Karlin- thank you for you for your thoughful response. basically what you are saying is where I am coming out - why do surgery when we have this heart issue and why not at least try medical management. I really do not want Ellie to have this long drawn out recovery with complications just to find out her heart has progressed and I took away her quality of life for the time she did have. How many dogs do you know that have gone through the surgery with Dr. Marino? This is what I am most interested in finding out when I meet with LIVS, how they keep track of how the dogs do in the long term and what outcomes they have.

Kate- thank you for the words of encouragement! yes, that was my thought, however, i don't know if its perhaps the fact that the echo shows both tricuspid and mitral regurgitation? im still waiting for a response from my vet for an answer to this

Momobvious- thank you, yes i have read through numerous blogs specifically these three: http://rileybeatssm.blogspot.com/, http://abbeygeorgelinda.blogspot.com/, http://fightforella.blogspot.com/

Rod- what makes you believe to go by his recommendation? I am still struggling to figure out why the follow up in 6 months via echo vs's yearly xrays? I will let you all know when I hear back from him as to his reasoning. That being said, does anyone have a good cardiologist in NYC? I never actually met Dr. Petrie - he comes to my vet once a week to do echo's, reading of chest xrays, and auscultation. My vet acts as a liasion between myself and Dr. Petrie and think it may be best to have a cardiologist I can speak with myself.

Thank you all - it has been very difficult to get opinions from friends and family as they sometimes don't understand the disease processes and even if they do, it is hard for them to be objective as I am telling them the information I know from researching, not from there own research, so thank you for everyone who has posted not only on my threads but on previous threads as well.