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I know this is long and I have 14 questions but if your dog has heart disease can you please read all of this and help me?

My 7 year old Chihuahua was just diagnosed with mild, early stage heart disease. We saw a vet who went to Cornell and has studied additionally in cardiology but she is not a board certified cardiologist. We are sending the heart sonogram pictures to cardiologists at a university as a second opinion. The vet prescribed Enalapril and for my dog to take it two times a day for the rest of her life and said that later on she will need to take more medications.
>>1. Does anyone have a dog that takes Enalapril? I want to get personal experience on how your dog/dogs are doing on this medication and if it helped.
>>2. Did your dog have any negative reactions to the medicine?
>>3. What are some things I should know about this medicine?
Obviously the vet answered all these questions for me but I know from personal experience that doctors don't always tell patients everything and every side effect.
My dog has not started on the medication yet because we are waiting to see what the university doctors say and what medicine they recommend. The vet said it is fine to wait a little while because the disease is so mild.

>>4. Another question I have is should my dog really see an actual cardiologist? There is only one cardiologist near me and we did see her but she was extremely rude and just strangely mean to us and would not do the sonogram without sedating my dog (which is dumb because my dog did just fine getting a sonogram done without being sedated yesterday). That is why we took her to a vet who just has a cardiologist specialty and will be mailing the sonogram pictures to university cardiologists.

>>5. Also what diet do you feed your dog? I wanted to give my dog Honest Kitchen because it is real food but the vet said not to because it has too much water content and dogs with heart disease cannot have too much water.
>>6. How can I feed my dog better without giving her dehydrated food? I am willing to cook for my little dog but I cannot find a realistic cook book that is also grain free.
>>7. Where can I find recipes for dog food that meet AAFCO requirements?

I am going to be calling all the holistic vets in my area to see if they can help.
>>8. My question is, do any of you with dogs that have heart disease take them to a holistic vet?
>>9. Did the holistic vet help?
>>10. What sort of supplements did they tell your dog to take?
>>11. Did the holistic vet have you change your dog's diet?

>>12. And my most important question: Have any of you reversed your dog's heart disease or have you heard of anyone who has? I believe that in most cases, all diseases can be cured so I really want to cure my dog's heart disease. I have a disease and many conditions that doctors say is incurable but I have read enough stories of people who have cured themselves to know that what doctors told me is not true. So I can't help but think my dog's mild heart disease can be cured.

>>13. If my dog does get cured of heart disease, can she stop taking the medication? Or is she going to become so reliant on it that she won't be able to ever stop taking it even if she does not have heart disease anymore?

>>14. Did you get your dog's teeth cleaned while they have heart disease? I am nervous to take my dog in to get a dental because of the anesthesia. Her teeth are building up some tartar and the vet said she can get a dental but I know that lots of dogs die during dental cleanings so I am just not sure if my tiny dog would be able to handle getting put under.

I know this is really long and I have lots of questions but that you for reading and helping! :)
 

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The vet says that my dog should take 2.5mg of enalapril twice a day. How much does anyone else's dog have to take? 2.5 seems like a lot. I looked online and children are only supposed to take .08mg so it seems weird that my tiny 5-6 pound dog would take 5mg a day.
 

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I know this is long and I have 14 questions but if your dog has heart disease can you please read all of this and help me?

My 7 year old Chihuahua was just diagnosed with mild, early stage heart disease. We saw a vet who went to Cornell and has studied additionally in cardiology but she is not a board certified cardiologist. We are sending the heart sonogram pictures to cardiologists at a university as a second opinion. The vet prescribed Enalapril and for my dog to take it two times a day for the rest of her life and said that later on she will need to take more medications.
>>1. Does anyone have a dog that takes Enalapril? I want to get personal experience on how your dog/dogs are doing on this medication and if it helped.
>>2. Did your dog have any negative reactions to the medicine?
>>3. What are some things I should know about this medicine?
Obviously the vet answered all these questions for me but I know from personal experience that doctors don't always tell patients everything and every side effect.
My dog has not started on the medication yet because we are waiting to see what the university doctors say and what medicine they recommend. The vet said it is fine to wait a little while because the disease is so mild.

