[bean]

Due to the wonderful people here I have planned on doing baseling testing with Si. He tested Positive Hetero for the DCM gene, and during an xray when he had the abscess, they said that his heart looked a little on the large side of normal - so it was important to me to be on top of it with the screening. Yesterday there was a cardio clinic at the local dog show with Dr. Gary Wood, THE cardio guy in the Portland area, so I hear. I'm really happy we went.

He had an echo. For those of you who know about the numbers I'm happy to post them, but I'll stick with the "findings" as they make more sense to lay people.

"Findings:
Study Indications: Screening for dilated cardiomyopathy.
Left Ventricle: The left ventricle is mildy dilated. The LVIDD is 47.9 mm. Normal is 46 or less. There is mild global hypokinesis of LV contractility. Shortening fraction is 21.8%. Normal is 25 or greater.
Aortic Valve: The aortic valve appears structurally normal. No subaortic stenosis or regurgitation.
Mitral Valve: Normal appearing mitral valve. No regurgitation.
Tricuspid Valve: Tricuspid valve and right -sided chambers are normal.
Pulmonic Valve: The pulmonic valve is normal.
General comments: Likely occult DCM. Recommend 20 mg Enalapril daily, Holter monitor and repeat echo in December. "


He told me that essentially, his left ventricle is slightly on the large side, and that he also has slightly less strong contractions than would be in the fully "normal" range.

If I hadn't had the marker test, he said that we'd probably just wait and see, but to be on the conservative side we'll start him on the Enalapril, which supposedly most dogs tolerate really well with no side effects. There is a chance that this is just his normal baseline and there will be no progression. We will re-check him at another cardio clinic in December and get a Holter to see what direction, if any, we need to go, and if I'll actually need to follow up regularly with him as a cardiologist.

He also said to continue my fish oil. I'm giving him 2400 mgs / day. Should I increase this?

He also said that we could do Co Q10 which is usually tolerated well.

What else do you all add for heart health? Any experience with these meds or supplements?

I'm trying to be level-headed about all of this, as it could be nothing. One thing he has on his side is that he's very active and fit - the boy could go for days. I guess I'll also always really want to be on top of his weight.

Dr. wood said that catching this early is the key, and if caught early and medicated you can often "double their life expetancy" than if not. He also said that a dog could live a normal life and die of something unrelated. All I want is my boy to live a long, healthy life.

 

[sam&macksmom]

oh man Erica. I got chills reading this. Maybe talk to Michelle about the results, if you haven't already, to see what advice she can offer you as well.

Hugs to Si.

 

[bean]

I've sent an email to Michelle, I'll let you all know what she says, if she has any insight or input.

Thanks for the hugs - I'm trying to stay positive. This is exactly why I recommend getting the marker test and doing the baseline stuff. Folks have said that they'd prefer just not to know, but if you don't know that there's something going on you can't do anything about it. I'd so much rather be proactive and then have a plan, (and possibly double his life span) than to have him show symptoms much later and be regretting that I didn't catch it.

 

[Murreydobe]

Razzle came up with borderline results for LVIVDD once during an echo. We rechecked in 6 months and it was perfectly normal, and has stayed that way in the rechecks since.

So I wouldn't panic right now, I'd wait and see what happens in six months.

 

[sam&macksmom]

I'd have to know too. It would kill me if something happened to Sam.

Keeping you guys in my prayers that everything will be ok.

 

[bean]

Definitely not panicking - I'm a worrier (hence the screening) but am not a panicker. I am pretty good at staying level-headed overall.

Hopefully his results will be the same as Razzles! I love to hear these stories.



Edit: Just saw this at the bottom of their report. Here is what their clinic considers "Occult DCM criteria in Dobermans: LVIDD >46mm if <39 kg body weight. LVIDD >49 mm if >39 kg body weight. Fractional shortening (FS) <25%. One premature ventricular beat on ECG, or more than 50 premature ventricular beats on a 24 hour Holter Monitor ECG."

 

[Hierarch]

Sending good vibes to your boy Si!

