30th July 2010, 04:00 PM
30th July 2010, 04:44 PM
Restlessness, not wanting to lie down, and panting are classic symptoms of fluid in the lungs (pulmonary edema). Is Charlie only taking Vetmedin and spironolactone? Spironolactone is generally not used as the sole diuretic for congestive heart failure because it is a very weak diuretic and is used primarily for its effects on the RAAS (renin-angiotensin-aldosterone system, a hormone system that helps regulate long-term blood pressure and blood volume in the body). When the degenerative valve disease is advanced enough to cause fluid in the lungs, furosemide (a loop diuretic) is the diuretic that is used as it has a more powerful diuresis effect. Spironolactone can be used in addition to the furosemide. Also, an ACE inhibitor (Fortekor in the UK) is generally given in addition to the Vetmedin (pimobendan). The ACE inhibitor also allows for a lower level of diuretics to be needed, which helps since the diuretics can be hard on the kidneys. Cardiologists often prescribe a combination of meds as the doses can be lower when used in combination and the synergistic effects of the various meds can be much more successful at keeping symptoms under good control. In the US, cardiologists generally don't start Vetmedin until a dog is in congestive heart failure because the drug can have adverse effects if contractility (the pumping strength of the heart) is still normal.
You might want to chat with the vet about the combination of these various drugs as Charlie's MVD is progressing into heart failure. I'm not sure if you are monitoring his progress with chest x-rays or echocardiograms or (ideally) both.
There is good information that you can read if you like to dig into the details. One great source is the recent ACVIM Consensus Paper (written by a team of cardiologists) on the Diagnosis and Treatment of Acquired Valvular Disease. Rod has posted a link to that in the SM/MVD section here. Yell if you can't find the link.
31st July 2010, 11:39 AM
hi hope charlie is well today
being through all of that with my rowley at the bridge
loads of love and kisses and medication.