12 yr , 6Kg dog stage C MVD. Pimo 1.25Mg Capsules BID, lasix 2mg/Kg and maintained. Increased RR again. Treated with Pimo, Lasix TID( 2.7 mg/Kg AM,2mg/Kg mid, and 2.7mg/Kg evening), SID Benazipril. Most Recent recheck and Echo clinically fine, RR 40/min( home and clinic), shallow- min effort, auscult = very mild crackles DH region. Rads = PV enlargement, mild hilar interstitial pattern. SBP=140. Renal panel =NAF. Lasix contd. TID, Benazipril increased to BID, Spirono 2 mg/Kg SID( added). Lasix total daily dose 7.3 mg/kg. Pimo( capsules) just below .25mg/kg. Recommendations?
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Hi! Was RR measured at deep sleep? Should be different from in clinic RR. Does the dog still have PU/PD? Is the dog clinically dehydrated? Do you have rads to post? 2 directions? I agree, E wave could indicate CHF. If truely congested, increase Pimo to tid, add Amlodipine at 0,1-0,2 mg/kg, probably starting at lower end and increasing. If needed, increase Furo to 8-10mg/kg/d or switch to Torasemide. Surgery could be an option.
Minimal lung changes now. Interstitial pattern in PH and dorsal caudal region with increased pulmonary parenchymal density. Lungs looked fairly good??Pulmonary veins increased in size. RR 36-40 at home sleep/relaxed. Shallow breathing with minimal effort or coughing.Seems to respond to furosemide. Clinically fine otherwise. Eating and drinking. Not significantly dehydrated- increased urination, renal values were all good. Fractional shortening a little low for MVD with volume overloading? Regurge velocity appeared adequate? HR at high end of normal to mild sinus tachycardia.