Puppers and MVD

[eisens]

Cathy, I've had Cavaliers since the 1980s (Puppers is the latest in a long line!) and had never heard of macrothrombocytopenia. Very interesting. Well, Puppers did a 10 day antibiotic course so no harm, no foul.

Poor little thing, I can feel her heart beating fast even at rest so I don't know how long the Vetmedin will buy us -- but she definitely feels much better. Here I thought I'd escaped MVD with Puppers

She is perched on a pillow watching me. My little princess. Thanks for all the kind words, I'll try to keep the board up to date on her status.

[Margaret C]

Vetmedin is a wonderful drug and sometimes cavaliers with MVD can go on much longer than anyone would expect.

Enjoy her, spoil her, and let her know how much you love her. She is lucky to have someone who cares so much.

[Karlin]

She's lovely!

If you want to give her the best chance now, I'd strongly recommend getting her to a cardiologist rather than a vet (see www.cavalierhelath.org for information on heart issues and why to see a cardio). Having a vet assess and treat MVD is like having a GP assess and treat cardiac failure -- a cardio will be able to tell you in far more detail what is going on with Puppers, where she stands, what might happen next, and the best array of medications to have her on and when to adjust them.

[eisens]

We're coming to the end with Puppers. It is so sad as she is only 7 years old.

Two weeks ago we thought she died. She fell over, pooped & peed and when I touched her I couldn't feel a heart beat or breath. My son was hysterical. . . then she coughed and started breathing. . .

The vet has upped her medicines twice since then. Puppers is now on 2.5mg of Vetmedin, 5 mg of Vasotec, 20mg of Lasix -- twice a day.

Thursday night she had a horrible time breathing and I didn't think she would make it through the night. In the morning I gave her 40mg of Lasix and a whole Vetmedin (5mg) and she perked up!

Since then though she sleeps 23 hours a day, and still coughs (5 coughs then a furball cough) 4-6 times a day. . . she is still drinking and eating though, and when I take her outside she even wanders around and sometimes runs a bit!

Since she doesn't seem to be suffering I am not planning on euthanizing her yet. The vet says we are at the end medicine-wise and when she does begin to suffer I won't have much of a choice. In the meantime we love her. . .

I've had Cavaliers since 1985 and for the first time and thinking of not getting another. I've only had one who lived to 17 -- and she was blind in both eyes (her corneas "blew"). All my Cavaliers (except for the 17 year old) had MVD. One had hip dysplasia and was paralyzed for 2-3 years. . .

As much as I love this breed I just don't know that the love is worth the grief. I have an almost 12 year old son and this is really hard on both of us.

[Karlin]

I am so sorry you are at this phase. The fainting/collapsing spells (asyncope and syncope), while frightening, often are not really that serious and the dog is back up and Ok very quickly. Because they collapse they tend to void their bowels/bladder.

I would really recommend seeing a cardiologist as there may be quite a few things you could be doing to make Puppers a lot more comfortable. For example they can aspirate out some of that fluid if it has built up, whih could relieve her breathing and give her many months of comfort. Or, there are other meds that can really help such as spironolactone -- adding this to my Lucy's regime gave her a whole new lease on life and she is four months now after having had a similar session to Puppers when she was rushed to the vet. So Puppers actually isn't at the end of the options for medications.

Also it can be extremely helpful to give 1000mg of fish oils and 30mg CoQ10 daily. You should really have direct cardio or vet advice before giving large extra doses of anything -- **especially Vetmedin** -- too much could kill her and it would never be a good idea to up that particular drug I think. Frusemide you can generally bolster a bit but again too much could do just the opposite of what you want to do (just ring your vet for advice). When a dog is struggling as she was she really also should go in immediately to the vet or cardio however -- they will generally give a frusemide injection which can help them recover quickly and really ease the breathing difficulties; I would not leave her to really struggle with breathing as this is a terrible experience for her. I would consider that kind of breathing to be an emergency and either the vet can help her recover or help her ease gently if her time has come -- it would be true suffering for her to suffocate at home instead due to lack of oxygen.

