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Can someone tell me what constitutes a positive diagnosis of DCM. What does the bed have to see or what has to come black on the blood work in order for a positive diagnosis for DCM. I do not know what is wrong with my pup. She only has these collapsing spills every now and again now. Those have pretty much subsided. Now she seems to have the seizure type things whenever she is most excited. That may be a whole separate issue. What I noticed now is she is just really out of breath easily. Has anyone ever had a Doberman that just didn't have that much Energy? If I take her out in the back and start playing with her with the water hose she will chase the water stream around for a good five minutes and then she is just Raggett out of breath. She will stumble with her tongue hanging out in her bag and will want to sit downbut she tries to keep going and I can tell she is tired. I'm not going to A&M to get this holter test only for her to not have an episode in the 24 hours that I have it. I can pretty much guarantee that's what's going to happen. It's almost as if a bit has two actually see her have an episode before they can guess what is wrong. And then it's just a guess. Pretty frustrating because in my line of work I can't go out and guess what's wrong at peoples houses in charge of the money for it and tell them maybe this'll make it better. I can't do that. It's frustrating. My pup comes in from walking in and immediately lays down on the floor on her side. Any activity we do she comes in and plops down on the floor immediately. I noticed her breathing last couple days it's kind of ragged. Like I can hear her breathing we're normally I couldn't. Otherwise she seems to be normal. She has a great appetite always wants to eat. Will initiate play with those all the time-she just can't really go for very long. I'm going to look at her bloodtest when I get back to see if I can see anything maybe the vet missed. Not sure if I can even read it but we will see. Google is amazing-hasn't been much help with my issue here though. Are use talk to text while driving so excuse my misspellings or punctuation errors. Thanks in advance


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To receive an accurate diagnosis and prognosis of DCM, you need a preliminary diagnosis followed by (usually) an echocardiogram/ EKG (ECG) and a 24 hr Holter monitor w/ interpretation. When our boy, who passed a few years ago had a serious cardiac episode, his follow-up, which occurred quickly, involved both of those procedures. His subsequent prognosis changed from "extremely poor" to one with a hope of some longevity and a reasonably healthy life, which is exactly what occurred.

Best to you and Haven

John
Portland OR
 

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chances are the Holter will pick things up if they're there to be found. I am so incredibly sorry she's experiencing all this, she's so young, I just want to cry for all of you! As for a Holter, I'm going to be using the service from NCState University, it's 150.00 to rent the equipment, and have a cardiologist read the results. It might be an option if the testing at A&M is a lot higher?

Sending Haven lots of hugs, please give her a kiss from me!
 

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reading this makes my eyes wet.
We lost our beautiful Leila in February at only 4 yo to DCM.
If it's any consolation, thank god your are going to find out early on.
A very good friends male was diagnosed, and treated. He is now 7 !!!
The vet figures he only has a year left.
Seven is still to young, but he has had a great life, and given them so much enjoyment.
Find a good cardiologist, do your DNA testing, ECHO, and holter, and we hope you get ahead of it, what ever it is quickly.
DCM is a terrible disease. Our friends boy was clear of all of the genes, and developed it later in his life.
 

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Very much hoping for your pup and you this isn't DCM but you need to find out. Do not waste money on vets that aren't well versed with Doberman and DCM. I did once and it delayed diagnosis, shortened the dogs lifespan and cost me thousands. I know better now.

Just because she isn't visibly displaying anything odd in a 24 hr period that doesn't mean a holter wouldn't be capturing data for things you cannot see.

Good luck.
 

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I also do the proBNP to keep an eye on things. clinics offer it as part of a 'senior package' that also checks liver, kidney and thyroid among other things for about 140.00 around here.
 

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The reason we are recommending a cardiologist is because DCM is diagnosed primarily through two tests - an echocardiogram and a 24 hour holter monitor reading. The echocardiogram gives one "picture" for the cardiologist to look at, and the 24 hour holter monitor another. They really work together to give a full picture of what the heart is doing, and you can't get a very accurate picture with only one - it's only "half" the story. And no, it really isn't very normal for your dog to be that tired - there is something going on with her that isn't normal. None of us can tell you what's going on, but if this was my dog I would have already been to a cardiologist to have both of these done. I KNOW it's expensive, but the symptoms you are describing are very worrisome. It's certainly possible it's not her heart, but I would rather rule that out than have it be her heart and not know. Because it's also possible that it is, given what you are seeing and describing and videoing.

