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Thread: when to start vetmedin with mvd

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    Default when to start vetmedin with mvd

    , my cavalier was grade 3 when the vet put him on vetmedin. he died less than a year later. We noticed after starting the medication his heart enlarged and we could see his whole body vibrating with each heart beat. Do you think this could be because he was started too early?

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    Quote Originally Posted by ailhill View Post
    , my cavalier was grade 3 when the vet put him on vetmedin. he died less than a year later. We noticed after starting the medication his heart enlarged and we could see his whole body vibrating with each heart beat. Do you think this could be because he was started too early?
    I was so sorry to read this and sorry for your loss.

    I am no expert but I do have a 11 1/2 year old ckcs whose murmur was just graded 4/6.(very, very, bad). When I asked the cardiologist if it was now time for Lyndsey to start meds, as she gets short of breath and pants a lot but still fairly active, she replied: count repsirations when she is at rest for a minute each night. When dog starts breathing 40 times a minute it's time to bring her in to start meds." The meds she will be put on if/when this happends is vetmedin, Enalapril, and Furesomide(Lasix). Lyndsey's murmur was audible before age 2 and stayed stage 2 for a very long time. At age of 9 she went to 2/3. I do not know much about vetmedin, but I'm going to research it now.

    Karen H

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    Quote Originally Posted by ailhill View Post
    , my cavalier was grade 3 when the vet put him on vetmedin. he died less than a year later. We noticed after starting the medication his heart enlarged and we could see his whole body vibrating with each heart beat. Do you think this could be because he was started too early?
    Probably, yes. Read this: http://bit.ly/evrxg9 Vetmedin (pimobendan) should not be prescribed to a cavalier with mitral valve disease (MVD) unless and until the dog is in congestive heart failure (CHF), which usually is when it has a grade 5 or 6 murmur, severe heart enlargement, and other signs, such as significant lung congestion, difficulty breathing while at rest, and unable to tolerate any exercise.

    See also, this: http://cavalierhealth.org/images/acv...ccvhd_2009.pdf It is a "Consensus Statement" issued by a panel of veterinary cardiologists who are board certified by the ACVIM. It concludes that no cavalier should be given any medications for MVD unless and until a moderate murmur, like a grade 4, some breathlessness, some fluid in the lungs, some heart enlargement. In the Consensus Statement, this is Stage B2.

    Pimobendan normally should not be prescribed until the dog's heart reaches Stage C in the Consensus Statement.

    Even then, pimobendan is not for every grade 6 or stage C cavalier. One of ours was in CHF failure and was prescribed a half dose of pimobendan. His heart muscle was so strong, despite his MVD, that on that dosage, I actually could see his heart beats through his chest hair. Our vet backed off of that dose immediately, but even a quarter dose was too much, so we discontinued it.

    One of our cardiologists told us that he does not prescribe pimobendan without first conducting an EKG to measure the contractibility of the heart muscle. He said that if the dog's heart muscle is strong despite the CHF, the pimobendan could over-stimulate the muscle, causing the mitral valve's main chords to rupture, and killing him instantly.

    At http://bit.ly/evrxg9, you will notice these quotes from cardiologists:

    "There is evidence that treatment with a positive inotropic agent such as pimobendan prior to the development of systolic myocardial failure can have deleterious effects. ... Pimobendan...should be reserved for use when systolic myocardial failure is detected or suspected." -- Dr. Amara Estrada, Board Certified Veterinary Cardiologist.

    "Most dogs with chronic valvular heart disease do not have decreased contractility and do not need positive inotropic support." -- Dr. George A. Kramer, Board Certified Veterinary Cardiologist.

    "One study in dogs with early mitral valve disease suggested an increase in valve damage in the dogs given pimobendan." -- Dr. Mark Rishniw, Board Certified Veterinary Cardiologist.


    Whoever prescribed pimobendan to your cavalier needs to explain himself. If you noticed your dog's vibrations with each heart beat, that alone should have been enough information for any veterinarian to discontinue that drug instantly.
    Rod Russell

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