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Today in the mail I finally received the echo report from the cardiologist that performed Harper's echo at MSU back on 1-9-12. We were told that Harper had early stage, occult DCM and he was only put on enalapril and spironolactone. After reading the report today I immediately wondered why more wasn't done (as far as meds) to begin with.
Just a little history...Harper had coughed maybe 4-6 times the weekend before his echo but was otherwise fine and we didn't know that it was heart related. We DID tell the cardiologist about the coughing but he dismissed it. According to him, Harper's first "symptoms" were after the echo and were some breathing difficulties that night and we were given a script for lasix and told to use it as needed. The cardiologist even mentioned to me that he thought Harper might have had some "mild heart failure" that day, but never said to do anything more at that time. I asked repeatedly about if he should be on pimobendan and he kept saying that he only uses it in animals with "clear, clinical signs of CHF" and that Harper didn't need it yet. He finally agreed to put him on a "low dose" of pimo after I explained to him again that Harper was more restless at night and I was concerned that his breathing was more labored and that we were having to use more lasix. The addition of the pimo made a HUGE difference and we were able to wean the lasix way back and Harper was back to his wild, bouncy self after just two doses of it.
The report is below and I'm not sure what all of it means, but I'd really appreciate some feedback on the findings. We are going to see a new cardiologist, but we're waiting for Harper's holter results before we consult with her. In the mean time I'm trying to decide if I should speak with the head of Cardiology at MSU about my concerns about how Harper's case was handled. Am I way out of line for thinking that more should have been done to begin with? Are these the results of a Doberman with early stage DCM???
M-Mode
IVSd 6.24mm
LVlDd 64.86mm
LVPWd 6.24mm
IVSs 9.67mm
LVlDs 53.17mm
LVPWs 10.76mm
EDV(Teich) 215ml
ESV(Teich) 136ml
EF(Teich) 37 %
%FS 18 %
SV(Teich) 79 ml
2-D
AoA 3.9cm2
AoD 2.2cm
Ao Circm 7.0cm
LA Diam 51.03mm
LA/Ao 2.304
ECG revealed normal sinus rhythm with intermittent premature ventricular contractions.
Severe dilation of the LA and LV. Systolic function was depressed. Color flow doppler revealed a small concentric jet of MR.
Diagnosis and Recommendations:
Dilated cardiomyopathy with intermittent ventricular premature contractions.
Pending holter results I am not recommending any primary anti-arrhythmic therapies.
He is not showing any clinical signs so I decided not to use any diuretics of vetmedin. I did start enalapril and spironolactone for the antagonism of the RAAS system. These drugs may help prolong the subclinical phase of DCM. "
Thanks for any thoughts or feedback.
Just a little history...Harper had coughed maybe 4-6 times the weekend before his echo but was otherwise fine and we didn't know that it was heart related. We DID tell the cardiologist about the coughing but he dismissed it. According to him, Harper's first "symptoms" were after the echo and were some breathing difficulties that night and we were given a script for lasix and told to use it as needed. The cardiologist even mentioned to me that he thought Harper might have had some "mild heart failure" that day, but never said to do anything more at that time. I asked repeatedly about if he should be on pimobendan and he kept saying that he only uses it in animals with "clear, clinical signs of CHF" and that Harper didn't need it yet. He finally agreed to put him on a "low dose" of pimo after I explained to him again that Harper was more restless at night and I was concerned that his breathing was more labored and that we were having to use more lasix. The addition of the pimo made a HUGE difference and we were able to wean the lasix way back and Harper was back to his wild, bouncy self after just two doses of it.
The report is below and I'm not sure what all of it means, but I'd really appreciate some feedback on the findings. We are going to see a new cardiologist, but we're waiting for Harper's holter results before we consult with her. In the mean time I'm trying to decide if I should speak with the head of Cardiology at MSU about my concerns about how Harper's case was handled. Am I way out of line for thinking that more should have been done to begin with? Are these the results of a Doberman with early stage DCM???
M-Mode
IVSd 6.24mm
LVlDd 64.86mm
LVPWd 6.24mm
IVSs 9.67mm
LVlDs 53.17mm
LVPWs 10.76mm
EDV(Teich) 215ml
ESV(Teich) 136ml
EF(Teich) 37 %
%FS 18 %
SV(Teich) 79 ml
2-D
AoA 3.9cm2
AoD 2.2cm
Ao Circm 7.0cm
LA Diam 51.03mm
LA/Ao 2.304
ECG revealed normal sinus rhythm with intermittent premature ventricular contractions.
Severe dilation of the LA and LV. Systolic function was depressed. Color flow doppler revealed a small concentric jet of MR.
Diagnosis and Recommendations:
Dilated cardiomyopathy with intermittent ventricular premature contractions.
Pending holter results I am not recommending any primary anti-arrhythmic therapies.
He is not showing any clinical signs so I decided not to use any diuretics of vetmedin. I did start enalapril and spironolactone for the antagonism of the RAAS system. These drugs may help prolong the subclinical phase of DCM. "
Thanks for any thoughts or feedback.