Enlarged Heart, Chf? Non Grey

[Roo]

Daisy the 12(ish) year old 18 pound rat terrier was diagnosed with an enlarged heart (and something about the left ventricle) a couple days after I adopted her last November (this was after she received a 'clean bill of health' from the rescue - in addition to the enlarged heart, she was also later diagnosed with arthritis, progressive vision loss, and incontinence). I took her in the Friday after I adopted her and she was diagnosed with a grade 3 heart murmur, then I took her back the next Monday for incontinence and the pesky cough. The murmur was upgraded to grade 4 on that Monday. The vet did x-rays (I have the files on my computer at home, but I'm at work) and confirmed an enlarged heart and referred us to a cardiologist that I couldn't afford. I tried to raise money for the appointment but only managed about $50, which then went to other vet bills once I realized I wouldn't be able to afford the cardiologist. She wasn't really showing symptoms (only the occasional cough/gag) so I decided to just wait and see for a while.

 

She's done really well since then. The coughing all but stopped. I found a food she'd eat regularly (and by regularly, I mean she only skipped a meal maybe twice a week instead of skipping one a day). She started to play with toys (as long as I was on the floor playing with her with the toys ). She tolerated her walks (she doesn't enjoy walking - cars and dogs and noises make her nervous, so she spends a lot of her walk checking her surroundings) and sometimes even seemed to enjoy them. She was super snuggly and wanted to spend lots of time getting loved on.

 

Last weekend she started acting off. She was eating grass and threw up bile on Saturday (she hadn't thrown up once since I adopted her in November, so it's out of the ordinary). She ate probably half a can of food over the weekend (she's supposed to have a can a day). She was worse on her walks, but it's been warmer lately so I thought that was it. She met a greyhound on Monday (I'm contemplating a brother for her to help boost her confidence...) and this actually seemed to raise her spirits - she slept like a rock Monday night from all the excitement and woke up with energy and joy on Tuesday (she even scarfed down her whole dinner!). But today she's back to acting off. She threw up a little bile again this morning after refusing breakfast and drinking a bunch of water.

 

Her other symptoms have been gradually appearing over the past week or two. She'll lay in bed and pant at night, which I assume is from her heart pressing on something (trachea? lungs?). She'll cough/gag, but only occasionally. She's never been keen on walks but now she's even less keen (she does really enjoy chasing the neighbor's cat, which makes her start hacking, and standing on the back deck, taking in all the smells, which she will gladly do for as long as I stay outside). She won't really play with me anymore, though she did manage a minute or two last night before she walked away. She's not super keen on cuddles anymore, either. She'll act like she wants to then when I start petting her she gets down and moves away and lays down sphinx-style, staring at me.

 

The most concerning things, to me, are that her feet and lower legs are cold to the touch (not, like, ice cold, but definitely cold - I just noticed this last week) and she's stopped eating regularly. This weekend I was a wreck because she wasn't eating her food. She'd take treats and peanuts and popcorn and Cheerios (just a piece or two of each...cleaning up food I've "accidentally" dropped is her favorite hobby, so I make it a point to "accidentally" drop stuff regularly) and she'd act hungry for a meal, but when I put her bowl down she'd sniff it like it was going to bite her (seriously - she stands as far as possible and streeeetches her neck out to sniff) and walk away. She used to come beg me for my breakfast when she didn't eat hers but the past couple of days she's refused food, she comes and lays down next to me instead of staring at me intently and trying to mind-control me into sharing.

 

She still gets excited about stuff - she races inside from her walks (we call it "Black Bart" from A Christmas Story because she will run in and look every direction like she's scanning the house for villains and only needs her trusty BB gun ), she play-bows at me when it's time to go to her crate (she loves her crate - I think going in for the workday and at night makes her happier than almost anything else nowadays), and hops halfway into my lap for cuddles (though this happens less and less often, and when it does happen she doesn't stay up as long as she used to).

 

I'm waiting to hear back from the cardiologist about the cost of an echocardiogram. I still don't have the money (especially not after my own hospital bill arrived over a week ago, and especially not since I know I'll be getting more bills from the fish bone fiasco) but I can't just sit here and do nothing, so I'll figure something out.

