22nd January 2014, 07:54 AM
MCD update... Wheezing?
So elizabeth was back at the vets yesterday for a review (14 days of taking fortekur and prilactone.)
She has been diagnosed with MVD and suffering with early stages of CHF.
I saw a different vet this time as previous vet was only Locum.
Recently- say 3 days ago elizabeth has started wheezing a lot and panting more regularly, a week after taking her meds she waa like a different dog, running on walks etc. now she is wheezing and panting on her walks after 5 mins. I dont understand, how can things be on a downwards spiral so quickly when a week ago she was 'loving life.'
the vet was not overly concerned but admitted there was effort with her breathing.
Someone on here mentioned vetmadin- i mentioned this to my vet whom said this is just an expensive drug, the prilactone is just as good??
can anyone offer me some advise, i am doing everything by the book; cut her food down, raised her bowls, regular walks. Shes also lost a bag of sugar in weight (intentionally- she was overweight!)
Shes also drinking more, is this a side effect of the meds? The vet has asked me to record daily how much she is drinking over 10 days then decide if blood tests are required.
feeling very sad at the mo, so worried about my best friend- can anyone shed some light?
p.s title was meant to say MVD- sorry!
22nd January 2014, 10:29 AM
Hiya, Leo is on vetmedin....it is not an experimental drug...its newly licenced I believe. Leo is doing remarkable well on it. I know that may be short lived but at the moment (he's been on it since beginning of December) he's responded brilliantly. He's also on Cardalis and Frusemide, starting on 40mg a day we've now cut it down to 20mg a day and he's remained stable. The wheeze would suggest fluid build up in her lungs or her trachea being squeezed by her enlarged heart. I know its frightening but once her meds have been tweeked she may improve......
Others here have much more knowledge than me Im new to MVD too.
Keep us upto date with Elizabeth
Mumma to Leonardo (Leo to his friends)
Waiting at the bridge
22nd January 2014, 11:34 AM
Thanks Mel, know you have commented on a couple of my threads and would just like to thankyou for the advice. It's comforting to know I am not the only one going through this difficult time. So glad to hear Leo is getting on well, I regularly check your updates that you've been posting on him. I will be sure to keep you updated on Elizabeth.
I did mention a fluid build up to the vet, but she said when she listened to her heart she could not detect any fluid - as this normally sounds like a bubbly/popping noise apparently- she said if I would like i could try meds to remove the fluid that may be present but this can be destructive on the kidney, which has really put me off. So confused - just want whats best for my little lady!
22nd January 2014, 12:46 PM
The drinking could be drug-related. I am quite surprised that a UK vet would say that Vetmedin "is just an expensive drug". It has been around a long time in the UK (it also goes by the brand name Cardisure, and its generic name is pimobendan). It is a miracle drug for many dogs in CHF. I know of no drug that compares to it.
Read about it here: http://cavalierhealth.org/mitral_val...tm#A_Few_Words
22nd January 2014, 01:30 PM
Also: prilactone is a COMPLETELY different drug used for entirely different results than Vetmedin.
Hmmm -- I'd change vets.
First off, prilactone is generally not used initially at all unless there are specialist reasons for needing it to help remove retained water (sigh -- so why did a vet put her on it in the first place if not for fluid?). Usually it is introduced at a far later point in the care regime for a dog with MVD as it helps with water retained in the belly, or boosts the working of frusemide. IF and only IF your dog is actually retaining water on the lungs or internally etc should she be on this class of drug. But the starting drug is generally frusemide, which is far less costly than prilactone as well.
Vetmedin is a very important drug for the management of MVD but is generally given when the dog has gone some distance down the journey of having MVD and is approaching or in congestive heart failure or if the cardiologist feels there is a good reason to give it. It helps support the working of the heart and has nothing to do with removing fluid.
What you have heard back is to me, a real highlighting of why it is very much worth asking for an immediate referral to a vet cardiologist. Vets are generally mediocre to poor at managing heart disease and from what Elizabeth is on, it sounds like neither really knows much about long term management of heart disease. Difficulty breathing and wheezing is exactly what a cardio would want to investigate further.
