pimobendan_on_the_Renin-Angiotensin-Aldosterone_System_(RAAS)_in_Dogs ):

The Effect of Furosemide and Pimobendan on the Renin-Angiotensin-Aldosterone System (RAAS) in Dogs. AC Lantis, CE Atkins, TC DeFrancesco, BW Keene. J Vet Intern Med 2009;23; (ACVIM 26th Ann. Vet. Med. Forum Abstract Program: Abstract #2). Quote: "We have shown that pimobendan, at the labeled dosage, does not accentuate furosemide- induced RAAS activation. We observed a three-fold increase in RAAS activity with furosemide alone and in combination with pimobendan. Therefore, furosemide, with or without pimobendan, is not recommended for chronic use in the absence of concurrent therapy to blunt RAAS activity, such as ACEI, aldosterone receptor blockers, or angiotensin II type I receptor blockers."

I'll let you all chew on this for a while and get back to you tomorrow.

Brian M
8th September 2011, 03:50 PM
Hi

At long last I have sent Daisy and Rosie's MRI scan reports to the A.H.T. and have also advised Daisy's breeder
via recorded post with a polite letter of advice ,thanks to Sins guidance, together with copy reports .

Also as advised on another thread I spoke to Daisy's cadiologist on Monday and we still await gudance re the
frusemide and fotekor issue .