What do you guys know about FS (Fractional Shortening)? I was told by a Vet at NC State where Dr. Meurs now works, that the FS% can be low if the dog is very active and also if the dog is over 90lbs. Can anyone elaborate on Fractional Shortening?

I was told by NC State that Normal Fractional Shortening was 30 and over. And 25-29 was in the grey zone.

Can someone please elaboate on this.

 

[rocketdoc]

Not sure if this helps but it is from the Doberman Pincher DPCA website:
"Occult disease: When the disease is in an asymptomatic or occult stage, the diagnosis maybe suspected by testing, but at this date these criteria are not uniform from center to center. Echocardiography of healthy Dobermans recently studied at the UDC nationals and it was found that the average fractional shortening of these healthy dogs was 26% using a short axis view, and 22.5% using a long axis view. In other breeds a fractional shortening of 25% or less in the short axis view is considered abnormal. This either indicates that a large percentage of healthy Dobermans have occult DCM or that the Doberman heart at baseline is not comparable to that of most breeds. As such, to diagnose occult DCM, most centers now require not only a depressed fractional shortening, but some evidence of functional impairment such as dilated heart chambers or frequent ventricular arrhythmias. "
Murreydobe is right. Wait and see what the next test shows.

Hugs to Silas.

 

[bean]

What do you guys know about FS (Fractional Shortening)? I was told by a Vet at NC State where Dr. Meurs now works, that the FS% can be low if the dog is very active and also if the dog is over 90lbs. Can anyone elaborate on Fractional Shortening?

I was told by NC State that Normal Fractional Shortening was 30 and over. And 25-29 was in the grey zone.

Can someone please elaboate on this.

I'm very much up for discussion on all of this. I'll just tell you what Dr. Wood said to me - that the FS% is not affected by the dog's activity level. I specifically asked him that because Si is very fit. Silas is only 70 lbs, so I don't know about that piece.

I know that with bloodwork, certain labs will have slightly different ranges of "normal." Curious to hear what others have heard as far as the range there.

 

[bean]

Not sure if this helps but it is from the Doberman Pincher DPCA website:
"Occult disease: When the disease is in an asymptomatic or occult stage, the diagnosis maybe suspected by testing, but at this date these criteria are not uniform from center to center. Echocardiography of healthy Dobermans recently studied at the UDC nationals and it was found that the average fractional shortening of these healthy dogs was 26% using a short axis view, and 22.5% using a long axis view. In other breeds a fractional shortening of 25% or less in the short axis view is considered abnormal. This either indicates that a large percentage of healthy Dobermans have occult DCM or that the Doberman heart at baseline is not comparable to that of most breeds. As such, to diagnose occult DCM, most centers now require not only a depressed fractional shortening, but some evidence of functional impairment such as dilated heart chambers or frequent ventricular arrhythmias. "
Murreydobe is right. Wait and see what the next test shows.

Hugs to Silas.

Well hopefully on our next echo there won't be an issue with the ventricles. And he'll have a perfect Holter.


Thanks so much for this info - I love to be as informed as possible.

 

[kates]

Sending Silas our heart-healthiest vibes ... and planning on following this thread closely.

I took Audrey to do a baseline with Dr. Wood around her 2nd birthday. He is definitely "the" dog heart guy around here.

(Not surprisingly, when I picked Audrey up from her day of testing, everyone who touched her had to find me before we left to rave about what a sweetie she is and how she could just stay and hang out with them any time ).

I'm planning on doing both of my dogs at the Mt Hood clinic in June.

 

[sam&macksmom]

something I was curious about. At health clinics, do they complete Echo's? I think they did cardiac auscultations.

Sam's Echo and EKG was completed at the cardiologist's office. Wasn't sure if this procedure could be completed at an onsight health clinic.

 

[AuraDobe]

I don't know if it helps any, but here is the sheet from Perrin's last echo.

Hope you can read it.

 

[AuraDobe]

something I was curious about. At health clinics, do they complete Echo's? I think they did cardiac auscultations.

Sam's Echo and EKG was completed at the cardiologist's office. Wasn't sure if this procedure could be completed at an onsight health clinic.

