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Thread: I need some advice, we're having a very rough time...

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  1. #1
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    Question I need some advice, we're having a very rough time...

    It's been some time since I've posted on the forum, although I've been on here reading posts often. I'll try not to let this get too lengthy, but my Bentley has a multitude of health issues, they started about seven months ago, or so.

    It started out with a very rapidly-spreading skin issue, it appeared as irregular reddish raised blotches, never itchy, and Bentley never scratched or acted as if it bothered him. It spread like wildfire from his neck to his tail, and along his upper sides. Got very crusty and there were numerous areas that seeped a bit of clear fluid and did bleed some. The vet put him on an antibiotic (cephalexin) and medicated shampoo, Malaseb. It really didn't do any good, although the shampoo may have helped a little bit. I won't get into that a whole lot, as there are other issues, and I hate to get too long-winded here, for now anyway. Other symptoms then started to really pop up, and as I was researching the skin issue online, I came across a site about Cushings disease, Bentley has nearly every single symptom: the pot belly, ravenous appetite (something new), excessive thirst, fatigue (he doesn't even want to go for walks any more), labored breathing and very loud snoring. So, another vet visit, and this vet (same clinic, different vet this time) tells me he thinks that Bentley has congestive heart failure, and starts Bentley on Lasix. I don't see any improvement on the Lasix, and it makes Bentley incontinent (although I can deal with that, if only the Lasix seemed to help). Another vet visit and I now the vet tells me Bentley has a grade 3 murmur. His breathing really scares me, especially at night, it's rather labored and noisy, and once in awhile it almost seems as if he stops breathing for a moment, then will gasp a little bit, and he is OK. And his pot belly has gotten larger, and that really has me concerned. All my poor boy does all day is sleep, and he doesn't play at all any more.

    So, I know you are wondering... well, what about any tests that we may have had done. And here is the other difficult part, I only recently (in the last few years) had health issues of my own, and I am now on social security disability. So, I have not been able to get any tests done (yet) due to not being able to afford much (I can afford the vet visit and meds, and plan to get tests as I can afford to), however I plan to get at least one test (maybe two) done in a couple of weeks, and then after that more tests as I can afford to have them done. I am just heartsick that I cannot do more right now for my boy, and I am so sad and scared and frustrated. I guess I am looking for some advice and suggestions, such as, what tests might anyone recommend and what meds seem to be appropriate for CHF, if indeed that is what Bentley has? With the way he is breathing, and the fatigue and pot belly, all signs really do point to that (although he is not coughing at all). I have also read that dogs with heart failure tend to lose their appetite and lose weight, Bentley's appetite has gone through the roof and that is something new for him.

    Anyway.... Bentley has so much going on I am overwhelmed, I just don't know where to begin. I am thinking right now I need to deal with his breathing issues and fatigue, and also try to get the skin disorder under control. The skin issue had started to get better, and was drying up/healing up, although it has left sort of hard chalky weird thickened skin in those areas and hair loss, only now he has many more new areas popping up on his tummy and neck and upper legs, and even his little butt. I do have somewhat of a plan set up with my vet, she has suggested some tests and went over them with me and we discussed it all, I plan to get started on them soon, at least with one or two tests, in a couple of weeks. I am curious if anyone has experienced these issues and what they did. Thanks for reading this, any suggestions or advice sure is appreciated. I forgot to say, Bentley is 8 years old, and right now he weighs 24 lbs. (had weighed around 18 - 20 lbs. when he was in good health).
    ~Renee, Bailey & Maddie, and RIP my beloved Bentley.

  2. #2
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    I'm so sorry both you and Bentley are going through these problems and hope things improve quickly for you both.

    This could be heart disease but it needs proper diagnosis, not vets making guesses and prescribing on that basis . Did you check Rod's page for upcoming heart clinics? Then you could get an inexpensive auscultation. A cardiologist auscultation would tell you pretty much immediately if you are dealing with serious heart disease. But the hair loss would raise other questions... and most CHF dogs lose appetite, not get ravenous.

    Cushings sounds possible. Has your vet also looked into hypothyroidism? Or hyperthyroidism? (one is under-productive, one is overproductive thryoid glands). Hypo is actually fairly common in dogs and I would have thought, been one of the first tests done given this combination of symptoms. Hyper is much rarer.