This is a difficult time and many of us are going through the same or have been through this. The single most important thing is to keep Puppers as comfortable as can be and if she is struggling, to have your vet help make a decision on whether it is just too much for her. It is far better to let them go kindly before either a heart collapse or suffocation, if they are close to that point, so I wouldn't hold back on getting proper professional advice and help if and when she is struggling. Often their difficulties can be quickly eased or else, we can relieve their suffering by letting them go before they truly suffer with a heart collapse or suffocation from being unable to breathe effectively. Many dogs at Puppers stage would still have many months of reasonable quality life left if properly managed with a good and appropriate mix of drugs. As I say Lucy was like this in Feb then went through a fainting phase and now has been back to her old self for many weeks and is perfectly happy. I know we are living with weeks or at bet a few more months to her future but she is not suffering at all/

You can really help prevent the fainting episodes by not letting Puppers run around, have access to stairs, get overexcited (eg avoid situations where she gets really excited -- in Lucy's case it is seeing strange dogs, but it might be not making a big deal of meals or treats for some dogs or working them up in any way. The excitement causes the fainting. I block the stairs and carry Lucy up and down as needed. No walks at all -- she just goes out to toilet and have a little wander. Walks will also induce problems).

[eisens]

Karlin, my vet is consulting with the local cardiologist. My vet is a family friend and has gone above and beyond consulting on behalf of Puppers. Puppers X-Rays and echo cardiogram show the heart is very, VERY enlarged. She just doesn't have much left to pump with.

I don't take her for walks. We live in a townhouse that backs up onto a large greenbelt and she loves to wander around in the "back yard." Neighbors don't mind as everyone loves her. I do carry her up and down the stairs -- although sometimes she jumps up on a couch or bed before I can stop her!

While I want to do what I can for Puppers, I've also been unemployed for some time so unfortunately money also enters into the equation. If I could save her life I could see spending a thousand or more on specialists -- but otherwise I simply can't justify the expense.

The good news (if there is any) is that she is not in pain and is comfortable. She ate like a stevedore this morning and was exploring the house. . . she seems content.

[Karlin]

I use interest in food as my main guidance on Lucy -- if she was attentive to a treat after a fainting spell I knew she was coming around fine.

I would ask about spironolactone as this has made a huge difference for Lucy (I give it at the upper end of what is acceptable for her size; think she is on 20mg and she weighs about 13 lbs) and also get guidance on what drugs can be upped if there is an emergency. Vetmedin at too high a dose could as far as I understand, cause serious problems but frusemide can generally be upped to a certain degree to counter a bad spell (dosage linked to weight).

The type of gasping breathing you describe though would generally be an emergency situation -- Lucy had one of those and vets were not sure she would last the day. She was given a frusemide injection and spironolactone to see if this would help and if not, she would have been euthenised. She rallied and has been generally good since though she went through a couple of weeks of asyncope and another session where she was poorly and so she got a frusemide injection. Then those sessions stopped as well and she is fairly stable though her activities are closely managed as it is running, excitiment etc that causes the collapses and they can only have so many of those before they may have a stroke or the heart gives out.

[anniemac]

I don't know much about MVD but just wanted to say I'm thinking of you and puppers

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[goda]

Puppers got her first Vetmedin at 8 this morning. By 9:30 she was frolicking.

Yes, frolicking!

From near death's door and not eating she woofed down a bowl of dog food, insisted on a (very short) walk and has been patrolling the new house. She is happy, I can tell. What a miracle drug!

I don't know how much time Vetmedin will buy her, but it is wonderful to see my happy girl back. Puppers is from the Tomnee kennel in Florida. Her official name is Tomnee Enola Gaye. See why we named her Puppers?

She is adorable! How fun to have an active playmate!

[eisens]

Puppers is a little "mama." She had two litters before we adopted her. When my son gets hurt she crawls into his lap and licks him. She licks his sores (not in an "I'm hungry -- yum BLOOD" kind of way but a gentle, "here let me make you feel better" kind of way.

She really has been a special little girl in our lives.