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.