 

The problem I'm having, though, is that I'm fighting with myself over what to do. I know the echo is the first step, whether I can afford it or not (I can't, but I'll find a way). Then they'll want her to be on drugs, drugs that I probably can't afford and drugs that'll mess with her body. I did all this research when she was first diagnosed and if I remember correctly, the drug cocktail can eventually hurt her kidneys. Is it worth it to treat the heart disease only to send her into kidney failure down the road? I don't know. And she hates being fussed with. I can't get near her mouth to brush her teeth (I tried). She won't let me touch her ears (even when I'm just petting). She wigs out if I try to hold her still. She hasn't bitten but she's offered to bite if I do something she's not fond of (I don't recall what I was doing but I got a snap from her - she didn't get me but she made it totally clear that it was unacceptable for me to do that and I haven't since ) and I don't want to push it. (Honestly, I don't blame her - if I had an enlarged heart and was feeling crappy I may be a little less patient with people messing with me as well.) I've started having trouble getting her pill for incontinence into her (she's even hesitant to eat plain yogurt these days). I can't imagine trying to hide four or five pills and actually getting them down the hatch, and I can't force them down her like I do with the hounds at the kennel who won't eat their meds (I've gotten pretty good at it too ) - that would stress her out more than is healthy for her.

 

And speaking of stress, I'm moving at the end of the month and she's coming with me. Two hours away from where we are now, out of my parents' house that she's finally comfortable in, away from my parents (who she adores), and to a strange place in the mountains that smells like black bears (there's one that appears in the neighborhood occasionally) with two loud hound dogs next door. That's a lot of stress for a little dog with heart problems.

 

I'm not sure what I'm hoping to get by posting... Maybe I'm just venting my frustration at not having a clear idea of what to do, and knowing I won't until we can get in for an echo, IF we can get in for an echo. Maybe I just want people who've been through dilated cardiomyopathy and CHF with their pups to share their experiences... Namely, how you knew it was time. That's been on my mind a lot lately - I don't want to let her go too early while she's still happy, but I also don't want to drag it out until she's miserable, and recently she's having more bad days than good.

 

Any advice would be much appreciated

[Remolacha]

My first greyhound had a leaky valve (that's the murmur, as I understand it) and that side of her heart was enlarged. She was first diagnosed with an ultrasound, and there wasn't a vet cardiologist in the area at the time, so we started with the basic heart drugs, lasix and enalipril. These are both people drugs and I got them at CVS for about $30 for a months supply for both. This was ten years ago, but I think both are still fairly cheap. That helped her a lot. About a year later, a cardiologist came to town, and she had the echocardiogram. He kept her on the same medicine. She did well for awhile, but started to pant and get picky about her food again, so we started her on Vetmiden, which is the drug that can cause kidney issues. She was 11.5 by this point, and also had spinal stenosis. Acupuncture help that, but I still kept her walks very short and spent a lot of time getting her to eat regularly I finally lost her to kidney failure at 12.5, probably caused by a combination of the Vetmiden and all the NSAIDs she'd had over the years for her spinal issues. I thought the extra year I got with her on the Vetmiden was worth it, mostly she was happy and comfortable.

 

The higher heat and humidity where you are are probably bothering her, as well as her general anxiety. Sugar ate a lot of people food in her last year, eggs, green tripe, tuna, Ensure, canned cat food, canned puppy food, it changed on a regular basis. Oh, and once we started all the meds, she also got a Pepcid with every meal, that helped keep her eating.

 

One day she just stopped eating. Nothing tempted her, and once we saw her kidney numbers were through the roof, started giving her fluids. The fluids (she stayed at the vet all day one day on a drip) didn't lower her numbers, she still wouldn't eat. I let her go a week later. I knew she wasn't going to get better, she hated being helped, I didn't want her to suffer or lose her dignity. Every dog is different, but that was right for her.

 

it is tough, but I hope you have some good times ahead

[Roo]

Ugh, no kidding - the heat and humidity is killing me! Can't imagine what it's doing to her.

I cooked noodles in low sodium vegetable broth (because the only other low sodium broth is chicken, which she can't have ) and I'm going to mix a little of her canned food in with that. She's acting hungry, so that's good!

I heard back from the cardiologist - it'll be a minimum of $435 for just the office visit ($133.50) and the echo ($301.50). It'll take a while to save for that

 

ETA: Here she is begging for ice cream...

 

Edited June 1, 2016 by Roo

[Roo]

The noodles in veggie broth were a hit! She scarfed the whole bowl down.

