– 7 year old F Spitz presented for coughing and an episode of collapse after coughing on the weekned
– decreased appetite and weight loss
– grade 4/6 systolic heart murmur and arrhythmia evident on auscutation with tachycardia
– chest rads showed a globoid heart, distended pulmonary vein and perihilar pulmonary edema
– echo consistent with stage C CVD, severe LAE, moderate RAE, trace pericardial and mild pleural effusion, distended CVC and hepatic veins and mild ascites
– mild-moderate pulmonary hypertension; Ao and Pul Max Vel wnl
– 7 year old F Spitz presented for coughing and an episode of collapse after coughing on the weekned
– decreased appetite and weight loss
– grade 4/6 systolic heart murmur and arrhythmia evident on auscutation with tachycardia
– chest rads showed a globoid heart, distended pulmonary vein and perihilar pulmonary edema
– echo consistent with stage C CVD, severe LAE, moderate RAE, trace pericardial and mild pleural effusion, distended CVC and hepatic veins and mild ascites
– mild-moderate pulmonary hypertension; Ao and Pul Max Vel wnl
– I have recommended a Cardiopet ECG in which owners have declined at this stage; started on Pimobendin and Furosemide with plans to start an ace-inhibitor if all goes well with this. Should I also be addressing the PH at this stage?
Comments
Many cases of PH in small
Many cases of PH in small breed dogs is due to Mitral insufficiency and volume overload. It makes sense to me to treat with Pimobendan, Furosemide and Enalapril. I would wait on Sildenafil until you see how this dog responds to conventional therapy. Like you said- this is “mild- moderate” pulmonary hypertension.
Thanks Randy – that what I
Thanks Randy – that what I was leaning toward but with the collapsing (although I know not just PH causes this in heart patients) I thought maybe it should be addressed sooner.
This looks like stage C1 VD
This looks like stage C1 VD to me triple therapy for sure and any C1 can have syncope in my experience. Holter monitor best as well but I would make the heart happier first with triple tx. Consider an alive cor ecg to keep with you and run off your i-phone. With exception of some cat arrythmias this has been a solid tool. My cardiologists like it when people send in echo for telemed review.
Thanks Eric – I have been
Thanks Eric – I have been using the Aliv Cor for over a year now and love it (so do the rDVM’s) I have sent the ECG’s for telemedicine review (just a quick e-mail diretcly from iPhone) and have had no complaints from the cardiologists. I just recently upgraded to an iPhone 6 plus (had a 5s before) You can still use the adopter for the 5s with the 6 as long as the phone is within 1 foot of the patient (can also use with an iPad) but for some reason has not been working for me – I am going to contact the company – they have been helpful in the past when I had issues. I just haven’t had time to contact them yet! Otherwise I would have definitely run an Aliv Cor on this one.
I haven;t tried it on the
I haven;t tried it on the i-6. Let us know if it works… im sure they say its not authorized for the i=6 but I know they said that for the -5 and it worked regardless just didnt fit the phone.