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Old 09-29-2012, 08:13 AM   #1 (permalink)
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Guidance requested for care of cardio myothopi diagnosis

After 3 weeks of suffering with acute onset respiratory distress and upon visit to our third referral vet a diagnosis of congestive heart failure was received. I am prepared to discuss specific lab values, the details and findings of the physical exam, xrays et cetera. Specifically, what Alex is faced with is right atrium enlargement. His heart is huge greater than 14 centimeters, on xray the heart is very indistinct the margins are unclear he is full of fluid.

Initial treatment has been lasix and an ace inhibitor. After 2 doses for 1 day of medication his response is remarkable. He's improvement is dramatic.

My background that includes work as a critical care paramedic and other medical and other places me in agu wonderful position to understand and work towards remediating this medical condition. I do not however, wish to reinvent the wheel. I am looking for input from other persons who have experience handling such a medical condition as this as relates to diet, medication et cceteraui
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Old 09-29-2012, 10:22 AM   #2 (permalink)
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Sorry to hear your diagnosis, DCM sucks.

I'd ask your vet about putting your dog on Vetmedin. It works by opening up the blood vessels carrying blood to & from the heart, which reduces the work the dogs heart needs to do to pump blood around the body. It also helps with their appetite, something dogs in CHF suffer with. We were also told to feed a low salt diet, which we did.

My boy was put on Vetmedin & it did wonders for him for about 3 months along with the other drugs he was prescribed. Ultimately, the build up of fluid in his lungs couldn't be controlled & at that point we let him go.

I would also recommend that you get an appt with a cardiologist to get a 24hr holter monitor fitted. This will tell you exctly what's going on with the heart & whether your dobe is at risk of sudden death.

There is never a good outcome with DCM, it's an awful disease.
I'm so sorry you're going through this.
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Old 09-29-2012, 11:18 AM   #3 (permalink)
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Originally Posted by Jors_greene View Post
After 3 weeks of suffering with acute onset respiratory distress and upon visit to our third referral vet a diagnosis of congestive heart failure was received. I am prepared to discuss specific lab values, the details and findings of the physical exam, xrays et cetera. Specifically, what Alex is faced with is right atrium enlargement. His heart is huge greater than 14 centimeters, on xray the heart is very indistinct the margins are unclear he is full of fluid.

Initial treatment has been lasix and an ace inhibitor. After 2 doses for 1 day of medication his response is remarkable. He's improvement is dramatic.

My background that includes work as a critical care paramedic and other medical and other places me in agu wonderful position to understand and work towards remediating this medical condition. I do not however, wish to reinvent the wheel. I am looking for input from other persons who have experience handling such a medical condition as this as relates to diet, medication et cceteraui
This took 3 vets to diagnose? Am I understanding you correctly?

What I would suggest is you get your dog to a cardiologist, if you can. You need specific help with this situation. What I can say about the lasix is that it does remedy the situation.....temporarily. I want you to understand that once these symptoms start and the heart is compromised you are on borrowed time. That is why getting to a cardiologist that can get your dog on the best med combo possible is imperative. That may include Vetmedin.

Once the heart is at a stage that it is failing the meds help for a while but lose effectiveness as time goes by. The reality is your dog has only a few months...I don't tell you that to hurt you, only so you can make the most of the time you do have. Love him to pieces.

I would say nearly all of us here on DT have dealt with this situation or know someone who has. All the best to you. We all here know what you are going through.
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Old 09-29-2012, 11:36 AM   #4 (permalink)
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I just lost my dog Tyson last month from DCM....it's the most horrible thing I have ever experienced. We had 2 months after the diagnosis, that's it. Even with Vetmedin, Lasix, Digoxin, Enalipril...it works for a while and then just doesn't. I wish you the very best, although I know your heart will be broken.

Everyone here on this forum is wonderful and supportive, it's really a fabulous group of Dber-lovers! My heart is with you.
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Old 09-29-2012, 11:42 AM   #5 (permalink)
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I just lost my dog Tyson last month from DCM....it's the most horrible thing I have ever experienced. We had 2 months after the diagnosis, that's it. Even with Vetmedin, Lasix, Digoxin, Enalipril...it works for a while and then just doesn't. I wish you the very best, although I know your heart will be broken.

