MVD Drug Types and Amounts??

[mlhirsch]

I am wondering if anyone could tell me what types of drugs their Cavaliers are on for MVD and the dosages? Also what kinds of side effects you have seen?
Right now I am deciding if I should enlist Colleen in a new Beta Blocker study that they are doing in my area. We are running the tests soon to see if she qualifies. I am not sure if I should participate or just go with the normal protocol. So I am trying to collect as much info as I can to make my decision. Thanks
Megan

[Cathy Moon]

Geordie is taking Enalapril - he gets one 5mg tablet in the morning and 1/2 tablet (2.5 mg) in the evening. He weighs 18 lbs, and the dosage is based on his weight. He has no side effects that we are aware of. Geordie's most recent cardiologist visit was in Feb. 2009, and his murmur is grade 4 of 6, x-rays show moderate heart enlargement, no evidence of congestive heart failure.

[Holly]

I hope that Pat B weighs in for you here. She is extremely knowledeable and helpful when it comes to MVD, among other things!

[Pat]

No sense in reinventing the wheel! Dr. Gordon's (veterinary cardiologist at Texas A&M) paper is probably the best reference I've seen regarding drugs for heart disease. This should be more accurate than anecdotal info from pet owners. Look under CVD (chronic valvular disease) and you can find wonderful flow charts about drugs used under various scenarios (such as complicated versus uncomplicated heart failure, etc.) Then look at the very last page, and she has a very useful chart of drugs, indication, dosage amounts and side effects.

Is this a trial for a new drug or a trial for a current drug (such as atenolol) to be used for canine patients? Where is the trial taking place? Who is doing the trial?

Pat

www.hcvma.org/notes/SpeakerNotesSonyaGordon.pdf

Everyone should print and save a copy of this in case it disappears from the internet.

[Pat]

Oh - sorry - Ohio! Is this a study that OSU is doing? Under Bonagura?

Is Colleen currently in CHF? Taking meds? How advanced is her MVD?

I'm sorry to admit that I'm kinda selfish and I'd be reluctant to participate in a trial because I wouldn't know if my dog was getting the placebo. It would depend on the circumstances for my particular dog. And I really hate to say that because someone's dog has to be in the trials or there would be no drug trials!

Pat

[Pat]

A couple of terms for clarification in Dr. Gordon's paper:

PO - this is a medical abbrev that means "by mouth" -- i.e., a medication that is taken orally versus IV or IM, etc.

ACEI - this is abbrev for Angiotensin Converting Enzyme Inhibitor - a class of drugs which includes enalapril, benazepril, captopril, lisinopril, monopril, etc. These are generally the first line drugs given for degenerative valvular disease.

Pat

[jasperpaw]

Jasper went on heart tablets about 6 weeks ago, he has a grade 4 murmur, he takes 1 5mg Fortekor tablet once a day and Frusimide tablet - it was 1 a day , then down to 1/2 , now down to a 1/4 and he will come off them, he does`nt appear to have any side affects and when he visited the vets just over a week ago she was pleased with him.

[mlhirsch]

Hi Pat
It is through MedVet here in Columbus. And yes I wouldn't know if Colleen was given the placebo, unfortunately. The study is through Bayer. they have already done the dosage study, so this is to see how dogs react to the medication, does it actually help them out. I don't know much about this at all, which is why I am so very nervous. I need to ask them what the drug is. I do know that they monitor the dog very closely and if something happens they immediately take them off of the study. and will treat them accordingly. There aren't any side effects I am told. I am torn and I have no idea what to do. I have only had her for 2 1/2 years, I just don't want to do anything to compromise her health. I really want to help her. I hate to say it, but she is really the best dog I have every had. She isn't showing any signs at all yet. She is happy and healthy otherwise, just with a murmur. I am very nervous and I have no idea what to do. Now, she may not qualify at all. They are looking for very specific profiles, and it is on all breeds, not just Cavaliers. She may not qualify. I hope that answers some of your questions. I do know that my vet has Dr. Bonagura read all of the x-rays and ekgs.
megan

[Pat]

Honestly, I'm way too much of a control freak to have one of mine participate in a drug trial. You have to follow a strict protocol for the time period of the trial regarding adding other meds, etc., and as we mentioned, your dog could be on the placebo. And, how the heck can they say "there are no side effects" if the trial hasn't taken place?! They can only say "we THINK there are no side effects" or "thus far we haven't seen side effects." (Not to mention new veterinary drugs that have been released with limited trials only to find out that there are side effects that aren't discovered until the drug is in wider usage - think rimadyl.) On the PLUS side - Colleen would get a lot of free diagnostic testing, including echocardiograms - and I presume they would share results with you. Also, you would be helping other dogs by participating.

A similar trial was the VETPROOF trial using enalapril. You can read the abstract here to get an idea of drug trials.

http://avmajournals.avma.org/doi/abs...rnalCode=javma

I guess I would reconsider if my dog was dying and it was the only way to get a shot at a promising new treatment. In a sense, though, I have participated in drug "experiments" but that was working closely with my veterinary cardiologist over a 15 year period. For example, one of my boys used sildenafil (viagra) for pulmonary hypertension way before Dr. Meg Sleeper did the drug trial on that at U Penn, and my dogs used pimobendan long before it was FDA approved here in the US.

Anyway, my best advice is to select a cardiologist - either Dr. Lehmkuhl at Medvet or Dr. Bonagura at OSU (depending on your preference for a teaching hospital versus a private practice) and work with him/her DIRECTLY (not having your GP vet consult with the cardiologist but having the cardiologist perform the tests directly and work with you directly rather than working through an intermediary). I presume you mean an echocardiogram versus an EKG/ECG (electrocardiogram). ECG's are pretty worthless tests for diagnosing chronic valvular disease - an echocardiogram (ultrasound of the heart using color doppler flow) is the correct diagnostic test. ECG diagnoses any heart rhythm disturbance, but an ultrasound will show the exact functioning and condition of the valves, presence and amount of regurgitation (blood flowing the wrong way because of malfunctioning valves), exact measurements of the cardiac chambers, and other valuable diagnostic info. My cardiologist and I generally make medication decisions based on the history, speed of progression, and the results of the echocardiogram.

Pat

[frecklesmom]

I can't tell you a thing about MVD protocols but I would be very non trusting of any individual that would say "there are no side effects". Every drug has side effects and ,depending on the individual sensitivity of the dog, may or may not cause problems.