Just my two cents. Hopefully some of our more science savvy folks can explain in more detail exactly why both an echo and holter are needed to get a picture of what's going on.
 

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Can someone tell me what constitutes a positive diagnosis of DCM. What does the bed have to see or what has to come black on the blood work in order for a positive diagnosis for DCM. I do not know what is wrong with my pup. She only has these collapsing spills every now and again now. Those have pretty much subsided. Now she seems to have the seizure type things whenever she is most excited. That may be a whole separate issue. What I noticed now is she is just really out of breath easily. Has anyone ever had a Doberman that just didn't have that much Energy? If I take her out in the back and start playing with her with the water hose she will chase the water stream around for a good five minutes and then she is just Raggett out of breath. She will stumble with her tongue hanging out in her bag and will want to sit downbut she tries to keep going and I can tell she is tired. I'm not going to A&M to get this holter test only for her to not have an episode in the 24 hours that I have it. I can pretty much guarantee that's what's going to happen. It's almost as if a bit has two actually see her have an episode before they can guess what is wrong. And then it's just a guess. Pretty frustrating because in my line of work I can't go out and guess what's wrong at peoples houses in charge of the money for it and tell them maybe this'll make it better. I can't do that. It's frustrating. My pup comes in from walking in and immediately lays down on the floor on her side. Any activity we do she comes in and plops down on the floor immediately. I noticed her breathing last couple days it's kind of ragged. Like I can hear her breathing we're normally I couldn't. Otherwise she seems to be normal. She has a great appetite always wants to eat. Will initiate play with those all the time-she just can't really go for very long. I'm going to look at her bloodtest when I get back to see if I can see anything maybe the vet missed. Not sure if I can even read it but we will see. Google is amazing-hasn't been much help with my issue here though. Are use talk to text while driving so excuse my misspellings or punctuation errors. Thanks in advance


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HavenMae, I am very sorry to hear that your dog is having such serious sounding symptoms. Regarding your questions of a diagnosis with dilate cardiomyopathy: this is a progressive disease which has occult and acute phases.

At the very beginning of the disease the heart starts having irregular beats (arrhythmias) which are not detectable without specialized equipment. During this stage it is called occult DCM because the disease has no symptoms, and is "invisible". Here is the first time holter monitor comes into play, because we can catch the disease before there are symptoms. When we use a holter monitor to test for DCM we are looking for a specific kind of arrhythmia called a VPC, and the threshold is 50 per 24 hour period.

If the disease progresses to the overt stage the heart begins to stretch out like a balloon that is being inflated. The heart walls stretch out and thin, they beat less efficiently, and the valves begin to leak. This is what causes outward symptoms of heart failure: shortness of breath, exercise intolerance, and even fluid retention.

The structural changes are what is being observed with an echocardiogram. Cardiologists have expert training in how to measure the wall thickness, flow through the valves, and amount of movement with each beat. Normal ranges are well established, and with regular testing you can also track the change in your dog's heart function over time.

It is imperative to test for both the structure (echo) and rhythm (holter) when making a diagnosis of DCM, as there are treatment options that can provide some relief for the symptoms. I would not hesitate to make an appointment with a veterinary cardiologist right away as 1) this is a Doberman, DCM is all too common, and several of the symptoms align and 2) it is not necessary for an event to occur while the holter is being worn in order for the information to be relevant..

*one thing that will be helpful if you could capture it however, is video of any episodes. Capture what you can using your smartphone and bring that to your appointment for the vet to watch.
 

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HavenMae, I am very sorry to hear that your dog is having such serious sounding symptoms. Regarding your questions of a diagnosis with dilate cardiomyopathy: this is a progressive disease which has occult and acute phases.
I'm going to add some information to Tobester's post.