    Hypo: http://dogs.about.com/od/caninedisea...id-In-Dogs.htm
    http://www.lbah.com/word/hypothyroidism/

    Hyper: http://www.petmd.com/dog/conditions/...m#.UcF4OODRfzI

    These both can cause increased hunger, skin diseases, lethargy and can cause heart complications.

    The blood tests for this can sometimes pinpoint it fairly quickly and other times can be complicated.

    Here's a list of possible symptoms for hyperthyroidism (a lot are the same for hypo-) and they pretty much match a lot of what you have been seeing:

    Symptoms and Types

    Involves many organ systems due to the overall increase in metabolism
    Weight loss
    Increased appetite
    Unkempt appearance
    Poor body condition
    Vomiting
    Diarrhea
    Increased thirst (polydipsia)
    Increased urine (polyuria)
    Rapid breathing (tachypnea)
    Difficulty breathing (dyspnea)
    Heart murmur; rapid heart rate; particularly an abnormal heart beat known as a "gallop rhythm"
    Hyperactivity
    Enlarged thyroid gland, which can be felt as a lump on the neck
    Hypo is more common than hyper and also easier to treat.

    From the Long Beach page (link above) on hypo:

    Integumentary System
    This is the most common manifestation of hypothyroidism. Typical skin symptoms include symmetrical hair loss (alopecia) along the trunk, although the hair loss is not consistently symmetrical. The hair coat is thin and dull, the hair easily falls out, it grows back slowly, and shedding occurs more often. Sometimes the hair coat resembles that of a puppy. Alopecia, if it occurs, is more common at pressure points and the tail.
    The skin might be cool to the touch and be darker (hyperpigmentation) than normal. A leathery feel called lichenification might also exist. Hyperpigmentation and lichenification usually occur when the problem has been long-standing. Also, the skin might be greasy due to seborrhea, and inflamed due to secondary bacterial or fungal infections. These secondary complications might cause excess scratching (pruritis) and odor.
    They skin lesions present in hypothyroidism mimic those in other skin conditions, especially allergies.
    I'd ask for the tests for hypothyroidism as a starting point.

    Others may have some ideas too.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    PS I would take him off Lasix -- no vet should have prescribed that without accurately diagnosing CHF first!!

    Rod has very detailed info on treating MVD and CHF on www.cavalierhealth.org and the points at which each medication is introduced.

    A grade 3 murmur would not necessarily (probably, even) cause any of these complications nor CHF.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    Quote Originally Posted by Remali View Post
    ... So, another vet visit, and this vet (same clinic, different vet this time) tells me he thinks that Bentley has congestive heart failure, and starts Bentley on Lasix. I don't see any improvement on the Lasix, and it makes Bentley incontinent (although I can deal with that, if only the Lasix seemed to help). Another vet visit and I now the vet tells me Bentley has a grade 3 murmur. His breathing really scares me, especially at night, it's rather labored and noisy, and once in awhile it almost seems as if he stops breathing for a moment, then will gasp a little bit, and he is OK. ...

    ... I guess I am looking for some advice and suggestions, such as, what tests might anyone recommend and what meds seem to be appropriate for CHF, if indeed that is what Bentley has? With the way he is breathing, and the fatigue and pot belly, all signs really do point to that (although he is not coughing at all). I have also read that dogs with heart failure tend to lose their appetite and lose weight, Bentley's appetite has gone through the roof and that is something new for him.
    I am focusing on Bentley's MVD here. You are getting mixed information about his condition. It is very unlikely that if he has only a grade 3 murmur, that he also is in CHF. And, normally Lasix, a diuretic, is one of the later medications which cardiologists prescribe for CHF, and seldom by itself.

    Here is what I would do about his MVD:

    First, to find out if he is in CHF, do a simple respiration test. Count Bentley's breaths per minute while he is asleep. Read about it here: http://www.cavalierhealth.org/mitral...piratory_rates If he breathes 30 or more breaths per minute (while asleep or resting) then he probably is in CHF.

    Second, get a cardiologist to auscultate his heart. Wisconsin's Dr. Stepien is doing it at a clinic in West Bend on June 29 for $40.00. You need to register by June 25. Details here: http://www.cavalierhealth.org/health...#West_Bend,_WI

    Medications: I have found that only a few cardiologists prescribe any mediations for MVD dogs before they are in CHF. If they do, they start with an ACE-inhibitor, like enalapril. They add a diuretic if they detect fluid in the lungs, but that usually means the dog already is in CHF.

