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I am going to give a very detailed account of what I am going through, so please bear with me!

My 12 year old, poodle mix dog Nino (around 11 lbs) started a hacking cough 2 weeks ago. He has never coughed like this before so we took him to the vet the next morning, where he was diagnosed with a heart murmur grade 3. The vet gave us heart medication, Vetmedin, a blood pressure tablet called Enalapril, and the Orbax antibiotic in case it was an infection.

So we immediately gave him the medicine when we came home. Nino later had diarrhea that same day and my Mom immediately blamed the Orbax antibiotic and told us to never give it to him again (her and my older brother hate antibiotics). The very next day, Nino started to do better, only coughing when excited. My mom continued to press on us to not give him the Orbax, so on day 2 it was only Vetmedin/Enalapril.

On day 3, Nino started to cough quite a bit more. I argued/clashed with my brother and mother that we should listen to the vet and give him the Orbax for 10 days like he asked. Although they strongly disagreed, I gave him the Orbax that same day as well as the next 5 days. Nino improved and once again only coughed when excited, and had no diarrhea.

My mom, brother, and then my dad started to lecture with me that the antibiotic is really "killing him," "may stop his cough but is destroying his liver and kidneys, blah blah blah." I know antibiotics have their side effects, but it seemed to be working. Once again I was overpowered and did not give Nino the Orbax for the next 2 days.

Nino did just fine without the Orbax. I thought "Maybe he did not need the full 10 days?". My mom/brother went to the vet on this day, and said his heart rate and blood pressure was a bit better than last time. The vet said to finish the Orbax until the 10 days are over. Of course, my mom told me the vet was wrong and said he did not need it any more. Later that same day, Nino had diarrhea again. There was no Orbax given to him the last 2 days so my mom couldn't blame the antibiotic this time.

Well, my mom then blamed the medications and told me to look up the side effects. I found Vetmedin/Enalapril had diarrhea as a possible side effect. I begged to differ still, but my crazy mom wouldn't stop and said he shouldn't take it anymore even though the vet said Nino will need it for the rest of his life...

The next day I tried to give Nino the Vetmedin/Enalapril but he refused to take it with his food. I saw that loss of appetite could be a side effect too, so I got a little worried. After a little struggle, I managed to give him the Vetmedin but no Enalapril. Later that day, Nino seemed to be in a happier mood, so I suggested to give him the Enalapril but my mom said it was too late. So no Enalapril this day.

The next morning, Nino started coughing a lot again. I became so worried. I gave him the Vetmedin/Enalapril but no Orbax. He started to calm down and rarely coughed throughout the day.

The very next day, Nino coughed a lot again to start the morning. Finally, my parents got worried and took him to the vet. Nino did not have a fever. Did not cough once at the vet (they were there for like 3+ hours). They got an X-ray too. They said he still had a grade 3 heart murmur, probably closer to 4. They said he has an enlarged heart (cardiomyopathy). The vet recommended a third medication, a water pill/diuretic called Furosemide.

OK, so we have given him the Vetmedin, Enalapril, and now the Furosemide the last 5 days or so. Nino is still coughing every morning/night, and random times during the day. It seems like the only time he doesn't cough is when we take him outside to pee/poop or when he's just resting/sleeping. The coughs are even becoming a little fainter at times. Does this mean he is not breathing well? It breaks my heart to see him like this.

I read a lot of things online about his condition. I know when he coughs, the heart has to work extra hard, there is fluid accumulation in his lungs, etc. I read online that the enlarged heart may disrupt airflow through his trachea and may die from not enough oxygen getting supplied to his brain, etc. I keep worrying that he's gonna drop dead at any moment.

I want to also include Nino suffered an injury from our other dog, Royal, where he bite Nino so deep and tore apart a lot of muscles in the upper chest/armpit area of Nino only a month before this hacking cough came up. His rehabilitation was such a hard thing to go through and we were so relieved he recovered. He was back to being Nino but then just 2 in a half weeks later he gets this?

It's just hard to fathom; Nino was doing so well before. We always said how healthy he was for his age before the injury and cough.

Is it possible to get the cough to go down again like it did for the first week? Or is it not going to get better and become chronic?

Is it possible Nino has an infection that was undetected? Should I start giving him the Orbax again? Should be collect his poop for a stool test?

Did the injury from Royal deeply biting him possibly cause this or accelerate this condition to occur?

How long can Nino live with this condition? I've read varying accounts from others online that it can be 2 years or just 2 weeks. I am so scared for Nino, should I take him to the vet again? Or should I seek a 2nd opinion, maybe look for one of those heart specialist/cardiologist?

If you've gone this far, THANK YOU so much for listening!

I would love to hear any advice/suggestions from anyone who has gone through similar experiences! PLEASE, all responses are welcomed!
 

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I would not stop the medications. I would ask the vet to do an echo cardiogram or refer to a specialist if necessary.

I had a dog with congestive heart failure. She did fine on the Enalpril with no side effects. Even if she'd had some diarrhea, I would not have stopped the meds.

I'm sorry you have to battle your family about giving your dog the medications recommended by your vet. I've no advice on that part. People believe all sorts of weird things about life saving prescription drugs.
 

