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Our Cavalier has been diagnosed with heart trouble

And thanks for your last post cwaters. This sounds very much like my Leo -- started him on meds because of coughing, but am not sure I think it is entirely due to MVD. I wonder if the meds are actually making it harder for him to function... anxious now to get him to the cardio.
You're welcome. I hope the information is helpful to you and to Leo.

Personally, I feel helpless and a bit frustrated not knowing what's causing the coughing ... and which direction to go. I don't like the idea of 'experimenting' on Freckles, changing / reducing the Furosemide (and, perhaps later, the Enalapril) ... and then wait to see if her condition worsens; on the other hand, there doesn't appear to be any other way to know if the medications are accomplishing anything--I certainly don't want to give her medications if that's the case. (Prior to her going on those drugs her breathing rate was good--and it still is. In monitoring her condition I'm relying on that fact perhaps more than anything else.) On the other hand, I can't ignore the fact that she has an enlarged heart and some fluid; but are the medications premature to treat those symptoms at this point? Perhaps her condition needs to worsen before anything more need or can be done.

I'm certainly finding Karlin's words to be true (earlier in this thread):
...Heart disease is such an up and down journey...
 
Rod, interesting that you note the contractibility aspect in post #31. My Leo has gone downhill very quickly with MVD, but am wondering if he should just be on frusemide and fortekor (actually he's on Nelio, benazepril). He has started vibrating too with his heartbeat very noticeable, shaking him when at rest. He's only on 1.25 mg of Cardisure 2x but don;t remember him having this noticeable a heartbeat. I am away with the dogs in the UK and making an appt with the cardio for as soon as possible next week when I am back but perhaps on this basis should try halving the cardisure... He is now exercise intolerant and has strong exhalations though resting resp rate is 30ish or below. I wonder if he is on the wrong mix.

Karlin, you might ask the vet about reducing the Cardisure (pimobendan) dosage, but I think the way to determine the adequate strength of the heart, and the affect of the Cardisure upon it, is an ultrasound. He sounds like he could be in CHF, with the exercise intolerance, but our MVD dogs typically have shown reduced inclination to exercise long before they really are in CHF. And, of course, the respiratory rate above 30 per minute is considered a key determinate of CHF these days.
 
You're welcome. I hope the information is helpful to you and to Leo.

Personally, I feel helpless and a bit frustrated not knowing what's causing the coughing ... and which direction to go. I don't like the idea of 'experimenting' on Freckles, changing / reducing the Furosemide (and, perhaps later, the Enalapril) ... and then wait to see if her condition worsens; on the other hand, there doesn't appear to be any other way to know if the medications are accomplishing anything--I certainly don't want to give her medications if that's the case. (Prior to her going on those drugs her breathing rate was good--and it still is. In monitoring her condition I'm relying on that fact perhaps more than anything else.) On the other hand, I can't ignore the fact that she has an enlarged heart and some fluid; but are the medications premature to treat those symptoms at this point? Perhaps her condition needs to worsen before anything more need or can be done.

Coughing is a very common problem for dogs with MVD as it progresses. In many cases prior to heart failure (HF), the coughing is attributed to the enlarged heart impinging upon the breathing apparatus. Sometimes, for dogs in HF, the pimo (and to a lesser extent, the ACE-inhibitor) will somewhat reduce the heart size and thereby resolve the cough. Otherwise, cough suppressants may be prescribed.
 
Thanks for the detail, very helpful. I rang the cardio earlier this afternoon (I am away from Dublin for the week but have Leo and the other dogs with me in the UK) and he is going to talk to my vet and then come back to me with a recommendation. I explained my concern about whether the Cardisure might be premature.

My worry is that either Leo is not on an adequate dosage of the various meds, or is on too much. Overall, he has tipped into needing meds very quickly after remaining stable for several years with a grade 3-4 murmur. The cardio was surprised when I was there a few months back, that Leo hadn't progressed more. I fear he will be one of those cavaliers who fails quickly now -- I've had a couple that took between 10 months to 3 years.

I'll post back on what the cardio says, in case it is useful for others.
 
Thanks for the detail, very helpful. I rang the cardio earlier this afternoon (I am away from Dublin for the week but have Leo and the other dogs with me in the UK) and he is going to talk to my vet and then come back to me with a recommendation. I explained my concern about whether the Cardisure might be premature.

My worry is that either Leo is not on an adequate dosage of the various meds, or is on too much. Overall, he has tipped into needing meds very quickly after remaining stable for several years with a grade 3-4 murmur. The cardio was surprised when I was there a few months back, that Leo hadn't progressed more. I fear he will be one of those cavaliers who fails quickly now -- I've had a couple that took between 10 months to 3 years.

I'll post back on what the cardio says, in case it is useful for others.

Sorry to read this Karlin. I would be interested to know what the out come is. My Leo is doing remarkably well on his meds but I would like to know what options there are for when things start going wrong :(
Im no expert so I rely on the vet/cardio advice on what to give Leo. He had a cardio check last week and she was delighted with him. His chest was clear and his resps low, she also said his heart rate was good He also bounded up the stairs to greet her :)
Ive got my fingers crossed that you can get Leo stable again X
 
Karlin, sorry to hear that Leo isn't doing well. Hopefully, when you speak with your cardiologist, they will be able to tweak or change his meds and make him much more comfortable.
 
