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Thread: Back to the Cardiologist

  1. #21
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    Quote Originally Posted by RodRussell View Post
    Viagra (a/k/a sildenifil) is prescribed to lower pulmonary hypertension by some cardiologists for dogs with congestive heart failure, often in combination with pimobendan.
    Sildenafil (see Plumb's Veterinary Drug Handbook page 1100 and Manual of Canine and Feline Cardiology page 309) is used exclusively for pulmonary hypertension. It does nothing for congestive heart failure, and it does nothing for pulmonary edema or ascites (fluid in lungs or in abdomen as a result of CHF). I've used it for two dogs - one had CHF but also had moderate PAH, for which the drug was prescribed. The other dog had no heart failure (but had very mild heart disease) but had severe acute PAH most likely as the result of a pulmonary embolism. The drug is also used in humans for PAH but most humans with significant PAH end up getting a lung transplant. I know a couple of dogs who use it due to permanent lung damage from heartworm disease.

    From Manual of Canine and Feline Cardiology:

    "Sildenafil has been shown to improve both exercise tolerance and quality of life.......may have a positive effect in dogs with acquired pulmonary hypertension secondary to chronic valve disease, congenital heart disease, chronic pulmonary disease and heartworm disease......can be used in combination with pimobendan for additional inodilator effect. Dosage is .5 to 1.0 mg/kg two or three times a day."

    Pat
    Pat B
    Atlanta, GA

  2. #22
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    Quote Originally Posted by gamefanz View Post
    I have written my post about 4 times now and each time I have deleted it. I wanted to share my experience with you as someone who just lost her dog(a peke) who had the heart issues. I wanted to go into detail but I don't think this forum needs that. I have shed tears just remembering back 2 months ago. But I will only write this, you are not alone. This forum is a great support system for those with health issues, I wish I knew of a forum to go to when I needed it the most. Wagtails is right, your CAV will tell you when its time. I needed him to tell me and I asked him to tell me. He finally showed me in no uncertain terms that it was time. Trust in your vet they will be there for you every step of the way.
    I just want to give you a hug
    Becky
    P.s. sorry if this does not make sense. Trying to think while crying. sorry
    I'm sorry about your Peke. I had a wonderful black Peke named Raisin who lived to be 16 1/2. He is my only dog that ever died on his own - he had a fatal arrhythmia one night during his sleep and just didn't wake up. He was curled up very peacefully, and I think it was a good way to go. He had severe heart disease for a long time but symptoms were well controlled until the very end. I'd like to have another Peke one day; he was very special.

    Pat
    Pat B
    Atlanta, GA

  3. #23
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    Quote Originally Posted by Sydneys Mom View Post
    UPDATE: More Medication, Viagra
    Last week, when Sydney had abdomenal fluid drained, his cardiologist added another diuretic AND increased the doses of some of his other heart meds. Yesterday, one week later, we were back for a recheck. His abdomen is starting to fill with fluid again and the pressure in his lungs in increasing. Rather than increase the doses again which can damage his kidneys, we added Viagra to the mix. I hope this helps him. The good news is that they did a kidney panel and his kidneys are functioning great!
    Joyce,

    I've used sildenafil (viagra) for two different dogs some years back before most vets and many cardiologists knew about its use for PAH. This drug can be very effective for PAH (pulmonary arterial hypertension) and can greatly reduce symptoms such as dyspnea (difficulty breathing) and tachypnea (rapid breathing) caused by the PAH. But the drug does nothing for heart failure so it can't help pulmonary edema (fluid in lungs) or ascites (fluid in abdomen). I purchased 100 mg tablets at Walmart and split them into 12 pieces. But the price then was only about $10 per tablet and I understand it is much higher now. I understand that Pfizer loses the patent next year so generic should be available soon.

    My boy who was most like Sydney also took enalapril, furosemide, sildenafil, digoxin and pimobendan. (He did not have the arrhythmia as Sydney has.) He actually did go into kidney failure when he was 15, so I understand that worry. We adjusted his meds and discontinued the digoxin and changed his diet to low phosphorus, added a phosphorus binder, and I gave twice daily subq fluids. His symptoms were well controlled for another year and a half, and he was put to sleep at 16 1/2 for reasons other than heart or kidney failure (quality of life - he ended up blind/deaf with extreme senile dementia agitation).

    I can't say that I agree that ascites is "better" than pulmonary edema.......they both are serious. The procedure to drain fluid is called abdominocentesis if you want to google and read about it. I've known many dogs who have had this process done repeatedly.

    http://www.vmth.ucdavis.edu/cardio/c...nocentesis.htm

    Question - you said earlier that Sydney took furosemide ONCE a day - that's unusual as it is generally given twice a day and can be given up to four times per day. Has that changed now that the ascites is not well controlled? If not, I'd certainly discuss it with the cardiologist. And you've now added spironolactone? Hydrochlorothiazide can sometimes also be given - this is called triple diuretic therapy for cases that become refractory. These are three different acting diuretics.