At the very beginning of the disease the heart starts having irregular beats (arrhythmias) which are not detectable without specialized equipment. During this stage it is called occult DCM because the disease has no symptoms, and is "invisible". Here is the first time holter monitor comes into play, because we can catch the disease before there are symptoms. When we use a holter monitor to test for DCM we are looking for a specific kind of arrhythmia called a VPC, and the threshold is 50 per 24 hour period.
While it is true that DCM is a progressive disease and very common in Dobermans the beginning of the obvious symptoms may not include arrhythmias--at least two of my own Dobes who were diagnosed with Occult DCM had no abnormal Holters and no arrhythmias (they also did not die from the cardio but were euthanized as older dogs due to unrelated conditions. But because the combination of a ultrasound (Echo) and a Holter (24 hour ECG) is so much more informative than any other group of tests that's why those are almost always the definitive tests used to diagnose DCM.


If the disease progresses to the overt stage the heart begins to stretch out like a balloon that is being inflated. The heart walls stretch out and thin, they beat less efficiently, and the valves begin to leak. This is what causes outward symptoms of heart failure: shortness of breath, exercise intolerance, and even fluid retention.
Sometimes the deterioration of the heart muscle, wall thinning, inefficient beating is the first thing that happens and often the first symptoms an owner might see would be exercise intolerance (which is what it sounds like is happening with your dog) shortness of breath or labored breathing.

The structural changes are what is being observed with an echocardiogram. Cardiologists have expert training in how to measure the wall thickness, flow through the valves, and amount of movement with each beat. Normal ranges are well established, and with regular testing you can also track the change in your dog's heart function over time.

It is imperative to test for both the structure (echo) and rhythm (holter) when making a diagnosis of DCM, as there are treatment options that can provide some relief for the symptoms. I would not hesitate to make an appointment with a veterinary cardiologist right away as 1) this is a Doberman, DCM is all too common, and several of the symptoms align and 2) it is not necessary for an event to occur while the holter is being worn in order for the information to be relevant..
Yes! While things like doing a blood test for ProBNP is useful it isn't actually definitive. The fact that your dog is acting lethargic, has breathing that seems labored or rough and is pretty clearly very exercise intolerant are definitely characteristic of some type of cardio--especially since this is a very young Dobeman. I would worry less about trying to get pictures of what she is doing than trying to figure out where the closest cardiologist is and if you can make payment arrangements to get her tested.

Because it involves a Doberman and because the Echo at least should be done by and evaluated by a board certified cardiologist you may be able to find a Dobe or Boxer club who has and will loan out Holter monitors and you can get a printed report of a 24 hour ECG to take to the cardiologist to cut the expense down somewhat.

Medications to control various symptoms are so much better now--I lost my very first Doberman to DCM with Congestive heart failure in 1968--but even at that I was lucky that he was even diagnosed--most cardio dogs back then only got a diagnosis because they died. He was 9, nearly 10 and all there was that could be done was put him on Lasix--which dried up the fluids that were collecting around his heart and in his lungs and eventually we euthanized him so that he didn't just plain drown because his lungs were full of liquid and his heart couldn't pump efficiently enough to remove.

Since then practically every Dobe I've had has had some degree of DCM--but I've only lost one other directly to DCM because I was able to get an early diagnosis and they were on medications that controlled the various symptoms and to some degree the deterioration. The other dog I lost to DCM was actually a sudden death case--arrhythmias--because I'm lucky enough to belong to a Doberman Club that offers twice yearly heart clinics we knew what was going on with his heart--he was on meds--he was about 6 weeks shy of 10 when he went to an agility trial (with his cardiologist's blessings--sudden death can happen at any time and the dog loved playing agility--to deprive him of something he had so much fun at was really kind of out of the question)--he came home from the trial and I knew something was wrong--we didn't quite make it to the clinic--but that dog had long full life doing things he loved to do--he had a bad 15 minutes and was gone. It wasn't exactly expected but I can't say it was unexpected either. He got to have that kind of live because of the cardio medications he was on for the last 4 years of his life.

Good luck with your girl...
 

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Discussion Starter #14
I would also suggest getting the NT-ProBNP and Troponin blood Test done. If there's something going on and the holter doesn't catch it then the blood test should.



Here is a study done on humans but the Doberman and human heart is virtually identical:



http://www.medscape.com/viewarticle/764400

How research into a deadly heart disease could save you ? and your dog | Globalnews.ca


That's ironic you say the hearts are identical. I used to have anxiety really bad and it affected my heart rate daily and I would yawn constantly. I see Haven Mae yawns all throughout the day. Maybe nothing but just an observation.