>>4. Another question I have is should my dog really see an actual cardiologist? There is only one cardiologist near me and we did see her but she was extremely rude and just strangely mean to us and would not do the sonogram without sedating my dog (which is dumb because my dog did just fine getting a sonogram done without being sedated yesterday). That is why we took her to a vet who just has a cardiologist specialty and will be mailing the sonogram pictures to university cardiologists.

>>5. Also what diet do you feed your dog? I wanted to give my dog Honest Kitchen because it is real food but the vet said not to because it has too much water content and dogs with heart disease cannot have too much water.
>>6. How can I feed my dog better without giving her dehydrated food? I am willing to cook for my little dog but I cannot find a realistic cook book that is also grain free.
>>7. Where can I find recipes for dog food that meet AAFCO requirements?

I am going to be calling all the holistic vets in my area to see if they can help.
>>8. My question is, do any of you with dogs that have heart disease take them to a holistic vet?
>>9. Did the holistic vet help?
>>10. What sort of supplements did they tell your dog to take?
>>11. Did the holistic vet have you change your dog's diet?

>>12. And my most important question: Have any of you reversed your dog's heart disease or have you heard of anyone who has? I believe that in most cases, all diseases can be cured so I really want to cure my dog's heart disease. I have a disease and many conditions that doctors say is incurable but I have read enough stories of people who have cured themselves to know that what doctors told me is not true. So I can't help but think my dog's mild heart disease can be cured.

>>13. If my dog does get cured of heart disease, can she stop taking the medication? Or is she going to become so reliant on it that she won't be able to ever stop taking it even if she does not have heart disease anymore?

>>14. Did you get your dog's teeth cleaned while they have heart disease? I am nervous to take my dog in to get a dental because of the anesthesia. Her teeth are building up some tartar and the vet said she can get a dental but I know that lots of dogs die during dental cleanings so I am just not sure if my tiny dog would be able to handle getting put under.

I know this is really long and I have lots of questions but that you for reading and helping! :)
Hello! You have some very good questions.

What kind of heart disease was your dog diagnosed with? Given the breed, I would guess DCM secondary to MVD?

Did you have your dog evaluated for cardiac disease because she had clinical signs (coughing, exercise intolerance, increased resting respiratory rate etc) or for an incidental murmur?

The answers to the above questions will help dictate whether pharmacologic intervention is necessary at this time. Unfortunately there is no clear cut answer as to when to start cardiac medications. According to the most recent scientific data, starting prophylactic medical therapy (i.e.: a patient who may have ultrasonographic and radiographic signs of cardiac disease, in the absence of clinical signs) does not increase the patients prognosis, nor does it increase survival. On the other hand, starting medications in patients who are clinical for heart disease unequivocally increases their survival and quality of life.

Enalipril is a class of drug called an ACE Inhibitor; the drug is actually an antihypertensive agent. Patients with DCM (dilated cardiomyopathy) typically are treated with 3 drugs: Enalipril (or benazepril), furosemide and pimobendan. Depending on which cardiologist you talk to, some will add spironolactone to the regimen because of its cardio-sparing effects. The utility of starting Enalipril in early-stage heart disease (and in the absence of clinical signs) is questionable and unfortunately there is no data to support its use in this fashion. On the other hand the drug is reasonably benign has as a very low incidence of side effects, so it is unlikely to cause the patient harm.

Should your dog see a cardiologist? Good questions. I suppose in an ideal world, cardiac disease would be managed by cardiologists, since they are the experts in this field. That being said, even if you see a cardiologist, you need a good GP to quarterback your care. It certainly wouldn't hurt for you to have a cardiology consultation, and then you have a specialists, in addition to your GP, coordinating your dog's care. I see this as the best situation possible. If you're not concerned about the cost, you can ask your family veterinarian for a referral to another cardiologist (one you are comfortable seeing).