    Has the cardiologist asked you to monitor resting respiration rate? That is something that pet owners can do. There is a canine CHF yahoo group where there are discussions about these things in great detail.

    Do you have urinalysis run as well as blood chemistry to check kidney function? Kidney failure will show up in urinalysis long before it shows up in blood chemistry. By the time that BUN and creatinine are elevated, kidneys are only working about 25%. But a low urine specific gravity gives you an advance warning and you can make some dietary changes, etc. I have actually purchased a digital refractometer so that I can measure USG at home.

    Pat
    Pat B
    Atlanta, GA

  4. #24
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    Thanks Pat, I was hoping you would see my post and reply. I've learned much from your posts. Now as to your comments:

    This drug can be very effective for PAH (pulmonary arterial hypertension) and can greatly reduce symptoms such as dyspnea (difficulty breathing) and tachypnea (rapid breathing) caused by the PAH. But the drug does nothing for heart failure so it can't help pulmonary edema (fluid in lungs) or ascites (fluid in abdomen). I purchased 100 mg tablets at Walmart and split them into 12 pieces. But the price then was only about $10 per tablet and I understand it is much higher now. I understand that Pfizer loses the patent next year so generic should be available soon.
    I did know all this. In order to get Sydney on the Viagra immediately, I had a local pharmacy fill a RX for 2 100mg tabs (which I split in 3 each for a 6 day supply) for a cost of $44!!!!! The cardiologist hooked me up with a compond pharmacy and I can get a 30 day supply for $60 plus shipping. Big difference.

    I can't say that I agree that ascites is "better" than pulmonary edema.......they both are serious. The procedure to drain fluid is called abdominocentesis if you want to google and read about it. I've known many dogs who have had this process done repeatedly.
    As it was explained to me, it is still serious, however, as far as controlling it, it was easier on his body to drain the fluid rather than give more drugs at this time. In all likelihood, since he is starting to retain fluid in his abdomen already, he will need the proceedure again. But, just one day with the viaga, I can see that he is already urinating more and his belly doesn't seem as bloated.

    Question - you said earlier that Sydney took furosemide ONCE a day - that's unusual as it is generally given twice a day and can be given up to four times per day. Has that changed now that the ascites is not well controlled? If not, I'd certainly discuss it with the cardiologist. And you've now added spironolactone? Hydrochlorothiazide can sometimes also be given - this is called triple diuretic therapy for cases that become refractory. These are three different acting diuretics.
    Orignially, it was once a day. The cardiologist is conservative and wanted to keep some "wiggle room" for increasing the meds. He is now on furosemide twice a day and spironoactone twice a day and his dose of vetmedin has also doubled. I haven't heard of hydrochlorothiazide, I will ask about that. Thanks for the suggestion.

    Has the cardiologist asked you to monitor resting respiration rate? That is something that pet owners can do. There is a canine CHF yahoo group where there are discussions about these things in great detail.

    Do you have urinalysis run as well as blood chemistry to check kidney function? Kidney failure will show up in urinalysis long before it shows up in blood chemistry. By the time that BUN and creatinine are elevated, kidneys are only working about 25%. But a low urine specific gravity gives you an advance warning and you can make some dietary changes, etc. I have actually purchased a digital refractometer so that I can measure USG at home.

    I have been monitoring the resting respiration rate. It seems to be at an average of 32 breaths a minute. As far as a urinalysis, we haven't had that done. Another thing I will ask about. I will also look into a digital refractometer. Another good suggestion.

    I appreciate your imput. Please, if you have any more suggestions, please let me know.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

  5. #25
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    Joyce,

    All I want to say is I've been crying for you and my post deleted so I just got back to tell you I feel for you. I will be praying for you and sydney. Ok. Here comes the tears. I can't offer advice about medication and mvd. I can pray for you and want you to know you have touched me. I will say that having recently lost my first cavalier (the love of my life), I will tell you they have a way of letting you know. All you can do is what you are doing and try as hard as it is, to savor each moment. People would tell me they can sense your pain, so no matter how hard it is I hope you find strength.

    Thinking of you

    Sent from my Droid using Tapatalk
    Anne Proud mother of Elton 5 and Angel Ella

  6. #26
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    Thanks Annie. I followed Ella's journey and shed many tears for both of you. Sydney is so special for me in so many ways. He was here for me when I was sick and would just lay near by watching over me. If I tried to get up he would walk next to me. I need to do that for him now. He deserves nothing less.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

  7. #27
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    Syndey's stone is in my jar of prayers already but I am praying extra hard right now
    Anne Proud mother of Elton 5 and Angel Ella

  8. #28
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    I don't really have any advise but I'm sending you a ! You guys are in our thoughts!

  9. #29
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    Sorry to hear this is happening to your sweet dog

  10. #30
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    I am just reading this right now and I want you to know I am thinking about you and Sydney. I went through the same thing with my last dog Sam so I know what you are going through. It's tough to deal with as you don't want to lose them but you don't want them to suffer either. My thoughts are with you.
    Deb

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