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What can be done for congestive heart failure?

Q: My in-law's Cocker Spaniel is between six and eight years old. She has been diagnosed with having a large heart. For about the last year and a half she has had this horrible hacking cough. She will cough continuously until she either gets everything moved around, is told to stop it, or if her chest is rubbed. The spell is usually brought on by excitement. She has been continuously treated with a cough syrup by the vet. They are now truing a new dog food call Purina O/M that another dog friend of ours with the same symptoms is using, and has worked for them. My in-law's dog is not improving at all. She also smells, even after a bath. Do you have any other suggestions?

A: When the heart fails to keep up with the circulatory needs of the body, the back pressure from the returning blood causes water to leak into the lungs. This water accumulation makes the dog cough. When the pool of water gets stirred up by excitement, the dog responds with a coughing spell. Many medications are available to help dogs with congestive heart failure. One group, the diuretics, help by moving water from the lungs back into the blood stream. You should consult your veterinarian for the best diagnostic and treatment approach to the problem. A full treatment program addresses the entire picture, and may include medication to improve the heart function, restricted exercise, diuretics, special low-sodium diets and regular rechecks with the doctor.


Heartworm prevention in Southern California

Q: I have a very small dog, a six-year-old chihuahua, and I was wondering if even the tiniest of dogs still need to be given heart worm pills, even thought she is rarely outside, except to go to the bathroom. Should I get some heart worm pills from my vet?

A: Small dogs are just as susceptible to heartworms as large dogs. Heartworms are transmitted by certain species of mosquito. If you live in an area with mosquitoes, your dog may be vulnerable to parasites. Your local veterinarian will be able to tell you if you live in a heartworm area. For instance, in Southern California, we do not have the species of mosquito that carries heartworm, so only people traveling with their dogs out of the area need to use the preventative medication.

Mosquitoes do find ways to enter your home, so even indoor dogs should have protection. Heartworm pills are only available from a licensed veterinarian. You should always have your dog tested before starting heartworm prevention medication, for if adult worms are already in your dog's heart, the preventative medication can be lethal.


Why is my dog exercise intolerant?

Q: Brandy, my six-year-old shepard/retriever mix has a problem. After playing for about 10 minutes she starts breathing heavy. I take her in and it takes up to six hours to start breathing normally. When she is breathing heavy her tongue hangs out but she doesn't drool. I've asked my vet for the last two years but he tells me that her heart is fine fine. She has allergies (grass, trees, etc.) and I give her shots. But her heavy breathing is year round. I'm afraid that her heart is getting stressed. Have you seen this problem before?

A: Exercise intolerance as described is usually related to heart disease, lung disease or excessive exercise relative to the dog's physical condition.

Heart disease may take more than just a quick listen with the stethoscope to diagnose. Radiographs and electrocardiograms are usually necessary to fully evaluate the heart. You may request additional testing on your next visit from your vet.

Lung disease can come from damage from disease, airway blockages, collapsed lungs, emphysema, bronchitis and other ailments. Radiographys, auscultation and blood panels are helpful in evaluating the lung's condition.

Overweight dogs, or dogs not used to exercise that are suddenly called upon to exercise heavily may lack the stamina of younger and more fit dogs. If this is the case, gradually increasing the daily exercise regime will help your dog become more fit. Do not do this until you have ruled out heart and lung disease.

Other conditions such as anemia, cancers, allergies, circulatory shunts and internal pain may also cause exercise intolerance. This does warrant further investigation by your veterinarian.


My dog has an irregular heart beat. Is this a problem?

Q: I have a toy breed spaniel, approx five-and-a-half pounds, who became ill with fever (104), lethargy, and no appetite. She was treated as having a cold with antibiotic shots and oral liquid, plus chlorpheniramine 4 mg tablets (.5 tablet morning and evening). The pup recovered and I took her to begin her vaccination shots the following week. At this examination (her forth at this particular practice) the doctor detected an irregular heart beat. This had not be picked up by his three colleagues in
previous visits, nor by the emergency room vet (who went out of his way to say the heart sounded good) nor by two vets in the UK (the pup is imported). We have an appointment with a cardio doctor this Friday. However, I'm now wondering whether the antihistamine could be responsible for this irregularity? Surely an irregular heartbeat would have been detected. Are you able to offer any information on the drugs and potential side effects?

A: Irregular heart beats are common, and usually not a problem unless associated with other cardiac related clinical signs. The most common origin is sinus arrhythmia, an irregularity in the pacemaker of the heart. If your dog is otherwise fine, you do not need to worry about the irregular heart beat.

If the veterinarian that identified the irregular heart beat failed to explain how common this is, and it is most likely normal, then he is using scare tactics to get you to spend more money on a full heart work up. Consider getting a second opinion from another veterinarian.

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