Diets that are cardiac disease friendly are those typically low in sodium. There is a large volume or research in people with respect to nutrition and cardiac disease; that same volume of research unfortunately does not exist in veterinary medicine. Most cardiologists will recommend a sodium restricted diet, however the benefit in canine patients is not as well demonstrated as in people. If your dog is being treated with furosemide, you should not restrict their access to water; this could lead to life threatening dehydration and may exacerbate kidney disease in these patients.

Unfortunately, heart disease in dogs (with the exemption of HCM caused by taurine deficiency - a very uncommon disease these days, or HCM secondary to hyperthyroidism - again a very uncommon disease in dogs) is irreversible, and is progressive. Pharmacologic intervention is aimed at improving cardiac function, and more importantly, quality of life. DCM in some dogs has a predictable disease course; in other patients less so. Dobermans, for example, that have DCM will typically succumb to disease in 6 months (some patients survive longer, some shorter). Small breed dogs can live with mitral valve disease and secondary dilated cardiomyopathy for years. Patients with pulmonary hypertension usually die very quickly. Every patient is different, however heart disease is unfortunately not curable.

Managing dental disease in these patient is very important. Small breed dogs frequently have severe periodontitis. Just as in people, periodontal disease in dogs is linked to kidney disease, liver disease, and in some cases can exacerbate cardiac disease. Not only is managing their dental disease important for their systemic health, its extremely important to their quality of life. I see many patients with this problem - I usually council owners that you are better off taking the risk with anesthesia then you are forcing your dog to live with dental disease for the rest of their lives. That being said - we have a board certified anesthesiologist managing our anesthesia patients; this dramatically increases the margin of safety in high risk patients, and many of the patients we treat are referred to us specifically for this reason (anesthesia risk). Ask your family veterinarian for a referral to a speciality hospital that has an anesthesiologist and a board certified dentist on staff (dental specialists are usually much faster then general practitioners, thus decreasing anesthesia time).
 

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The vet says that my dog should take 2.5mg of enalapril twice a day. How much does anyone else's dog have to take? 2.5 seems like a lot. I looked online and children are only supposed to take .08mg so it seems weird that my tiny 5-6 pound dog would take 5mg a day.
Remember your dog is not a person. Dogs metabolize drugs very differently than people. Do not adjust your dogs medication dose without directly consulting the prescribing veterinarian. Nobody over the internet should be dispensing specific dosing advice. What one person is treating their dog with (dosage wise) may be very different from what another person is treating their dog with; and for good reason.
 

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Discussion Starter #5
"What kind of heart disease was your dog diagnosed with? Given the breed, I would guess DCM secondary to MVD?"
I don't know what kind of heart disease. The vet did not say.

"Did you have your dog evaluated for cardiac disease because she had clinical signs (coughing, exercise intolerance, increased resting respiratory rate etc) or for an incidental murmur?" We brought my dog to a new vet just because I wanted to change vets and he listened to her heart for a long time and said he heard a slight murmur. All he said is that whenever we get her teeth cleaned, we had to get a sonogram of her heart first. He assumed that her heart murmur was not heart disease, but I got it looked at as soon as possible just in case.
My dog has no outward symptoms. She will sometimes make this gagging motion as if she is trying to throw up, but she has done that for years and used to throw up bile so we and my vet assume that she does that because of acid reflux, not because of her heart.

"Should your dog see a cardiologist? Good questions. I suppose in an ideal world, cardiac disease would be managed by cardiologists, since they are the experts in this field. That being said, even if you see a cardiologist, you need a good GP to quarterback your care. It certainly wouldn't hurt for you to have a cardiology consultation, and then you have a specialists, in addition to your GP, coordinating your dog's care. I see this as the best situation possible. If you're not concerned about the cost, you can ask your family veterinarian for a referral to another cardiologist (one you are comfortable seeing)."
There are no other cardiologists in the area. I would have to drive 5 hours to the next closest one. I don't think my dad would be okay with doing that anytime soon since he just paid $500 for the sonogram yesterday.