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The reason we are recommending a cardiologist is because DCM is diagnosed primarily through two tests - an echocardiogram and a 24 hour holter monitor reading. The echocardiogram gives one "picture" for the cardiologist to look at, and the 24 hour holter monitor another. They really work together to give a full picture of what the heart is doing, and you can't get a very accurate picture with only one - it's only "half" the story. And no, it really isn't very normal for your dog to be that tired - there is something going on with her that isn't normal. None of us can tell you what's going on, but if this was my dog I would have already been to a cardiologist to have both of these done. I KNOW it's expensive, but the symptoms you are describing are very worrisome. It's certainly possible it's not her heart, but I would rather rule that out than have it be her heart and not know. Because it's also possible that it is, given what you are seeing and describing and videoing.



Just my two cents. Hopefully some of our more science savvy folks can explain in more detail exactly why both an echo and holter are needed to get a picture of what's going on.


We've done the echo already and blood test. I'll call A and M in the morning.


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We've done the echo already and blood test. I'll call A and M in the morning.


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I didn't know you had a full echocardiogram done at a cardiologists already? If you had an ECG or EKG, that's a short reading of the heart's electrical impulses. An echocardiogram is an ultrasound of the heart that usually takes about a half an hour of the dog lying on their side (each side, in turn). They are different. Maybe my mistake, but I thought you'd mentioned they'd done an EKG of her heart, which is essentially a very, very shortened version of a 24 hour holter.
 

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I didn't realize that you had already done an echo either. Did Texas A & M vet clinic give you a diagnosis of DCM? Did they put her on any medication?

Essentially the vet would have seen an enlargement of the heart in general and specifically of the left ventricle. I'd have thought they would have done an ECG as well. The blood test (depending on what panels they ran) can tell some things about a possible cardiac condition but usually what they are looking for is a normal blood panel to see if the symptoms you are seeing should require more specific testing than a general blood panel.

When are they suppose to let you know about the results?
 

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Ok that's my mistake. It was an Ekg that they said they have her. I wasn't there. On the paperwork I see
Health profile
T4 in house
CBC comprehensive
Exam comprehensive

That's all that's on the invoice. I thought there was a copy of the blood work here but there isnt.


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I hope you are able to get in touch with Dr. Gordon today at A&M, as one of our really good Doberman folks recommended back at the end of May. I think we're all still very worried for your pup. Please keep us posted.

In the Houston area, you'll find cardiologists at Gulf Coast Veterinary as well as Bay Area Vet specialists.

However, you are within driving distance of one of the best veterinary cardiologists and one with extensive Doberman heart experience: Dr Sonja Gordon. She is at the Texas A&M Veterinary Hospital. This is where my dogs go for their annual cardiac work ups.

Syncope can be caused by a wide variety of things, but in this breed it's typically caused by arrhythmia. This is why you're getting so many suggestions to see a cardiologist. While she is very young, cardio at this age is not unheard of sadly. As TAMU is a Veterinary teaching school, they typically get very complicated cases and have an incredibly experienced teaching staff. So this is wherI I would go if I were you.

And since they are a teaching hospital, TAMU is actually very affordable compared to a specialist clinic like Gulf Coast. I don't know who you have her insured with, but the insurance policies I've had covered specialist visits and visits to TAMU. I just had to pay upfront and submit for reimbursement.
 

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I'm still trying to figure this out--so did the vet who saw her and ordered these tests give an actual diagnosis?

Is she supposed to come back for more testing? What you list as "on the paperwork" doesn't show that TAM clinic did an EKG--even a short strip (3, 5 or 10 minutes)--did one of the vets who saw her earlier do one and send it to them with her earlier records?

Did who ever took her to the appointment tell them about the exercise intolerance and periodic difficulty breathing and ragged breathing?

What you've listed as the tests that were done look mostly like a general work up not looking for cardio specifically. She's very young to be having the symptoms you've talked about but I know of some very young dogs (younger than your bitch) who have died, ad ts was verified from a necropsy (inspection of the heart after death).

What did the vet at TAMU actually say at the conclusion of the testing?

I'm also very concerned that it doesn't seem that the most definitive tests for DCM and arrhythmias (ECHO and Holter) have been done or even considered. Please do keep us informed.
 
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