DCM question about Marcus - Doberman Forum : Doberman Breed Dog Forums
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post #1 of 8 (permalink) Old 01-16-2020, 08:22 PM Thread Starter
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DCM question about Marcus

I am starting a new thread about my 1 1/2 year old Dobie, Marcus. 6 months ago, he was diagnosed with DCM. It was found by accident, because he ate my underwear, and it was discovered during an echo. His halter monitor confirmed problems with (sorry, I do not know the technical terms) with several incidents of afib. I can dig out the report, but it is not relevant. He also had a murmur.

He was started on Pembendon and Sotelol (sorry for the mis spelled words. My wonderful Vet that I found that handled the holder even told me that we might not want to have him neutered, even though the had a non descended testicle, because he might not live long enough to have the cancer risk factor in to our decision.

Several weeks ago, we had him re holterted. Miracle of miracles, it came out positive...no rhythm problems, and the murmur was gone. We decided to have him neutered. At her recommendation, we took him to a surgeon, rather that her or another Vet, because of having to put him under for longer to get the nondescended testicle. It cost A LOT OF MONEY. But, he is my very badly behaved baby.

We got a new echo. It came out positive. No signs of DCM.

That was a long story for my questions. I plan on calling my holter Vet and talking to her about this. The report from the cardiologist said to stop the Pembendon and to gradually take him him off of the Soteleol.

I am VERY reluctant to do this. Those drugs are what has put his heart into check. There is no canine cardiologist for hundreds of miles from Memphis. The report that the surgery center received was done by a physician that is not on the premises.

For those of you that know about these things, am I right in thinking this way? Are there side effects from Marcus staying on these drugs? My local Vet has zero knowledge about this, so I don't intend to even bring him into the conversation. Besides, his Vet Tech/manager got really snippy with me, when she found out that I had taken Marcus elsewhere and way buying his drugs elsewhere. They wanted to charge me about 6x what my halter Vet charged me.

I am happily mystified here. All of the tests were done by the same facilities.

Any input will be greatly appreciated. I want to be a little educated when I speak with my Vet.

Thanks

Susan
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post #2 of 8 (permalink) Old 01-16-2020, 09:04 PM
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It sounds like the vet who did your holter is not a cardiologist??

Would she be amenable to helping you find another cardiologist for a long-distance 2nd opinion consult? Maybe you could send various test results and have her provide her vet observations and skills in a group phone or skype type thing with a new cardiologist to get a second opinion?

I'm wondering if he was on any meds when his arrhythmia showed up (because of his unfortunate eating indiscretion ) I know there are some meds which give me an irregular heartbeat which then goes away when I get off the medication. Seems like a vet would think about that possibility though.

Last edited by melbrod; 01-17-2020 at 07:57 AM.
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post #3 of 8 (permalink) Old 01-17-2020, 11:04 AM
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Given the entire history of everything I've seen you post, both here and on Facebook...you need to see a cardiologist. Personally, I wouldn't care how far I drove, or what I spent. I'd stay overnight if needed. Just my opinion.
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post #4 of 8 (permalink) Old 01-17-2020, 11:49 AM
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I posted a long answer to your first post (the one on 9/13/19) I think you should go read it again.

Marcus was only a year at the time the non-cardiologists were doing a Holter and making diagnosis of DCM and putting him on meds.

I said and I'll say it again--very young dogs often (in fact at least one cardiologist to me MOST) show fairly bizarre symptoms when it comes to cardiac examinations--and it is directly related to the age and immaturity of the cardiac system. This includes things like murmurs, arrhythmias or afib (and actually while afib may occur in Dobermans their problems are more often vpc's)

I don't think it was a miracle nor do I think it was the cardiac drugs that have improved things. I would think it was more likely to have been the simple matter of the dog growing up. if I was doing this I would, at this point, take the advice of the cardiologist (I gather he was doing a phone consult and had the whole history?)

I don't know what your various vets have now said, but I can tell you, even though I am not a vet and not a cardiologist, that both the Vetmedin (pimobendan) and sotolol can have side effects that can be big problems if they are not actually needed.

I absolutely agree with MeadowCat that you need to get your Marcus in to see a cardiologist. And I find it hard to believe that there is no board certified cardiologist closer to Memphis than hundreds of miles (but frankly, if this was my dog and I was in your position of dealing with vets who know nothing about the meds, who aren't cardiologists but have decided to specialize in Dobermans so have a Holter--I have a Holter--anyone can buy a Holter--doesn't mean I'm qualified to make the recommendations you've had--MY OPINION, ONLY MY OPINION!)

I would be doing an internet search for a board certified cardiologist. If there is a vet school in Tennessee--they would have a cardiologist or might be able to refer you to one.

Find the closest cardiologist to you--make an appointment--get Marcus in to see the proper specialist. Get the appropriate advice from the right medical specialist. The vet with the Holter could do a Holter to take with you so the cardiologist has that information as well as the echo which they would perform. Cardiologists can make appropriate recommendations and give you correct information.

Please--for the sake of your dog--you need information that is correct and appropriate and so far you are getting bits and pieces which isn't entirely appropriate. I wish you the best of luck and hope you'll do the right thing.