At the very least do go see a cardiologist for an auscultation (listening by stethoscope) as this is NOT expensive and will give you 10 times the information and 100 times the expertise in management. If your vet won't make a referral you can ring the nearest cardiologist and make an appointment yourself/.
I've just had six cavaliers here to the vet cardiologist and the cost for each was the same as a vet visit (actually he gave me a discount for the number I brought in). We actually discussed the issue of when to use prilactone. He also has put one of my foster cavaliers with a strong murmur on her right side of her heart, on low dose vetmedin in advance of CHF because he feels it may help support the heart and slow any worsening. Left side murmurs are of greatest concern.
Most vets can only tell you the dog has a murmur -- not which side, cannot give a really accurate grade, miss early grade murmurs (two vets told me two of mine were heart clear recently, but the cardio easily picked up grade 1 and 2 murmurs), and are not adept at prescribing meds to maximise benefit to the dog. Most actually stick dogs on meds simply because they have a murmur which is wrong and can even hasten decline (and is a waste of money as well). My cardio went through a detailed rundown for each dog, including where they are at and what to watch and listen for to indicate they need to go back in for assessment again. So worth every cent!
My guess is that if you see a cardio you will feel far happier, have a better sense of where Elizabeth is at and the timeframe for decline, the best possible management approach, and a proper medication regime that will like mean frusemide, Fortekor, and if CHF has started, low dose Vetmedin. (but that is a guess of course).
In memory: Lucy
22nd January 2014, 01:46 PM
Thankyou everyone for the advice - i think i may seriously think about changing vets! Is the vetmedin expensive like my vet said, or was this also wrong information?
Can anyone else clarify meds for removing water of lungs being destructive on the liver?
I am now seriously doubting everything my vet said on monday!
22nd January 2014, 02:38 PM
I too have a dog with MVD and has been on medication since he was nearly 10 yrs old, he has 1 5 mg Fortekor per day 1 20mg of Frusimede per day which was up until October last year on varying doses from as little as a quarter a day. He was quite poorly in October last year and Vetmedin 1.25 mg was added - he takes 2 per day and I must say his coughing has improved - he actually has been to the Vets this morning for his 3 month check and his review of medication and the Vet is quite happy that the Vetmedin has helped him, my dog is a good age - he will be 14 yrs old in March. I get my medication through my Vet and the Fortekor tablets are about £1.00 each and the Vetmedin is not as much as that - I pay about £46 for 100 tablets. I hope this is of some help to you.
22nd January 2014, 04:25 PM
22nd January 2014, 08:58 PM
If you find a new vet who doesn't charge the earth for prescriptions, it can be very much cheaper to get a prescription and buy through a reliable online pharmacy such as Hyperdrug or several others. My vets charge between £6.90 and £3.70 for a prescription, depending how many I buy at one go (both my Cavaliers have SM and eye problems, so they need a lot of medication!).
Is Elizabeth insured? If so, have a talk to your insurers and see whether they will pay for the drugs - otherwise it can get very expensive if she lives for several more years like Pam's Jasper (let's hope she will!). Two of my Cavaliers have died of CHF, but that was in the 1990s and there are more drugs available now to keep them going, happy and comfortable.
Kate, Oliver and Aled
23rd January 2014, 12:11 AM
My Pippin is in early stage heart failure but doing well for the moment on Cardisure and Cardalis. My vet has done doppler scans and ecg's on him and could see that his heart had enlarged, his mitral valve on the left side had weakened a little more and he had the start of some fluid in his lungs. He was already on Cardisure after the first scan two years ago and was back to my vet three weeks after the last scan and she could hear after examination that his lungs were clear.
As others have said the two medications, vetmedin (cardisure) and prilactone are different medications and are to treat different things. I would question your vet on that if I were you and change vets if you don't get a proper answer.
I live in Ireland but the cardisure is not overly expensive I pay about the same price for the heart meds in euro as Mel does for Leo in pounds so it's more or less equal.
You are not alone in this there are sadly a few of us here with dogs in the same boat and at the same stage in the disease
I hope with medications we get to spend a lot more time with our precious companions.