[tbhounds]

Can you apply for care credit and use that for the echo? Honestly, the echo (as you already know) is important-important to understand the degree or lack of the heart disease. All further treatments will be contingent on the outcome of the test.

You are putting the cart before the horse-all of your questions will be answered after you get the echo done.

[FiveRoooooers]

That is one cutie patootie little girl, she is just adorable. No advice, just good thoughts for Daisy going forward. And glad your fish bone fiasco is done!

[claudiav]

i second applying for Care Credit... at least that way, you can take 6 months to pay it, interest free..... longer with interest.... and it can be used at any medical facility... animal or human... i just used mine to pay for my $2,500 bridge.... and am still paying for older vet services...

[Roo]

I tried to make an appointment but apparently they purged my referral I called our vet and he's going to re-refer us so I guess I'll call Monday... I asked about available appointments while I was on the phone with the woman and she said they'd be able to see her fairly soon - I was worried they'd have a really long wait.

[Roo]

Another question

 

Has anyone noticed dogs with chf sneezing more than usual? Daisy is the sneeziest dog I've ever encountered. She just...sneezes. A lot. And usually they're not SNEEZES and are more like little snorts or like she's trying to force a smell out of her nose or something. That probably doesn't make sense but I can't think of another way to describe it... She's done it since I got her in November or I'd think it was seasonal allergies (goodness knows I'm suffering with them this year!). I've tried googling it but all I get are results about dogs with CHF coughing.

[Roo]

Alright, we have an echo appointment at 9:30 on Thursday morning.

[Remolacha]

hope you get good news

[Roo]

hope you get good news

 

Thank you! So do I...She's starting coughing more often this past weekend (when she first gets up, when she's laying under the kitchen table...), so it's definitely time for the echo.

[Roo]

Echo today. I wasn't really worried earlier (she's had a couple great days the past couple of days) but she's been doing the choking cough for about half an hour straight this morning...so now I'm pretty worried. Glad her appointment is today though.

[Roo]

They decided to do x-rays instead of an ultrasound. The vet said it'll give her a better idea of what stage she's in? I thought that's what the ultrasound was for, but she was adamant that the x-ray would be more helpful for her in determining what point we're at and if she needs to be on medication or not...

[Roo]

She's not in heart failure yet! I'm so relieved. They said she definitely has an enlarged heart and she will eventually be in heart failure by that could be in a couple weeks or a couple months or a couple years. For now I'm supposed to just watch her and keep an eye on her resting breathing rate. They said anything over 50 per minute and she needs to be seen again. They gave her a cough suppressant to take in case of a hacking fit like this morning. I got the X-rays from them but don't really know how to read them

[tbhounds]

Usually rads and an echo complement each other. Rads will determine heart size and look for any fluid build up and the echo will look at the structure of the heart (valves, chamber enlargement, thickness of the wall etc.

Well-glad you are not currently dealing with chf.

[Remolacha]

I am a little surprised they didn't start her on some of the basic meds, but good to know she is not in failure at this time! I hope it is years before it gets bad.

[Roo]

The vet said that she didn't need meds until she was in actual heart failure and showing symptoms regularly. As it is, she only shows symptoms occasionally. I'm a bit relieved, honestly - Daisy can be finicky to feed, and she's gotten smart about taking her tiny little incontinence pill so I think it would be difficult to get multiple drugs in her!

[Guest Sportingfields]

Glad the echo gave you answers. From what I've read there seems no benefit to starting them on Enalapril at 2-3 grade murmur than waiting until later. Something all 3 of my CHF pups did was a gag type retching thing, different than a cough, as if they were trying to dislodge a dog hair in their throat. Also, all 3 did not handle the heat/humidity at all and you could see excessive panting with slightest bit of exercise. Those two things sent us to the vets ASAP with #1 and gave me the clues on the next two.

 

Have you tried hiding pills in liverwurst? If not, get Oscar Meyer brand, costs about 1.99 it comes in a small roll, looks like an overblown sausage link. This stuff makes great meat balls, much better than any of the other brands or types of liverwurst. Make the ball as teeny tiny as you can & still hide pill, so that it can be swallowed and there is little temptation to chew. Will keep in fridge, sealed covered container for about 3 weeks, after that it starts to dry out and look ucky.