Looking for advice for Cavalier with SM and newly diagnosed Mitral Valve issue
Long message ahead, but I'm looking for some help with my Cavalier. He's my companion and best friend and I want to make his life as comfortable as possible and give him the best care I can in the face of some not-so-good health news. He's too young and I'm not ready to give up on him!
I have a five-year old Cavalier (Bogie) who was diagnosed with SM about 18 months ago and who was just recently found to have some irregularities with his Mitral valve. So far the heart issue is just that when the vet listens very carefully he can hear some irregularity in the sound of the blood going through the mitral valve. We haven't done a heart ultrasound yet. Up to now he's been heart clear through many vet visits and from his previous owner. I haven't had Bogie from a puppy but got him at 1.5 years old from a breeder who was looking to rehome an adult Cavalier. (He was a show dog who wasn't winning)
After having him for about a year I guessed at the SM diagnosis from symptoms and had it assessed first by his normal vet and then by a veterinary neurologist who did an MRI. Once I had learned more about SM trying to figure out what was wrong with him I guessed that he had it from the beginning but I didn't know the early signs as well and couldn't see it when I got him from the breeder. The breeder I got him from wasn't his original breeder but had purchased him as a show prospect and stud dog. I've never bred him as he was meant as a companion only and so I had him neutered some time ago.
He's got a significant problem but he's pretty ok functionally. He does "air scratch" but no yelping, etc. The neurologist said he would make a good surgical candidate at the time but also stressed the risk of the issue not being resolved because of scar tissue and that the surgery was high risk for complications or death since the neck area is so small. The vet neuro was suggesting the surgery which would remove part of the back of his skull to release the pressure. She's done this before on other Cavaliers with success. At the time I decided to wait and see if the problem could be managed with medication.
My current vet had been prescribing prednisone at 5mg daily at first and then we moved Bogie to a slower schedule to minimize stress on his body, to a two days on one day off schedule. I've also tried to slow it further when possible. Now he's exhibiting some signs that the prednisone needs to be stopped which according to my vet are concerns about weakening of the adrenal gland like chronic dry eye, stuffy nose/sinus problems- signs that he's not naturally able to fight off every day irritantants the way he should be at his age.
Also he's gained some weight fromt he prednisone and is always hungry which is hard for both of us! Before the Pred he was a natural eater, clearly eating when he was hungry eventhough he's fed at regular times, morning and evening only. (Not free fed) He was interested in people food but ok if he was denied and good about eating his normal dog food. Now he seems constantly starving and cleans his bowl in seconds and then looks at me as if to say, "is that it?" He was on the small side for a male when I got him, and maintained weight of around 16-17 pounds. Now he's at 20 pounds and I've had to switch to low calorie food with veggies as treats in an attempt to lower his weight. So that's not good for his heart or health either and I'm hoping weight loss may help the heart problem.
Also he was on Prilosec/Omaprazole for awhile. The vet and I would like to put him back on it at his former dose of 10mg per day. I have trouble getting my local pharmacies to carry that dosage so I haven't been able to get it for awhile and was wondering about buying OTC Omaprazole at the human dose of 20mg and splitting the pills. Has anyone done that and has anyone had any problems with it? I had one vet suggest that it wouldn't be good for dogs since there's a coating on the human dose and splitting the pill would cause a different absorption and be less effective.
In addition we're looking for another medication to help with the SM other than prednisone. Also my vet has suggested that I go back to the vet neurologist for another assessment to see if we should go ahead with surgery now since in a few years if his heart degrades further he may not be able to make it through the stress to his body of the surgery and recovery. Finally, he wants to do the heart ultrasound and decide with the neurologist if surgery is worth it at all if the heart is going to degrade in a few years anyway to the point where he may need to be put down. I can't bear the thought and want to do anything I can to keep him healthy and happy for as long as possible. He's got great spirit and I want to find a way to make him more comfortable. If possible I'd like to find a way to get him a few more comfortable years where he's the dog he was when I got him, able and happy to play and run around the back yard searching for lizards and chasing butterflies. Now he's a little slower and naps more often, particularly since we've stopped the prednisone.
Any thoughts, shared experience or advice would be greatly appreciated.
Monica and Bogie