Question for cardiology meds:
- 7 YO MN LAB presented unable to run his daily 6 miles with owner,
- ProBNP is 2457
- Diagnosed 6 days ago with atypical Addison’s dz
- CBC, BP WNL
His echo: Bradycardia attributed to his athleticism. DX Prob DCM So my question is given the dog’s fitness condition, what are the drug TX of choice?. What are the current standards in Europe for TX of DCM? Are any drug combinations prophylactically given in larger breed dogs to try to control onset of DCM?
Question for cardiology meds:
- 7 YO MN LAB presented unable to run his daily 6 miles with owner,
- ProBNP is 2457
- Diagnosed 6 days ago with atypical Addison’s dz
- CBC, BP WNL
His echo: Bradycardia attributed to his athleticism. DX Prob DCM So my question is given the dog’s fitness condition, what are the drug TX of choice?. What are the current standards in Europe for TX of DCM? Are any drug combinations prophylactically given in larger breed dogs to try to control onset of DCM?
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Any thought or ideas are greatly appreciated.
Comments
Hi!
I don´t think that
Hi!
I don´t think that there exists a European consensus on the treatement of occult DCM. So, what I´m writing here is what we and lots of others do:
Based on O´Gradys retrospective study we use ACEI in occult cases since they were reported to prolong time to CHF by 25%. In case of systolic dysfunction we use pimobendan additionally. As soon as CHF develops we add Furosemide, of course.
Currently there are some studies under way to evaluate different medications on the progression of DCM but results are pending.
Regarding your case: I would also check the kidneys (CRF could increases NT-proBNP) and the thyroid (seems to be quite bradycard).
Best Regards!
Peter
Hi!
I don´t think that
Hi!
I don´t think that there exists a European consensus on the treatement of occult DCM. So, what I´m writing here is what we and lots of others do:
Based on O´Gradys retrospective study we use ACEI in occult cases since they were reported to prolong time to CHF by 25%. In case of systolic dysfunction we use pimobendan additionally. As soon as CHF develops we add Furosemide, of course.
Currently there are some studies under way to evaluate different medications on the progression of DCM but results are pending.
Regarding your case: I would also check the kidneys (CRF could increases NT-proBNP) and the thyroid (seems to be quite bradycard).
Best Regards!
Peter
I would also check a thyroid
I would also check a thyroid and assess for any endocrinopathy (Addison’s not likely but who knows) that may be responsible for subcontractile heart. Event or holter while exercising is a good idea as well in case of paroxysmal arrythmia. In Dobies there was a link between DCM and hypthyroidism making it worse.
I saw a cardiologist dx of dcm in a Lab with fs25% epss 0.8 and lve and minor lae but had systemic disease for GI issues and then when the Gi disease resolved the heart was fine >30% epss normal volumes ok. So when its borderline for the dcm dx then its important to repeat the echo especially in light of systemic disease as many factors can make the heart look DCM-esque and the dog can end of on meds when not needed long term if at all.
Similar scenario with cats and steroid induced chf… most dont need meds after getting over the initial steroid load crisis.
I would also check a thyroid
I would also check a thyroid and assess for any endocrinopathy (Addison’s not likely but who knows) that may be responsible for subcontractile heart. Event or holter while exercising is a good idea as well in case of paroxysmal arrythmia. In Dobies there was a link between DCM and hypthyroidism making it worse.
I saw a cardiologist dx of dcm in a Lab with fs25% epss 0.8 and lve and minor lae but had systemic disease for GI issues and then when the Gi disease resolved the heart was fine >30% epss normal volumes ok. So when its borderline for the dcm dx then its important to repeat the echo especially in light of systemic disease as many factors can make the heart look DCM-esque and the dog can end of on meds when not needed long term if at all.
Similar scenario with cats and steroid induced chf… most dont need meds after getting over the initial steroid load crisis.