Everyone here on this forum is wonderful and supportive, it's really a fabulous group of Dber-lovers! My heart is with you.
The key to somewhat managing this disease is to catch it early. Holter and Ultrasound on all dogs annually after a baseline at two. The earlier you catch the disease the better the treatments work and the longer the dog will live.

Been there too. Best of luck OP.
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Old 09-30-2012, 08:33 AM   #6 (permalink)
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Everyone, I thank you for all of your input and kind words.
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Old 09-30-2012, 09:25 AM   #7 (permalink)
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The key to somewhat managing this disease is to catch it early. Holter and Ultrasound on all dogs annually after a baseline at two. The earlier you catch the disease the better the treatments work and the longer the dog will live.

Been there too. Best of luck OP.
So very sorry to read this. But, yes, early detection by holters and echos is the key. My Baron was diagnosed with early onset DCM a little over a year ago at 4 1/2 years after doing his first holter and echo and in a year with meds his arrhythmias went from 987 to 4. As suggested, I would try to get Alex to a cardiologist as soon as possible. Sending lots of good thoughts and prayers for Alex.
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Old 09-30-2012, 09:56 AM   #8 (permalink)
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sorry to hear this, I lost my 8yr old to dcm may 26 this year while we were walking. He was diagnosed a year ago and was not expected to live as long as he did. I contribute that to the great care of a cardiologist who treated him. I will never forget everyones astonishment at him living so long with this disease as well as chronic active hepatitis and also he had a ventral slot 3 years before. I do know the doc said the Vetmedin was the medication keeping him going, as well as a number of other medications. I agree with everyone else you need to see a cardiologist for his care. Good luck to you and Alex.
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Old 10-01-2012, 02:53 PM   #9 (permalink)
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Currently we are at Purdue University Vet School awaiting cardiologist consulation. Waiting rooms and waiting hours (or what seems like) in the exam room are not my thing.
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Old 10-02-2012, 07:20 AM   #10 (permalink)
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How did the consultation go?
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Old 10-02-2012, 04:30 PM   #11 (permalink)
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We are now about 24 hours post cardiologists consultation. The news was as expected which is to say not good but realistic. While Alex remains at risk for sudden cardiac death his overall condition is dramatically vastly improved.

Vetmedpin Was prescribed. With a total daily dose of 15 milligrams. His dosage of Lasix was doubled. THE ACE inhibitor was discontinued.

At this point in time, his condition is dramatically improved. His heart rate his back at 100. Previously, his resting heart rate was150. Is respiratory rate has gone from 60 to20. His gums have gone from bluish gray to warm and pink. His appetite is returning. He is eating he hasn't eaten well in 3 weeks.

The cardiologists prognosis was 2 months. Alex is not only my companion and family member but my working service animal.. this situation is tearing my guts out I can't describe how sick I am right now.
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Old 10-02-2012, 04:47 PM   #12 (permalink)
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Im so sorry your boy has dcm, my girl was diagnosed 7 weeks ago and is on vetmedin and frusimide which have helped her tremendously, there is so much help and support on here and people are only too happy to help.
Wishing you lots of happy times with Alex. x
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Old 10-02-2012, 05:16 PM   #13 (permalink)
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Glad to hear you were prescribed Vetmedin, sounds like it's helping already. It's great his appetite has picked up, it's always a worry keeping a dog in CHF eating.
My advice to you is treasure every moment with Alex, spoil him rotten & give him all the love you can. I know this is tearing you apart. Try to stay strong, Alex needs you. We are here for you if you need the support.