Yes they can. Perrin had his echo at a clinic at a show. They had a whole room set up for it.

 

[sam&macksmom]

wow, ok thanks!

Yes they can. Perrin had his echo at a clinic at a show. They had a whole room set up for it.

 

[bean]

Sending Silas our heart-healthiest vibes ... and planning on following this thread closely.

I took Audrey to do a baseline with Dr. Wood around her 2nd birthday. He is definitely "the" dog heart guy around here.

(Not surprisingly, when I picked Audrey up from her day of testing, everyone who touched her had to find me before we left to rave about what a sweetie she is and how she could just stay and hang out with them any time ).

I'm planning on doing both of my dogs at the Mt Hood clinic in June.

Are you a member of the MHDPC?

something I was curious about. At health clinics, do they complete Echo's? I think they did cardiac auscultations.

Sam's Echo and EKG was completed at the cardiologist's office. Wasn't sure if this procedure could be completed at an onsight health clinic.

They don't always, but this one had echo, which is why we went. They had a separate room set up - they laid him on his side on a table with a hole in it at his chest. Had the machine/computer set up there. It wouldn't likely be possible in a different setup.

Edit: eventermal got to it already!

 

[mmctaq]

I am not a wait-and-see kind of person. My dog's baseline shortening fraction when he was maybe two fell into the gray area... I think maybe 28%. He was officially diagnosed when it had fallen to 26% four years later, due to the fact that it obviously was declining.

He was on various supplements from a very young age... I was pretty sure of what was coming. He got 2 G. each l-carnatine and taurine, 1 T. fish oil (equal to about 15 capsules), 100 mg. ubiquinol (a "better" form of co-enzyme Q-10... one of the few supplements for which brand does not matter, since all of the active ingredient is produced by a laboratory in Japan which holds the patent), a B 50 complex capsule, Vitamin E... later, I also added some magnesium. I do not know if any of this was helpful, but none of it was harmful (except to my wallet!).

He was also prescribed a full regimen of meds when his shortening fraction was still much higher than your dog's is now... Vetmedin, enalapril, digoxin.

The cardiologist I used is a Doberman person. She had had owned a bitch that she had diagnosed at the exact same age as my dog, in the exact same stage of disease. That animal died at thirteen of non-cardiac related causes. I held on to that for as long as I could, until it was undeniable that not all dogs are the same.

The cardiologist talked one time about the difficulty of measuring Doberman hearts, specifically. I was left with the impression that not all cardiologists measure precisely the same, and so results need to be evaluated a little bit keeping in mind whose results they were. I am hoping for you that this is very much the case, since the measurements you were given scared me.

If my dog had been diagnosed just some months later than he was and if I had not already spent every extra dollar there was on three years of chemotherapy for a dog with lymphoma... if I could have the opportunity to do it over with those two factors changed, I would pack up my car and head for Florida and Dr. Estrada.

 

[dax0402]

Oh Bean, my heart was in my throat reading this. When is Silas having the holter done? These are Baron's 3rd Echo readings:

IVSd 1.03 cm
LVIDd 4.10 cm
LVPWd 0.90 cm
IVSs 1.29 cm
LVIDs 3.04 cm
LVPWs 1.15 cm
%FS 25.71%
LA/Ao
AoDiam 2.83 cm
LA Diam 3.79 cm
LA/Ao 1.34

These numbers actually improved from the first 2 echos since he has been on the Sotolol and fish oil (Baron gets 2,000 mg per day per Dr. Goodwin his cardiologist who is also Rah's and was Petey's). His heart is all normal. No signs of DCM on the echos. Baron's DCM is showing up on the holter with VPC's and couplets. And the number of VPC's has also improved greatly on his last holter compared to the first 2. Baron is negative on the DNA gene test. Also something to note: On Baron's last holter, which he only had 21 compared to 464 on the second holter, most of the VPC's came during periods of resting. Hope this helps.

Please feel free to PM me or e-mail me to vent or talk about it at any time. Lots of good thoughts that Silas' next echo comes out OK.