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post #5 of 8 (permalink) Old 01-18-2020, 07:28 PM
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I will second what dobebug said!! The Vet cardiologist that does our club cardio clinics does not like to test dogs till they are over 2 years of age because there are too many false positive tests in very young dogs. Not to say that a young dog could not have cardio, they can...... just that false positives are common.
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post #6 of 8 (permalink) Old 01-22-2020, 02:10 PM Thread Starter
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Believe it or not, there is not a veterinary cardiologist in Memphis, nor is there one at the Veterinary College in Mississippi. The closest seems to be in Nashville.

He was not on medication at the time that the first monitor was done, nor was he on them at the time that the echo was done. The echo was done by a specialist here in Memphis. They sent the reports out to a cardiologist for an opinion. I will find out who it was sent to. My local Vet (now ex vet) is clueless, who said to me after we got the first report, "You are going to put him down when it is time, right"
My new Vet who holtered him, is not a cardiologist. But, she is knowledgeable about DCM and calls a cardiologist for consultation.

We probably will end up trying to call Nashville and making an appointment. But, both my husband and I are facing surgery in the next 2 weeks, and travel in a car for 3 to 4 hours with Marcus, will not be an easy or doable thing at this time. My husband is ill and will be having a pacemaker put in in two weeks.
I am just mystified at the totally different readings in the echo. I understand to monitor. The meds have helped his heartbeats and murmur. But, I do not understand the differences in the echo. That, as I understand it, is structural.
We have to take Marcus back to the specialty practice where he had the echo on Friday for a recheck from his surgery. Among all of his other problems, he had an undescended testicle, so we took him to a surgeon for the nutter, rather than a Vet at the recommendation of the Vet who holtered him.
I am totally confused right now.
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post #7 of 8 (permalink) Old 01-22-2020, 04:31 PM
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iluvMarcus123,

Geeze, what does the vet school do when they get to the segment on cardiology--bring in an outside vet just to do those classes? Pretty weird but never mind.

I suspect, as I said in my original post to you, that he was so young when you got the the first results--most vet cardiologist DO NOT RECCOMEND doing echos or Holters on very young dogs because the results are so often all over the map and don't always tend to be accurate. It takes time for the heart and it's electrical system to mature and along with all the other things that often present as problems in very young dogs you can and often do get wacky results on young dogs--Not all general practice vets know this and they freak out when they see results that would be frightening on older dogs.

Most cardiologists recommend starting testing between two and three years unless there is some pressing reason (symptoms for instance) to do so earlier.

I'm sorry to hear that both you and your husband are having your own health problems--and it will delay your ability to make the trip to Nashville but eventually you really need to have a cardiologist see Marcus--I think. Along with phone consults I think the cardiologist can do a better job of explaining the results of various testing at various times.

I still am not at all convinced that the meds Marcus was put on actually help anything. Vetmedin (pimibendin) has been contraindicated prior to the onset of actual DCM--there have been and still are ongoing studies to see if medicating before indications of problems actually prolongs life--the just still seems to be out on that. And sotolol, as I understand it should not be used in the absense of arrhythmeia. Sotolol is one of the more benign antiarrhythmia drugs but neither one is something that would cure murmurs or heartbeat issues.

Surgeons usually use equipment when doing surgery on a dog with known cardiac issues--that lets them see what is going on during the surgery--and there is usually someone monitoring the equipment during the surgery. It's only a guess on my part but I'm guessing because the surgeon wasn't seeing the problems that had you using a surgeon instead of a general practice vet for the neuter he contacted the cardiologist for an opinion.

The very short version is, that in general cardio monitoring is the best way to see what is going on with a dog and cardio and you are very likely to get false positives if the dog is very young when you are doing this.

Normally starting early (between two and three years with an echo and Holter) and doing this yearly allows your cardiologist to identify problems as they start to appear and the dog can be medicated properly which will usually extend the life of the dog.

Murmurs in puppies are a good example of this--most mild murmurs disappear as the heart matures--at the clinic where I've worked for 16 years if it's anything other than a very mild murmur the recommendation would be to wait and recheck--if it gets worse our vets would immediately refer to one of the 5 (I guess Portland is lucky) board certified cardiologists in or immediately near Portland. Very bad murmurs in puppies usually means a very bad or very defective valve and while I know of occasional heart surgery done on dogs it's pretty rare.

That's kind of why you want a cardiologist to make that kind of call.

Good luck on your husbands pacemaker--I've heard that results are often pretty immediate.

Keep us posted on Marcus's situations--often one persons problem with their do is one that someone else has and more information is always helpful.

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post #8 of 8 (permalink) Old 01-23-2020, 02:29 PM Thread Starter
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When my husband's new cardiologist told us that he had DCM, I knew exactly what he was talking about, because the Vet that put on the holter monitor explained it to me. Ha Ha. Lucky me.
Marcus had some pretty significant arrhythmeias on the first monitor. They are clear now. He has had health problems from day 1, which is why we have been proactive and cautious with him. We probably should have returned him when we were told that he had pneumonia 2 days after we brought him home. But, we were in love, and did not. He was the only puppy that survived from the litter. ( I may be repeating my self here). It has been one issue after another.
On top of that, he is super crazy. Perhaps exuberant is a better word. He was not raised with a mother or littermates. They took her away, because she was licking him too hard (so they said ha ha) So, he was bottle fed and spoiled.
Anyway, thanks for your information. I never know what to think with this dog. Super smart and super bad. But, we love him.
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