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Thread: Not good news for Pippin at annual check up:(

  1. #1
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    Default Not good news for Pippin at annual check up:(

    Hello all...

    Don't get a chance to post on here much lately.


    I had Pippin up for his annual bloods and new vet (who has specialized in heart problems) found a murmur..., itís not the usual kind of murmur that cavs get (trust Pippin) itís a problem with the valve not opening fully rather than not closing and closing too quickly, so doesnít cause fluid to build up on the lungs but blood to gather around the heart,we could clearly see what was happening on the scan, anyway she has scanned and done an ECG, which she took a close look at later and called us about after giving us loads of info at the scan,- she is excellent,- and he is not showing any signs of heart failure, but is showing signs of some damage caused by the heart trying to compensate, and slow heart rate. She said this type does not show the normal coughing or abdominal swelling that the usual murmur does, so can get bad without noticing any problems other than a little weakness and loss of energy, which he does have recently.

    She has started him on vetmedin 2.5 twice daily for two weeks and if it gives him more energy she will keep him on 1.25 twice daily but if heís much the same will leave him off meds for the moment, she has reduced his phenobarbital to half a 15mg tablet twice daily, (sheís not sure now whether it may have been his heart all along it was a different vet who thought it was fits although they werenít the classic fits) she is not withdrawing them altogether at the moment just in case.

    Other than this she said she will scan him annually and told us not too worry too much about walks and playing as it is important at the moment that he is happy and allowed to live as normal as possible. We only walk him for 10-15 mins twice daily anyway and he doesn't play as much as he used to...

    Pippin was 7 last feb, we have had him since he was 9 weeks.

    Gus (who is 9 and a half) has his check up next week, and DJ (7 in June) next month, so I am a little nervous about that, but fingers crossed.

    Just wondering if anyone has experience of this type of murmur?
    Gus(blenhiem) Pippin(tri) DJ(ruby)

  2. #2
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    I saw that you posted again in the health section.

    Do you have a written report with a diagnosis? It's not at all clear to me what your vet is describing. If you can find out the name of the particular heart disease/condition, I could tell you much more.

    Remember that a murmur is only a noise, it is not a heart disease or condition - so saying that a dog has a murmur or even that a dog is in heart failure tells you nothing of the underlying disease. Cavaliers typically have degenerative valve disease - there are several names for this disease including MVD, endocardiosis, acquired valvular disease, chronic valvular disease. In this disease, the valves become leaky, mishapen, warped, prolapsed - or similar and the valve becomes incompetent and doesn't work properly. This can result in several problems - not just fluid backing up into the lungs (pulmonary edema) but ascites (fluid building up in abdomen and extremities), pulmonary hypertension when the tricuspid valve fails (high blood pressure in the lungs only), etc. Blood gathering around the heart (in the pericardium or sac that surrounds the heart) is called pericardial effusion.

    Find out an exact diagnosis and I can give more information. I can't tell if you are describing mitral valve dysplasia (present at birth) or stenosis or a rhythm/electrical disturbance or what. There should be an official name for the exact disease.

    Pat
    Pat B
    Atlanta, GA

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    Sorry to hear this.

    Don't now at all what is being described -- but putting a dog on Vetmedin early (before advanced CHF) remains controversial, I would want to understand exactly the reason for this.

    For anything heart related, especially if it is unusual like this, I still would go to the cardiologist (Tom Mullally at Nutgrove vet, or Bray Vet also has one who visits once a week or every two weeks or so)) if this were one of my dogs. Vets with some heart training still lack the expertise of cardiologists.
    Karlin
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    The description of "damage from the heart trying to compensate" almost sounds like myocardial disease. Myocardial disease is most often DCM - dilated cardiomyopathy - which is the disease found in large breed dogs. In this disease the heart muscle becomes flaccid and enlarged and doesn't pump blood efficiently. A dog can have myocardial disease AND degenerative valvular disease at the same time. I definitely agree with Karlin that using a cardiologist for diagnosis and treatment planning really will give the best results as far as quality and quantity of life. Vetmedin is actually used earlier in myocardial disease (because contractility or the pumping strength of the heart is a problem early on) than in valvular disease and can be a very useful drug. It may be problematic, though, in the presence of bradycardia (slow heart rate) that you describe as the drug can slow the heart rate even more.

    Here's one link that describes heart disease in very everyday language:

    http://dogtime.com/heart-disease.html

    This link also talks about why dogs don't have heart attacks (myocardial infarcts) as humans do. MI, or heart attack, is when the blood supply to the heart is suddenly cut off. This is generally due to coronary artery disease, or athlerosclerosis. It appears that this link was written before the advent of Vetmedin.

    Pat
    Pat B
    Atlanta, GA

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    "It's problem with the valve not opening fully rather than not closing and closing too quickly, so doesnít cause fluid to build up on the lungs but blood to gather around the heart,"


    I should have said it's the Mitral valve that's the problem, the left one, which means that when the blood is trying to leave the heart the valve is closing too quickly, therefore not allowing all the blood out, also he has a slow heart beat which doesn't help resulting in low blood pressure.On the scan there was a lot of disturbance either side of the valve and blood mixing.

