Panting / No Cough
Hi all:It has been a few years since I've been around. In, Madison, who was 3 years old underwent decompression surgery for sm. She appears to have done well (knock on wood) since then with the sm. She hasn't really yelped like she used to. She does still itch a lot. I would say that she isn't as with it as she used to be. She often barks at me during feeding time--even after I've put the food down--and gets confused running to and from her bowl.In any event, for some reason, I've noticed that she pants more and more when at rest. In fact, she basically is always panting except when she's sleeping. I think she also breathes really fast. So, I'm concerned about MVD of course. She is a little girl approximately 9 pounds and I have not noticed a cough or a temperature. And since she's doing it all the time and otherwise not exhibiting symptoms of pain otherwise, I'm thinking it's unrelated to SM. We've got an appointment tomorrow with the vet. Any other ideas or things we should look for? Many thanks,
Panting can be a sign of pain -- so it is good that you are having this checked. It would be unlikely that she would be having advanced signs of MVD at only three, but is possible. Heavy panting usually starts well into the condition and it would be surprising if a vet hadn't picked up a murmur before if you were seeing advanced MVD.
There may be something going on though if as you say, she seems confused at times. Undersized cavaliers like this may have some underlying health problem that has kept them quite small and so that would be worth talking to your vet about -- hydrocephalus being one possibility which could be causing confusion etc.
Is she on any medication for the scratching? Many dogs need to continue on gabapentin for example to manage their scratching -- if she is scratching a lot that is definitely something that should be medically managed to bring her more comfort as this can indicate a lot of discomfort. Clare Rusbridge's FAQ on SM has a lot of information: http://www.veterinary-neurologist.co.uk/ -- it would be worth directing your vet to this if they haven't read it already. I'd actually check back with the neurologist who did the surgery though about the scratching and additional signs you are seeing -- the confusion would likely have a neurological cause of some sort I would think.
You might have missed some points to my admittedly poorly articulated post (along with information I neglected to include). Madison is now close to 7.
She was diagnosed with SM early on and had decompression/shunt surgery at age 3. I documented her surgery in this forum then. I have not been giving her gabapentin because I noticed no difference in her scratching with and without the medicine. I figure that, if it's not doing anything to alleviate the scratching, we better not build any resistance to the drug so we can use it later in her life if she needs it. With regard to her being "special," it's just the way she's been the last couple years after the surgery. My little girl has gone through a lot and we've kind of accepted her being a little different since the surgery.
This panting thing is more prevalent of late, which is why I'm thinking it's MVD related.
Oh sorry, I read that as her being three.
On the scratching -- this can be managed in many ways and does remain a sign of discomfort -- most neurologists do not consider it something that should really be left. At 7, she is unlikely to build a resistance to gabapentin -- many, maybe most dogs need more over time not because they build a resistance but because the condition progress. As well, there are many other drugs that can manage scratching -- Lyrica (pregabalin) being a generally more effective form of gabapentin, for example; many dogs here are on it and find it works when gabapentin doesn;t. Also: the dose needed to manage scratching has to be determined for each individual dog and reassesed. Some are on 100mg three times a day, some are on 300mg 3x for the same result. It may not have worked because the dose was too low/the trial too short.
She may actually also need a daily pain medicine like Metacam (which I use for Leo on his bad days, but many dogs are on troxocil or other meds). These can be used alone but generally are used with gabapentin for scratching dogs. If she is continuing to scratch, and is also having sessions where she is confused, I would really stress how imortant it is for her neurologist to see her and assess these issues. The scratching can be helped (meaning the underlying pain/discomfort can be helped) and it would be im[ortant to assess if the confusion is related or not and if it implies further pressure in her cerebellum etc. A vet is just not adequate to assess these issues -- it would be like seeing a GP to manage a cancer diagnosis or a brain tumour (or SM for that matter). The continued scratching and the confusion could indicate a decline post surgery as well that should be assessed, perhaps whether she has developed scar tissue or the condition is progressing for other reasons. And hydrocephalus -- which would cause confusion -- is a consideration in undersized dogs (it is a reason sometimes for them being small, amongst other possible health reasons) as well as being seen frequently in SM dogs, and a neurologist can assess for that.
The panting could be from MVD, but can also be a sign of pain. If she has seen a vet annually it would be odd for no murmur to have been picked up well in advance of her starting to pant heavily, which is usually a sign of more advanced MVD. They can have very rapid onset but usually you would have picked up a murmur at least a year or more before seeing panting associated with MVD.
Either way I'd see both a vet and a neurologist for the other issues. She should not be be 'special' after this surgery -- it is an indication that something is not quite right and a neurologist needs to assess what might be going on. Dogs do internalise pain -- as is mentioned in another thread, there's a new research project starting to try and assess pain in SM dogs because much of it is internal extreme headache and other signs that may not be visible to owners or vets (or neurologists). Humans report severe pain of this sort but they can speak, whereas our dogs cannot tell us what is going on. I know you would not want her to be suffering -- that's why it is so important to have a neurologist assess her especially if it has been four years since her surgery and she is still scratching.
If your vet diagnoses a murmur then it's a good idea to see a cardiologist as vets are mediocre at getting murmur grades correctly and so-so at treatment (eg they take a quite standard approach that often introduces meds too early or too late or the wrong ones).
Some others who have dealt with both surgery and MVD might have some other ideas or observations.
I would want to find out if she has an MVD murmur, and if so, what grade. If it is 4 or higher, I would want a cardiologist to perform an echocardiograph exam. Panting usually comes quite late in the progression of MVD.
Originally Posted by Bridam
We took Madison to the vet today. The vet detected no indication of a murmur. Chest xrays are clear. There is no sign of any inflammation that would effect the lungs or increased size of the heart. The vet did pick up respiration rates of up to 45 per minute. The night before I picked up resting respiration rate of up to 70. We're waiting on blood work. I also have a call into a local neurologist for follow-up sm-related care. So, we'll hopefully see what, if anything is going on.
We're also going to try going back on gabapentin. I truly sense no pain in my little girl. She's always air scratched, which I believe is different from the scratching at the back of the head where the dog is trying to really get at a point of pressure. It really seems to be more like a nervous tick than anything at this point that she can't control. But, I'm certainly open to trying to see if the breathing is pain related. So, we'll see on that too.
My last dog (a rottweiler) also constantly panted unless he was asleep. His heart was just fine. I second that the panting may just simply be from pain, as he had hip dysplasia, shoulder problems, and elbow problems, which made daily life and moving around quite painful for him.