Page 4 of 4 FirstFirst ... 234
Results 31 to 40 of 40

Thread: Daisy - More Bads News From Chestergates Last Night

  1. #31
    Join Date
    Mar 2005
    Location
    Atlanta, GA
    Posts
    765
    Post Thanks / Like

    Default

    Quote Originally Posted by Brian M View Post
    We have a conundrum over medication he commented that she needs no medication but he is not happy she is on frusimide as that stimulates certain hormones to over produce some items which may affect the heart so he is considering if he should prescribe an Ace Inhibitor to counteract the frusimide but he doesnt know if that is the right thing to do .So he is going to approach many other cardiologists both in the UK and the US to ask them and then arrive at a majority decision and then tell me which way we will go.
    Well, thank you Simon Swift!!! I have long been concerned about dogs receiving furosemide (US spelling) long-term for SM. I have made a few mild comments here that I would never give this drug long term for SM because of the side effects. The drug activates the RAAS (renin-angiotensin-aldosterone system) - a very complex compensatory neuro-hormonal system that I'm not going to try to explain here. The RAAS is compensatory and helps with an acute problem but it becomes maladaptive over the long term so this is something that you don't want to activate. This is why furosemide alone is never given for dogs in heart failure but an ACE-I is always added. (Any vet that gives furosemide only to a dog in heart failure is sadly out of date.)

    I personally would not want my dog on furosemide for SM, and I'd certainly not want to prematurely add an ACE-I simply to compensate for the furosemide for a dog that is in the early stages of MVD. Since cimetidine and omeprazole are also drugs given to reduce CSF, I would opt for one of those drugs and not use the furosemide. I also know what furosemide does to kidney function, so I would not use that drug long term unless it was necessary to control symptoms of CHF.

    All of this is of course my own opinion, but I feel somewhat vindicated that Simon Swift has voiced the concerns that I've had for a long time about this drug in the SM treatment protocol. I've also not been happy with the monitoring recommendation for dogs on this drug - I'd monitor much more aggressively.

    Brian - would you consider talking with the neurologist about using one of the other drugs that is reported to reduce CSF and just skip the furosemide and the ACE-I? Then you would start those drugs when necessary for CHF from MVD, but that may well be years down the road.

    Pat
    Pat B
    Atlanta, GA

  2. #32
    Join Date
    Jun 2010
    Location
    Charlotte, North Carolina, United States
    Posts
    2,080
    Post Thanks / Like
    Blog Entries
    18

    Default

    brian,

    It seems like you have done a really good job going over the different drugs etc and got a lot of information. What pat wrote, it seems like this might be something good to know for others too. Since simon swift is such a well known cardiologist (is he the breed clubs cardiologist?) anyway since SM and MVD are both concerns it seems like something that might be beneficial to address which it looks like he might do. Oh daisy and brian, you have had a tough week but you are in good hands

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

  3. #33
    Join Date
    Jan 2008
    Location
    Prenton Cheshire
    Posts
    4,716
    Post Thanks / Like
    Blog Entries
    1

    Default

    Hello Ladies

    And Good Morning to all ,How are You my good friend Sabby and Harley.

    Pat I dearly hoped you would respond and your comments are what Ihoped for and I will be phoning Geoff Skerritt this morning to advise
    what Simon Swift said and to ask for a change from frusemide to the negate the need for an Ace Inhibitor at this stage of Daisy's journey.
    Your comments on frusemide activating her renin-angiotensin-aldpsterone system (RAAS) and that these are harmful hormones in the setting of
    heart disease and that ACE Inhibitors such as Fortekor will help blunt this effect,are Simos words

    Pat I will pm you and wish to ask you a confidential question which I think you will be interested in so pls look out for my PM .


    I would also like to hear Rods comments if hes about .

    PS Hello Annie ,yes Simon is the clubs cardio and deals with all the breeders.
    Brian M

    Poppy the Tri, Daisy the Blen, Rosie the Ruby and Lily the B & T

  4. #34
    Join Date
    Jun 2010
    Location
    Charlotte, North Carolina, United States
    Posts
    2,080
    Post Thanks / Like
    Blog Entries
    18

    Default

    For some reason I thought he was who rod always mentions that spoke to the ckcsc usa meeting in 98 about MVD and set forth the mvd protocol. I must have been wrong but I have heard many talk about him in good ways

    I am sure he will be able to make sure she gets managed.