"Small breed dogs frequently have severe periodontitis."
I know that small dogs usually have bad teeth but my dog is not usual in this way. She got her teeth cleaned when she was two and then had healthy white teeth and fresh breath until she was almost 7. Now just the outside of her top side teeth have a little bit of tartar. Her bottom teeth and the insides of her teeth look fine. I am going to be talking to a vet dentist to see if a dental is something I want to risk. I am just hoping to find personal experience from people. I have read so many horrible stores of healthy dogs dying during dental cleanings.

"Nobody over the internet should be dispensing specific dosing advice. " I am just looking for people's experience. My dog has not even started the medicine yet. We haven't even had the prescription for 24 hours.
 

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"What kind of heart disease was your dog diagnosed with? Given the breed, I would guess DCM secondary to MVD?"
I don't know what kind of heart disease. The vet did not say.

"Did you have your dog evaluated for cardiac disease because she had clinical signs (coughing, exercise intolerance, increased resting respiratory rate etc) or for an incidental murmur?" We brought my dog to a new vet just because I wanted to change vets and he listened to her heart for a long time and said he heard a slight murmur. All he said is that whenever we get her teeth cleaned, we had to get a sonogram of her heart first. He assumed that her heart murmur was not heart disease, but I got it looked at as soon as possible just in case.
My dog has no outward symptoms. She will sometimes make this gagging motion as if she is trying to throw up, but she has done that for years and used to throw up bile so we and my vet assume that she does that because of acid reflux, not because of her heart.

"Should your dog see a cardiologist? Good questions. I suppose in an ideal world, cardiac disease would be managed by cardiologists, since they are the experts in this field. That being said, even if you see a cardiologist, you need a good GP to quarterback your care. It certainly wouldn't hurt for you to have a cardiology consultation, and then you have a specialists, in addition to your GP, coordinating your dog's care. I see this as the best situation possible. If you're not concerned about the cost, you can ask your family veterinarian for a referral to another cardiologist (one you are comfortable seeing)."
There are no other cardiologists in the area. I would have to drive 5 hours to the next closest one. I don't think my dad would be okay with doing that anytime soon since he just paid $500 for the sonogram yesterday.

"Small breed dogs frequently have severe periodontitis."
I know that small dogs usually have bad teeth but my dog is not usual in this way. She got her teeth cleaned when she was two and then had healthy white teeth and fresh breath until she was almost 7. Now just the outside of her top side teeth have a little bit of tartar. Her bottom teeth and the insides of her teeth look fine. I am going to be talking to a vet dentist to see if a dental is something I want to risk. I am just hoping to find personal experience from people. I have read so many horrible stores of healthy dogs dying during dental cleanings.

"Nobody over the internet should be dispensing specific dosing advice. " I am just looking for people's experience. My dog has not even started the medicine yet. We haven't even had the prescription for 24 hours.

I would contact your vet for some clarification. You should ask him what her specific diagnosis is, and whether he believes there is structural changes within the heart. If all your dog has is an incidental heart murmur, then there is no indication for pharmacologic intervention at this time.
 

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The vet says that my dog should take 2.5mg of enalapril twice a day. How much does anyone else's dog have to take? 2.5 seems like a lot. I looked online and children are only supposed to take .08mg so it seems weird that my tiny 5-6 pound dog would take 5mg a day.
I will just say that no, the dose is not weird. You can clarify with your vet but this seems like a legit dose.

Ditto pretty much everything Calgary has said.

I think a cardiologist appointment may be a good idea just to ensure your dog needs the Enalapril since it can negatively affect the kidneys.
 

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Discussion Starter #8
Do you guys know if sending the sonogram pictures to a cardiologist would have the same benefit of physically going to a cardiologist?
 

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Depends on the images (quality) and the person looking at them. This type of thing (having images sent to someone to look at) is done a lot, but in my experience, specialists (whether cardiologists or Internal Medicine specialists doing abdominal ultrasounds) like to see the images/do the procedure themselves. Doing it themselves helps them orient and, if they're not sure about something, adjust to get the best images they can to help them make a diagnosis.
 

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Hm, I'll have to talk to my dad about going to see the cardiologist since it is so far and the disease I have keeps me from being able to drive. I'll also talk to the cardiologist who will be looking at the pictures and see if he thinks my dog should be seen personally.
 
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