Just looking for some advice regarding dogs with congestive/chronic heart failure. My 18 year old yorkie/maltese mix has a lot of issues going on right now. He had a small heart murmur last year and upon exam 3 weeks ago the vet said his murmur has become very loud. So we did some blood work and x-ray. On the x-ray we could see his heart was enlarged, trachea collapsed, and pulmonary congestion (edema?). This murmur is caused by a mitral valve issue, forget the exact name though. The only clinical symptom he has is that heart murmur and some coughing with excitement. Though, he's started to cough during rest a few times. His coughs are not bad though, very mild. His breathing is fine and his activity is fine. He has become a picky eater in the last 2 months or so. Despite all this the vet said he is not in heart failure yet but is on his way. So we've decided to start him on medication, we just got the meds yesterday but I'm waiting until tomorrow to administer, I just want to give him and us one more normal day before we start on this medication journey. We were initially prescribed lasix (liquid form), enalapril, and vetmedin. Upon inspection of the x-ray the vet decided to take off vetmedin and prescribed theophylline which I believe is a bronchodilator for his collapsed trachea. Got to get the dog breathing right first. I did want him on vetmedin because I had heard good things about it but it doesn't go well with the theophylline. I know these meds do not cure heart failure or prevent it from happening but would it make the heart return to a somewhat normal size as the meds help it pump better? I would just like to get him off theophylline and on to vetmedin if that happens. Also what are your experiences with these meds and the side effects to your dog? I really am afraid of the decreased appetite. How the heck do you get your dog to eat the meds if they have decreased appetite? Also he's only 11.6 lbs right now, last year he was 12 lbs. I know he's older so he may just have lost weight but it still bothers me. Also how did you deal with the decreased appetite and the type of diet (low sodium) needed for heart failure? My dog does not eat that much dog food which I heard has a lot of sodium anyway and he also is super picky so I don't know what I can make that will make him eat. He's been eating more human food than dog food lately but he's even picky with that. I just want to be prepared for this appetite issue before I start the meds. Any super picky eaters out there that you had success with making your own dog food?
Also, I've been doing a lot of reading about CHF in dogs and am now really worried about kidney failure from the lasix. I'm wondering if I should just put off medicating him until he reaches mild heart failure? Do you think I am prematurely medicating my dog or is it good that I'm catching it at this stage and treating him? I also heard that enalapril may be the one to blame for the decreased appetite and upset stomach. I don't want to put him through that so early if its not necessary. Although I could see the lung congestion myself so seeing that and knowing that there's some fluid in his lungs I should give him meds to take it out right? I'm so confused right now. Thank you so much and I would appreciate any words of advice/support!
I offer a few thoughts based on my experience with human heart problems, mine. I do not have any experience with dog heart issues, but I bet there are a lot of similarities.
First the mitral valve problem may have been call Prolapse, or just leaky. That condition can cause heart enlargement, specifically in the atirum chamber above that valve (humans). It is not reversible unless the excess pressure it taken off, such as a mitral valve repair or replacement (me, my heart is no longer growing, but it did not shrink back after mitral valve surgery). I am not suggesting open heart surger for your dog.
High blood pressure can also cause general heart enlargement. Did you mention that? If not ask you vet about it. There are effective blood pressure medications for people, assume similar stuff exists for dogs, such as beta blocker and calcium channel blocker.
As will all of us aging the balance that seems best is to address Quality of Life. If the treatment is worse than the diastase, some medication side-effects can be very troubling, and the poor dog can't talk.
At the age of the dog I would discuss with the vet quality and extension of life issues and treatments, not seek cures. There is no cure for growing old. Well a healthy life-stile is a good underpinning, but that has to be done along the way, not after senior age is reached.
I hope I am not spinning a negative reply, I do not intend to be negative and I know about loving a dog, and people too, and know life and death decisions are very difficult and the "right" answer is not obvious.
I have some experience with CHF. My Boston was diagnosed with it and lived approx 1.5 years after his diagnosis. We put him on lasix and enalapril right after he was diagnosed. He did develop kidney failure which was what I ended up losing him to.
It's a very hard decision to make, whether or not to put him on he heart meds. I wasn't given a choice by my vet and didn't have any prior knowledge of the side effects at the time.
I'm not sure I would have put him through the treatments/medicines after seeing what he went through. He had to go on Pepcid because he wasn't interested in eating. Apparently ulcers are common in pets with kidney problems.
I eventually cooked his food. He refused dog food and it was very hard to find foods to stuff his 7 daily pills into. One day he'd eat hot dog and the next wouldn't touch it. Getting his pills down was a daily struggle.
I would cook 1 lb of small noodles, 1 or 1.5 lb of ground beef (or chicken breast), 1 bag of pureed pea/carrot mixture (look for bags that only contain the veggies - no salt), and some low-sodium broth. He really liked it and by that time it was more important that he WAS eating; it mattered less WHAT he was eating.
I also had to do subcutaneous fluids every other day on him for probably 6 months before I lost him.
Looking back, I'm not sure it was fair to put him through all of that. I know I was keeping him around for myself. He was my best friend though and I know now that I was selfish not to let him go sooner.
I wish you all the best of luck and hope that your Yorkie lives a healthy, full and happy life until his time comes. It sounds like he's in good hands.
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