8th August 2008, 05:08 PM
Holly - update
I am bemused! We are going back to UK on 18th August when Holly's passport is valid. On the basis that it might be cheaper in France, I persuaded the french vet to x-ray Holly with a view to taking the picture back to the UK to show to my vet there. After a few problems with getting an x-ray developed, he examined it and said her heart is the normal size for a dog her size, there is no evidence of fluid on the lungs but she appears to have an inflamed larynx (now have cough syrup) and to stop the diuretic. When I queried with him how bad her heart condition is on the grading scale that I believe is used, he said grade 1 (i.e. not bad). He also said she is to continue the Vetmedin. I am not sure whether to laugh or cry (or even whether to believe him!) I can't wait to get back to UK now to get to my vet (appt. made for 19th) so he can do a proper examination (he has all the proper equipment for heart cases). Hopefully all this worry will have turned out to have been for nothing and it was just a misdiagnosis of her cough - does anyone else have experience of this?
9th August 2008, 12:09 AM
I'm surprised she needs any heart medicine at all if she's only a grade 1. Geordie was put on an ACE inhibitor when he reached grade 4, and the cardiologist will not change Geordie to Vetmedin until he sees signs of congestive heart failure, which it has been confirmed Geordie doesn't have yet. Geordie didn't need any heart medicine until he reached grade 4!
You really need to see a cardiologist. Could you get a second opinion from a regular vet if you cannot see a cardiologist? I just feel very strongly that your current vet is making a mistake. Sorry if I offended him/her, but someone needs to look out for your little dog.
India(tri-F) Geordie(blen-M)Chocolate(b&t-F)Charlie(at the bridge)
9th August 2008, 08:36 AM
Yes Cathy, my vet in UK will give a second opinion on 19th August (I hope she will be ok taking the Vetmedin until then) & he will refer me to a cardiologist if necessary. I don't feel I can stop the Vetmedin in case the French vet was right at first and the x-ray maybe wasn't clear enough. She seems very bright in herself (and always has been except for the 1st few days after she was started on diuretics and Vetmedin which was when I started this thread). Luckily she seems like a pretty tough little dog - very sweet and gentle - with a love of everything and everyone.
17th August 2008, 04:47 AM
I finally figured out -- thanks to Karlin's patience -- how to activate my membership on this list, which (I am embarrassed to admit) I think I have had for a couple of years. So, I am reading some posts that may be a little archival for some of you. This one, however, seems still to be somewhat current, since the dog is going to see the UK vet this coming Tuesday.
I am a strong advocate of having MVD patients examined and treated by cardiologists. It is frustrating to read that there are very few veterinary cardiologists in France, and that you have to go to the UK for a decent examination. I know of some French cardiologists who are ECVIM-CA board certified: Drs. Valerie Chetboul, Gerard Le Bobinnec, and Jacques Sottiaux. An alternative could be a internal medicine specialists; ECVIM-CA board certified internal specialists in France include Drs. Jean-Luc Cadoré, J. P. Cotard, Patrick Lecoindre, Karine Savary-Bataille, and Eric Schrauwen. That certainly is not a lot, and I know that some of them do not see patients.
If the grade one auscultation is accurate and the x-ray analysis is accurate, then Bonnie barely has MVD, and I would be very concerned about giving her Vetmedin at her early stage of the disease. Vetmedin has its downsides, and it seems that most of them are the result of prescribing it too early -- which means before congestive heart failure. If the auscultation of grade one and the x-ray are correct, she is not anywhere close to congestive heart failure, and it is possible that she may not be there for several years. At her stage (and I am writing only as a layman), I would not give my grade one Cavalier -- with no outward MVD symptoms -- ANY medications like Vetmedin, ACE-inhibitors, or diuretics.
Two of the problems I have observed about general practice vets prescribing these medications are (1) the do it too early, and (2) they prescribe too great dosages. Many of them seem to have only a superficial knowledge of MVD and when medications should be given, and they are much too susceptible to the sales hypes of pill salesmen. In the United States, since Vetmedin was approved for dogs last year, the Boehringer Ingelheim sales forces have been pushing Vetmedin on general practice vets with a vengeance. Our family's own general practice vet, who we know well and socialize with, has been convinced by pill salemen that Vetmedin is a wonder drug for any dog in any stage of MVD. I have been able to show her research articles which directly contradict the sales hype that Boehringer Ingelheim's representatives have spread. Just imagine how many other general practice vets there are, in the USA alone, who have this misapprehension and are prescribing Vetmedin too early and too often and may well be killing their patients by over-working their heart muscles.
So, I hope that the UK vet's exam reaches the same conclusions of grade one murmur and no enlargement and no fluid in Bonnie's lungs. If that is the case, whatever problems she may be having would not seem to be due to MVD and should be treated for what actually is causing them.
17th August 2008, 04:38 PM
Thanks for your observations - less than 2 days to go now - her name is Holly by the way!