    Financial aid: Check out this webpage for help in paying for vet bills: http://www.humanesociety.org/animals...rding_pet.html
    Rod Russell

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    Came to suggest what Rod already has--the low cost clinics that breed societies offer. My Tess was not declared to be in CHF until she had a grade six murmur and that was after multiple tests including ultrasound and X-ray. You really do need to see a cardio for a firm diagnosis. Re: the skin issues, it would be helpful Bentley could see a dermatologist. Tess had some skin issues that sounded a lot like Bentleys and our regular vet,who was quite good, just never thought they were too worrisome. I finally took her to a derm for treatment. She had severe flea allergies, and while she didn't get bitten often, one bite could set up a sore spot that would take a while to heal. With consistent flea meds and antihistamines, we finally got her healed. If you have a university vet medicine school nearby, they can be a good source of help, sometimes at a lower cost. Good luck to you and Bentley for improved health!

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    Thank you SO very much!! Wonderful replies all of you, I sure appreciate it!! I would have gotten back here sooner, but I also have a nearly-13 year old house rabbit who has mobility issues, and I have been helping him a lot lately due to his disability (as you can probably tell, my pets are my family and my life). So many things going on lately, it seems my pets all decided to have health issues at once. Murphy's Law.

    I'm going to read through all the links provided, thank you! I did take him off Lasix, I just didn't see how it was helping, and I also took him off the antibiotics too, as he just seemed to be acting real off after we started that. I agree, I really do need to get tests done and get an actual diagnosis, and we really do need to see a specialist. A dermatologist and a cardiologist. I doubt if we have any where I live (I am about an hour east of Minneapolis, Minnesota), but I will look around and refer to the links.

    I'm going to monitor his breathing tonight (or today, seeing as he snoozes so much), thanks Rod, for information on the respiration test. And thank you Karlin and Emkaybee. I have a lot of reading to do, I'm going to bookmark all those sites. I knew I would get some good advice here, awesome!! Thank you! Much of what all of you have said makes total sense to me, I really am not all that crazy about the two vets we have seen so far, I questioned what they've said so far and I just didn't feel real confident about them.... so I am now looking for another vet. I will let you all know how it goes. And I will let you know what I find out with the respiration test, I'm going to do that today/tonight.
    ~Renee, Bailey & Maddie, and RIP my beloved Bentley.

  7. #7
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    What have the vets said about Cushing's symptoms and do they recommend testing for Cushing's? You have said that he has many symptoms of Cushing's, and that seems to be accurate - so what do the vets think about this? Cushing's can explain everything you have reported.

    The problem with the respiration test is that Cushing's also causes increased respirations, so this may not tell you if this is heart failure versus Cushings.

    Manual of Canine & Feline Cardiology, Chapter 13, Cardiovascular Effects of Systemic Diseases, Hyperadrenocorticism:

    "Panting and Dyspnea (that means labored breathing)

    Altered ventilation mechanics are often present owing to weakness in the muscles of respiration, increased thoracic fat deposition (decreasing chest wall compliance) and increased diaphragmatic abdominal pressure resulting from adipose tissue and hepatomegaly (means enlarged liver). MILD RESPIRATORY DISTRESS OR RAPID RESPIRATORY RATE AT REST OFTEN RESULTS.

    Many cushingoid dogs have variable degrees of lower airway disease or parenchymal disease.

    The triad of mitral/tricuspid insufficiency, respiratory disease, and Cushing's syndrome may create intractable dyspnea due to cardiopulmonary failure."

    I don't know if you read the reply posts to your first thread. But Cushing's can also cause pulmonary thromboembolism and high blood pressure is present in over half of dogs with Cushing's.

    I think I'd start with testing for Cushing's (if the vets think that is worthwhile) and then do chest x-rays. Chest x-rays can tell alot about possible heart disease, possible airway disease, and can also give clues about Cushing's from changes that can be seen. I don't know costs for Cushing's tests, but chest x-rays are about $100 to $150 in my area so you get a lot of "bang for your buck."
    Pat B
    Atlanta, GA

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    I poke around on the interent and there are several veterinary schools in Minnesota, one near you in St. Paul. Here is a link to their FB page:

    https://www.facebook.com/umnCVM

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