 

[AuraDobe]

The cardiologist talked one time about the difficulty of measuring Doberman hearts, specifically. I was left with the impression that not all cardiologists measure precisely the same, and so results need to be evaluated a little bit keeping in mind whose results they were. I am hoping for you that this is very much the case, since the measurements you were given scared me.

This.

Dr Gordon, the cardiologist who did Perrin's Echo, said the same thing. She mentioned that the normal range for a Doberman isnt necessarily the same as the normal range for another breed.

 

[bean]

I am not a wait-and-see kind of person. My dog's baseline shortening fraction when he was maybe two fell into the gray area... I think maybe 28%. He was officially diagnosed when it had fallen to 26% four years later, due to the fact that it obviously was declining.

He was on various supplements from a very young age... I was pretty sure of what was coming. He got 2 G. each l-carnatine and taurine, 1 T. fish oil (equal to about 15 capsules), 100 mg. ubiquinol (a "better" form of co-enzyme Q-10... one of the few supplements for which brand does not matter, since all of the active ingredient is produced by a laboratory in Japan which holds the patent), a B 50 complex capsule, Vitamin E... later, I also added some magnesium. I do not know if any of this was helpful, but none of it was harmful (except to my wallet!).

He was also prescribed a full regimen of meds when his shortening fraction was still much higher than your dog's is now... Vetmedin, enalapril, digoxin.

The cardiologist I used is a Doberman person. She had had owned a bitch that she had diagnosed at the exact same age as my dog, in the exact same stage of disease. That animal died at thirteen of non-cardiac related causes. I held on to that for as long as I could, until it was undeniable that not all dogs are the same.

The cardiologist talked one time about the difficulty of measuring Doberman hearts, specifically. I was left with the impression that not all cardiologists measure precisely the same, and so results need to be evaluated a little bit keeping in mind whose results they were. I am hoping for you that this is very much the case, since the measurements you were given scared me.

If my dog had been diagnosed just some months later than he was and if I had not already spent every extra dollar there was on three years of chemotherapy for a dog with lymphoma... if I could have the opportunity to do it over with those two factors changed, I would pack up my car and head for Florida and Dr. Estrada.

Thank you so much for this information. I've read it and will re-read it and look up those supplements. I'm all for supplementing.

I know that Dr. Wood is very experienced, and that there are a lot of Dobermans in this area. He runs cardio clinics for the Mt. Hood Doberman Pinscher Club every June and December. I plan on starting his Enalapril now, and supplementing.

We'll be getting a Holter within a week or two from the wonderful Jan (Marieldobes). Once we get the Holter, I'll probably make an appointment with Dr. Wood to help interpret it and I'll bring up some of these concerns at that time once I've read up some more. I could always do the repeat echo in June instead of December. I wonder if he would consider consulting with Dr. Estrada?

Oh Bean, my heart was in my throat reading this. When is Silas having the holter done? These are Baron's 3rd Echo readings:

IVSd 1.03 cm
LVIDd 4.10 cm
LVPWd 0.90 cm
IVSs 1.29 cm
LVIDs 3.04 cm
LVPWs 1.15 cm
%FS 25.71%
LA/Ao
AoDiam 2.83 cm
LA Diam 3.79 cm
LA/Ao 1.34

These numbers actually improved from the first 2 echos since he has been on the Sotolol and fish oil (Baron gets 2,000 mg per day per Dr. Goodwin his cardiologist who is also Rah's and was Petey's). His heart is all normal. No signs of DCM on the echos. Baron's DCM is showing up on the holter with VPC's and couplets. And the number of VPC's has also improved greatly on his last holter compared to the first 2. Baron is negative on the DNA gene test. Also something to note: On Baron's last holter, which he only had 21 compared to 464 on the second holter, most of the VPC's came during periods of resting. Hope this helps.

Please feel free to PM me or e-mail me to vent or talk about it at any time. Lots of good thoughts that Silas' next echo comes out OK.

Thanks for sharing, and for your thoughts and support, Lois. What is Sotolol?