    You got a double whammie and I'm so sorry

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

  5. #35
    Join Date
    Jan 2008
    Location
    Prenton Cheshire
    Posts
    4,716
    Post Thanks / Like
    Blog Entries
    1

    Default

    Hi Annie

    It could be the same as I know he spent some time in The US in Missouri with John Bonagura

    http://www.thecavalierclub.co.uk/hea...swift_bio.html

    What time is it there ,you should be in bed ,its gonna get windy tomorrow you stay safe .
    Brian M

    Poppy the Tri, Daisy the Blen, Rosie the Ruby and Lily the B & T

  6. #36
    Join Date
    Jun 2010
    Location
    Charlotte, North Carolina, United States
    Posts
    2,080
    Post Thanks / Like
    Blog Entries
    18

    Default

    3 am. I'm up. I'm always worry about these babies. I went through some old emails and read my blog going back in time. I have an 11 lb baby in my lap telling me its time to sleep.

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

  7. #37
    Join Date
    Jun 2010
    Location
    Charlotte, North Carolina, United States
    Posts
    2,080
    Post Thanks / Like
    Blog Entries
    18

    Default

    I looked at my calendar for some reason and it was on daisys photo. Maybe someone was telling me something ...

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

  8. #38
    Join Date
    Mar 2005
    Location
    Atlanta, GA
    Posts
    765
    Post Thanks / Like

    Default

    Quote Originally Posted by Brian M View Post
    Your comments on frusemide activating her renin-angiotensin-aldpsterone system (RAAS) and that these are harmful hormones in the setting of heart disease and that ACE Inhibitors such as Fortekor will help blunt this effect,are Simos words.
    The problem is that I believe that furosemide causes these unwanted side effects for ALL dogs, not just for dogs with heart disease. This is not a benign drug (probably no drug is entirely benign). There are always negative consequences that one must balance against the positive effects when giving any drug, especially long term.

    Furosemide is an essential drug in the treatment of heart failure - in that situation the positive effects outweigh the potential harmful effects. It is also never used as monotherapy for heart failure but it is part of a multi drug treatment program.

    For these reasons, if I had a dog with SM, I'd select one of the other drugs used for CSF reduction. I have not studied these other drugs in depth so I'd probably want to read up on them but I feel pretty certain I'd not want to use furosemide.

    Pat
    Pat B
    Atlanta, GA

  9. #39
    Join Date
    May 2006
    Location
    Orlando, Florida USA
    Posts
    1,186
    Post Thanks / Like
    Blog Entries
    1

    Default

    I am not sure where we all are on this topic, but I want to jump in based upon what I think is going on, because I am in a rush and need to get out of here before being able to read all of the foregoing posts. I have read the two reports, one from Geoff Skerritt and the other from Simon Swift. This is what I think concerns Simon Swift:

    From http://cavalierhealth.org/mitral_val...tm#--_moderate:

    In a 2009 study report which did not include CKCSs, veterinary cardiologists observed a three-fold increase in RAAS activity using furosemide. Their conclusion was that "furosemide is not recommended for chronic use in the absence of concurrent therapy to blunt RAAS activity, such as ACE-I, aldosterone receptor blockers, or angiotensin II type I receptor blockers.

    Here is a summary of that 2009 report (from http://cavalierhealth.org/mitral_val...(RAAS)_in_Dogs ):

    The Effect of Furosemide and Pimobendan on the Renin-Angiotensin-Aldosterone System (RAAS) in Dogs. AC Lantis, CE Atkins, TC DeFrancesco, BW Keene. J Vet Intern Med 2009;23; (ACVIM 26th Ann. Vet. Med. Forum Abstract Program: Abstract #2). Quote: "We have shown that pimobendan, at the labeled dosage, does not accentuate furosemide- induced RAAS activation. We observed a three-fold increase in RAAS activity with furosemide alone and in combination with pimobendan. Therefore, furosemide, with or without pimobendan, is not recommended for chronic use in the absence of concurrent therapy to blunt RAAS activity, such as ACEI, aldosterone receptor blockers, or angiotensin II type I receptor blockers."

    I'll let you all chew on this for a while and get back to you tomorrow.
    Rod Russell

  10. #40
    Join Date
    Jan 2008
    Location
    Prenton Cheshire
    Posts
    4,716
    Post Thanks / Like
    Blog Entries
    1

    Default

    Hi

    At long last I have sent Daisy and Rosie's MRI scan reports to the A.H.T. and have also advised Daisy's breeder
    via recorded post with a polite letter of advice ,thanks to Sins guidance, together with copy reports .

    Also as advised on another thread I spoke to Daisy's cadiologist on Monday and we still await gudance re the
    frusemide and fotekor issue .
    Brian M

    Poppy the Tri, Daisy the Blen, Rosie the Ruby and Lily the B & T

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •