Matters of the Heart

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Valentine’s Day 2012– A Note from Dr. Cloutier

When it comes to matters of the heart, emotions can run high. When it comes to a potentially life threatening heart condition the best treatment is a diagnosis. With knowledge comes comfort. In a recent case, a family, recovering from the loss of their dog to heart disease, learned that their newly purchased puppy also had heart disease.   It was more than their hearts could bear, and they returned the puppy to the breeder.

Whether it is a newly found murmur heard during a routine examination or an evaluation of a coughing dog, the words, “heart disease,” bring fear to a pet owner. According to veterinary cardiologist Jim Ross, not all murmurs are cause for concern, not all coughs are due to congestive heart failure, and not all fainting spells are due to the heart.  His reply to nearly every question on heart disease is “It depends.”

Without a diagnosis we can only guess at what is wrong. But what test is best? The echo, also known as the cardiac ultrasound, requires the most expensive equipment and technical expertise to perform, therefore, one might reason that it’s the best. But what about chest x-rays, an EKG or ECG, a holder or event monitoring, blood pressure measurement, and blood tests?  I, personally, would argue for the lowly stethoscope. Everyone has one, they work without electricity, and they can tell an experienced practitioner a great deal. Ultimately, each test on its own is only a piece of the puzzle; together they reveal a complete picture.

“But why go through all these tests if there is nothing one can do?” and “They don’t do open heart surgery on pets so what difference does a diagnosis make?” are often asked questions. Fortunately, most conditions improve with medication but there are some that respond better to surgery. In fact, we perform these corrective cardiac surgeries at the Veazie Veterinary Clinic and many of our patients go on to live normal lives.

Most heart disease is managed with medication. While medication cannot repair a leaky heart valve, it can relieve the back pressure on the valve so it is easier for it to pump blood forward. If blood pressure is too high, medication can reduce it. If the heart rate is too fast, it can slow it down. If the kidneys are retaining fluids and flooding the lungs, the excess fluid can be cleared with a diuretic. Extra heartbeats can be eliminated, and a failing heart muscle can even be made to pump more forcefully.

“How long will my pet live?” is the hardest question to answer. The severity of the heart failure, how bad the patient looks at presentation, even the results of the tests, does not give us a definitive answer. If the patient responds, if the heart function can improve in response to therapy, the prognosis is good. If, however, the heart just cannot respond, regardless of the medications we try, it means time is short.

Fortunately, most of the pets that come to us in heart failure improve and live a good life. And, I do mean a good life. There would be no point in extending a pet’s life if he were not able to enjoy it. If we support the heart and restore function, the patient can run and play again.  When it comes to matters of your pet’s heart, I think that is the best Valentine’s Day gift we could ask for.

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