Sending big hugs to you & Alex.
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Old 10-02-2012, 05:20 PM   #14 (permalink)
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Im so sorry your boy has dcm, my girl was diagnosed 7 weeks ago and is on vetmedin and frusimide which have helped her tremendously, there is so much help and support on here and people are only too happy to help.
Wishing you lots of happy times with Alex. x
Hi dobiemads, How is your girl doing? I've been thinking about her & wondering how she was?
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Old 10-16-2012, 01:20 PM   #15 (permalink)
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We are now about 24 hours post cardiologists consultation. The news was as expected which is to say not good but realistic. While Alex remains at risk for sudden cardiac death his overall condition is dramatically vastly improved.

Vetmedpin Was prescribed. With a total daily dose of 15 milligrams. His dosage of Lasix was doubled. THE ACE inhibitor was discontinued.

At this point in time, his condition is dramatically improved. His heart rate his back at 100. Previously, his resting heart rate was150. Is respiratory rate has gone from 60 to20. His gums have gone from bluish gray to warm and pink. His appetite is returning. He is eating he hasn't eaten well in 3 weeks.

The cardiologists prognosis was 2 months. Alex is not only my companion and family member but my working service animal.. this situation is tearing my guts out I can't describe how sick I am right now.

Boy does my heart go out to you. We are dealing with this right now too. Klaus was diagnosed with DCM in July and we have been working through it day by day. I would love to know how your boy is doing now.
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Old 12-25-2012, 09:58 AM   #16 (permalink)
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Guys it has been sometime since ive been on and posted. My renewed thanks and appreciation to all.

Of course, Alex continues to deteriorate but is holding his own. His heart rate climbs ever higher, his fluid retention ever greater. His current prescribed is 15mg vetmedin and 100 mg lasis split into an am and a pm administration.

A few days ago we began supplemental oxygen administration using a 2 nd hand oxygen concentrator for and a home made snout mask. He is respondibg very well to the oxygen with decreased heart rate, respiratory rate and improved capillary refill is -dramatically gorgeous pink lips and gums.

A couple times a week i season his food with No- Salt to supplement his pottassium that lasix is notorious for depleting.

Thanks for caring! Expect future updates.
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Old 12-25-2012, 10:33 AM   #17 (permalink)
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Best of luck to you and Alex--as others have said cardio has no good end but at least the diagnostics and available meds are infinitely better than they were for my first Dobe who is the only one I actually lost to to DCM/CHF.

I expect that the vets at Purdue already told you that in Dobes heart failure from atrial enlargement is relatively uncommon--and usually indicates that the condition has been there and been compensated for, for some time. Most Dobe cardio involves the ventricular enlargement. Atrial disease is much more common in Boxers and is a major cause of death in that breed.

Loss of appetite is common and eventually the solution ends up feeding whatever the dog will eat. Several people have found that things like frosted mini-wheat cereal (which is pretty low salt) is something that will pick up appetite--stinky cat food, rinsed canned mackeral, salmon or sardines appeal to some dogs.

Good luck and keep him happy...just do the best you can--at least you have the credentials to understand the physiology of this kind of disease.

From me and my dogs to you and Alex...
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Old 12-25-2012, 12:54 PM   #18 (permalink)
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I feel compelled to comment a bit more about Purdue. Their emergency department and the subsuquent cardiologist have been incredibly unresponsive and unhelpful.

Over the past three months I easily have a dozen or more unreturned phone calls placed either directly to the cardiologist, dr lauura ilie and her department. Her bedside manor in no uncertain terms sucks and has been far from professional..

Following up on potassium depletion and info such as how dar the orogression is in consideration of the atrium enlargement has come from sources such as this.

Furthermore, my clear impression from purdue has been that unless you vast funds you are second class. Ive spent a considerable amount thereand when money slowed down -to not ranout- service declined very dramatically.
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Old 12-25-2012, 04:53 PM   #19 (permalink)
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So very sorry to read this update regarding Alex's cardiology care. Is there somewhere else in your region to get a second opinion? Hopefully, someone else will chime in with some more information to help. We were extremely lucky to have found a cardiologist who is wonderful. We have moved and it is now a 3 hour drive but for us it is worth the drive. Hope you can find someone you can feel comfortable with. My thoughts and prayers are with you.
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Lois and Baron

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Baron #1, Lonesome, Dax, and Misty Waiting at the Bridge
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