I know I've said it before, but when I read all these posts on MVD I am so thankful that none of my dogs has it. Oz (at 7 years old) has a congenital murmur that has not progressed since it was diagnosed when he was 4 months old. His cardiologist said he doesn't even need to see him any more. My other three are oldies at 13 years old, 12 next month, and 11 in two months and MVD clear. I feel blessed. And I'm so sorry for all of you who have dogs who are struggling. My heart aches for you.
 
...respiratory rate above 30 per minute is considered a key determinate of CHF these days.

When I measure Freckles' breathing rate, I count the number of breaths during a 15 second interval, then multiply by four. I do this when she is sleeping (and sometimes snoring loudly, BTW; it's a wonder she doesn't wake herself up). So far, she is remaining at 16-20 breaths per minute. Occasionally, she breathes faster; however, I've been ignoring those times because she seems to be dreaming; i.e., her legs twitch, her eyes 'dance' underneath partially closed eyelids, etc. Am I correct to not measure her breaths during those times of escalated activity? I want to make sure I'm being realistic in measuring.
 
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That's the right way -- when totally relaxed. That's a good respiratory rate! Dreams get them a bit excited sometimes... :lol:. Leo's has dropped to about 20 but he does harder exhalations each time.

Every one of my 7 cavaliers I've had, has had MVD eventually. All the current 6 have it, at age 9+. Two of them have murmurs at only about grade 1 and so slight the cardio noted he was really impressed and would love to see all cavaliers come in at that age with murmurs that negligible. I suppose at their age, they probably fall into the level that is likely for any older dog to acquire heart murmurs -- most small breeds in particular have a higher risk, but not as widespread as cavaliers. So, the two best hearts in the gang are 1) the ex puppy farm cavalier; 2) the obviously BYB-bred cavalier from the pound. So much for breeder arguments that all the heart and SM problems centre primarily on BYB and puppy farm dogs!! ... setting aside a small subset of breeders that do truly breed for health and test and follow protocols, who do indeed get statistically significant results (and are the reason why it is soooo important to support health-focused breeders). I continue to think there could be good genetic health out there in some of the random-bred dogs that should be brought back into the fold, but this would involve testing programmes and a major change of accepted thinking in breed clubs.
 
Hi Karlin,Pippins breathing is about 18 -22 but he sucks his whole chest in on exhaling is that what Leo does? He was with the vet 2 weeks ago for an unexpected visit (anal gland abscess) and she was happy that his heart was stable considering, he is due check up at the end of the month.
 
Hey cwaters,

I've only had our 8 year old male CKCS (Ziggy) a year and he came to us with a grade 3 heart murmour and a prescription for both vetmedin and furosemide. He has both twice a day and his heart murmour hasn't changed in grade during that time. I'd say that if a vet recommended and prescribed it, I would give it to him. It certainly hasn't done my little chap any harm, although he does have a cough about 10 times a day.

Ta,

Ben
 
I think our Ziggy is at 20 breaths per minute (might have to check with the vet). He's got a grade 3 murmour and the vet said his breathing was textbook. She also said it's good to get an idea of what his normal behaviour is in case things change - sounds ominous.
 
We've noticed that Freckles has become a bit restless over the last year or so; we figured it was due to age and/or the minor arthritis in her hips she was diagnosed with a few years ago. Over the same about of time, she has also begun favoring lying on harder surfaces instead of in her bed or on our bed--although she still does use the beds quite a bit. It's difficult sometimes to know what things are typical for her vs age-related vs boredom vs something else. Can restlessness--and favoring harder surfaces--be additional indicators of CHF?

This is so like Buddy right now. If you're back on line I'd love to hear how Freckles is doing now.
 
Sorry for the delay in responding; I was away on vacation ... and then had to recover from being on vacation. :)

I've been meaning to post an update on this thread for many weeks. In my last significant post I mentioned my having a long conversation with Freckles' cardiologist--and her agreeing that it was premature to begin administering Vetmedin. Freckles' vet was surprised at this; she suggested I get a second opinion--which I did.

The second cardiologist is board-certified, is on the staff at the University of Pennsylvania School of Veterinary Medicine, and has treated approximately 750 Cavaliers. She examined Freckles and considers her to be in Stage B1 of degenerative valve disease--not Stage B2, as the first cardiologist, as well as Freckles vet, believed. She also doesn't think that Freckles needs to be on any heart medication; she recommended weaning her off the medication over the period of a week--which I did. She instructed me to continue to monitor and record Freckles' at-rest breathing rate. She believes the cough is likely due to a "bronchial disease" (i.e., not the MVD) and that symptoms from such can be treated with a prescription cough suppressant, if necessary. If Freckles' condition remains stable, the cardiologist recommends a follow-up visit in 12 months. Needless to say, I was very relieved and happy with this second opinion! That was about five weeks ago. Since that time, Freckles seems to be doing about the same; an occasional cough and an excellent at-rest breathing rate.

To your point karen100, Freckles continues to be a bit restless. She can be fine for hours on end; other times, she seems to move around every 10-15 minutes. I'm still not sure why that is. Sometimes I wonder if it's the summer heat and/or humidity; if so, perhaps the restlessness will decrease as the colder weather returns.

Interestingly, when I first arrived home from vacation after being away for a week (during which time I had a house/dog-sitter), Freckles seemed less restless, cuddling against me for very long periods of time--something I neglected to mention in this thread that she had stopped doing at about the same time the restlessness began. I guess her relief at my being home 'won out' over her restlessness. Now that things are back to normal, her cuddling against me has gone back to being for only short periods of time. Harrumph!
 
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