    The vetmedin is to see if there in any improvement in heart rate resulting in increased energy levels. After a week we are seeing some improvement, we are due to see the vet again on Thursday next.

    I was a bit shocked at the time of posting so sorry for not explaining fully.

    We will be discussing on Thursday where to go from here.
    Gus(blenhiem) Pippin(tri) DJ(ruby)

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    Talked with the vet on Thursday, she has reduced the vetmedin to 1.25 and will keep him on this and see how he goes, he had to have his phenobarbitol increased back up to 15mg twice a day last Wednesday as he was showing signs that he may have being going to fit.

    Also poor little man ended up in emergency vets on Monday (bank holiday) as he had been having trouble with his hindleg, pain and reluctance to use it on Sunday, I had checked him over and couldn't find anything obvious, but wasn't happy to leave him in pain, vet didn't find anything either after a very long and thorough check,(he looked for hip and patella problems also) so presumes it may be muscular and has him on metacam for 8 days and no walks for two weeks. I have to bring him back for x-rays if it doesn't improve. The thing is Pippiin has always had weakness in his hindlegs and had a whole serious of x-rays last year which showed nothing and then the weakness improved when he was put on PB for epilepsy..my vet is very clued in on SM and has said if we are worried could have MRI done...at the moment I am hoping this is just a pulled muscle, he is showing some signs of improvement after only two days on metacam. If I am not happy with him by Friday I will bring him to see my usual vet.


    Gus (who will be 10 on Oct) got a clean bill of health on Thursday, no heart problems or any other problems other than he is deaf in one ear and almost in the other. Poor Pippin gets everything and he is such a little character, and only a little cavalier, he is so sweet and gentle and never complains. I only know he has pain in his leg because he is so quiet and reluctant to use it. Although if he brushes it against anything/one he yelps and then holds it up for a couple of seconds, but is ok after I comfort him and massage if for him.
    Hopefully he will be better today/tomorrow, if not it's back to the vets on fri, even though he is not finished on metacam until monday.

    Does anyone have an opinion on whether this could be muscular or something else?
    Gus(blenhiem) Pippin(tri) DJ(ruby)

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    Oh goodness such a lot going on poor wee fellow.

    I'm still not quite understanding the heart issue, did your vet give you the name of it?


    Sorry he is also now limping - hoping it is just muscular, Metacam would also help pain from SM so it's no guarantee that it is not that. See how he goes, is he showing any other signs?


    Good news on Gus though
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    I'm so sorry to hear that he is continuing to have problems with his leg/hind end.

    I can't imagine what is going on if the Vet hasn't figured it out. Could it just be arthritis? Do you have acupuncture there? My Vet facility has 3 Vets, and one is an acupuncturist, which I have been told works well with pain issues.

    How big is Pippin?
    Cindy and Claire
    Claire was born on Feb7, 2010

  9. #9
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    As far as I can gather he has MVD, just a different type, and low blood pressure intermittently. It was a lot to take in but I'll be talking to the vet again tomorrow as he was only given a week's supply of the lower dose of Vetmedin and we will review again tomorrow.

    The leg has me baffled; he is much brighter today, so not in constant pain, and he can walk on the leg when he needs to go out to toilet or drink/eat etc. We are careful to lift him when he needs to be lifted up steps, etc. and he is not having any walks, but although much brighter today he still is getting intermittent pain, where he suddenly yelps and holds the leg up, but a few seconds later is fine?

    Hopefully my own vet can shed some light on things tomorrow.

    He had a metacam injection on monday and a tablet yesterday, and today, he has 6 more tablets for 6 more days. I am just worried that he is still having these episodes of pain that don't seem to be brought on by anything in particular eg. tonight he was walking away and moved too quickly which caused him to yelp and lift the hind leg, but 10 seconds later he was fine...

    Has anyone else had to deal with anything like this? Is it likely to be muscular or ligament like the emergency vet said or something else? I am of course as I said going to say all this to my vet in the morning. just wondering if anyone can shed light on these symptoms to put mind at rest as I am thinking all sorts...

    'mummytoClaire' he is a smallish cavalier and weighs 7.5 kg and is lean. Thanks for your suggestion...
    I may consider accupunture but really want to try find out what's going on first.
    Gus(blenhiem) Pippin(tri) DJ(ruby)

  10. #10
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    I presume you're beginning to think the leg issue may be neurological in origin,like SM.
    It may also be a simple sprain,muscle injury or a disc problem.
    Hopefully giving the metacam will reduce inflammation and allow a chance to heal.
    I think watch and wait for a few weeks and if it recurs,then perhaps consider a scan.
    Many people assume that cavaliers with SM will scratch.
    It's not necessarily so.Daisy was not a big scratcher,but it was intermittent lameness and unsoundness that gave away the fact that she had become truly symptomatic around 3.5 years of age.
    I know it's frustrating and worrying,but it makes sense to see if it improves before deciding on a scan.Considering the cardiac concerns,maybe a scan should be a last resort?
    Sins

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