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Discussion Starter #3
I would not stop the medications. I would ask the vet to do an echo cardiogram or refer to a specialist if necessary.

I had a dog with congestive heart failure. She did fine on the Enalpril with no side effects. Even if she'd had some diarrhea, I would not have stopped the meds.

I'm sorry you have to battle your family about giving your dog the medications recommended by your vet. I've no advice on that part. People believe all sorts of weird things about life saving prescription drugs.
Thank you so much for you response, greatly appreciated! And sorry to hear about your dog going through that. I suppose there is nothing I can do except to continually give him his medications and hope for the best.

Unfortunately, my parents would be the ones to decide on an echo cardiogram or to see a specialist since they are the ones with the $$$. I think they would only consider it if he somehow gets worse but by then it might be too late.

However, when will I know that the condition got worse? I may be wrong, but isn't grade 5-6 of a heart murmur pretty much congestive heart failure? How can I tell if Nino is at that stage? Can it go from grade 4 to grade 5 in a short amount of time? Once again thanks for the advice.
 

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You don't really have a diagnosis at this point as far as what is causing the cough.

Not all murmurs result in heart damage. If she has heart damage, it's important to know what kind.I understand that it's not your decision to pursue a diagnosis. If the cough persists after she finishes the antibiotics, I'd try to get your parents to take her in for further tests. An x ray can sometimes be helpful if the heart is the problem.

Symptoms of heart problems are persistent coughing, lack of energy, fainting, loss of appetite and I'm sure there are more.

My dog lived six years after she was diagnosed. Her heart problem was caused by Chagas disease. She gradually got worse but many of those years she was quite active and enjoyed fetching her tennis ball.
 

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@ob1force,
Well, you may not like what I'm about to tell you, but I feel compelled to warn you.
Enalapril is toxic to dogs & cats. Here's the link: Pet Poison Helpine | ACE-Inhibitor Toxicity in Dogs and Cats
I gave my dog Enalapril for 9 months. After 9 months my dog died. The Vet who tended to my dog at the Emergency Hospital told me she never used Enalapril because it can attack the kidneys. After 9 months, my dog went into kidney failure. Her renal readings were up and down like a roller-coaster everyday. Frankly, I wish I'd never given her that poison, but it's too late.
Here are the side effects of Enalapril:
http://www.petmd.com/pet-medication/enalapril
If you click where it says in gray: "More items", in small letters it warns about the kidneys.
Also, please note, the first side effect is "labored breathing".
Several times, when my dog was taking Enalapril, she seemed as if she was having a heart attack. My vet laughed at me and ridiculed me. Now, my dog is dead. Vets do NOT pay attention to the side-effects of all these drugs. And as long as you're paying them, they don't care.
Please also note, a SIDE EFFECT of Enalapril IS BELABORED BREATHING and high blood pressure. Sound dangerous? It IS!
WHY is your dog on Orbax if the Vet doesn't know for sure whether your dog has infection? That makes no sense. Would you take a cancer drug if you didn't have cancer, but your Dr. said, "maybe" you have it? Maybe your dog just has allergies. Afterall, it is allergy season. I've had pets all my life. MOST of them had "heart-murmurs" - or so the vet claimed. All my animals with "supposed" heart-murmurs lived long lives. I gave them nothing for their "murmurs".
I now have a new dog, which I will not treat like a garbage disposal for every drug that comes out on the market.
I won't make that mistake again.
JMHO.
Good luck!
 

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@karenb2, any drug, even over the counter, so called "natural" products can be toxic if ingested in dosages above what a vet would prescribe which is what the link you provided states. I hope your future dogs don't develop a condition that requires a life saving drug. Treating my dogs like a garbage disposal? Not even going there.
 

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@karenb2,

I feel it is dangerous to post such one-sided remarks. Some of these drugs can save a pet's life, and someone might read this thread further down the line and decide not to give a drug solely on one opinion and their pet may die because of it. All drugs have their risks and it is up to the owner to converse with their vet to weigh the pros and cons with additional research and do proper diagnostics of kidney/liver values beforehand. Laboured breathing is a also a symptom of enlarged heart, higher grade murmurs, and fluid overload; so to blame it exclusively on a drug is not correct. I'm sorry that your dog died, nothing hurts as much as loosing a much loved family member.

To the OP, did the vet do blood work to see blood cell count?
 

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I have to agree with the suggestion to take your pet to a specialist… the cost is often a 'one time only' thing, involving a thorough exam and and echo… then he/she will offer recommendations and assessment and you are done.. .could run maybe $400- $800… but could also save your pet's life. But if you don't have the funds, you don't have the funds.. not much can be done about it… you can also opt for a specialist's assessment of the radiographs… that is rarely even $100 and often well worth it. Did your vet say anything about 'pulmonary edema'.

An enlarged heart certainly does NOT mean cardiomyopathy (two very different things) but does suggest at least some degree of heart disease. This is not saying your dog cannot ALSO have cardiomyopathy, but that would be very unfortunate to have two different heart problems at the same time (cardiomyopathy is nearly impossible to diagnose without an echo, by the way).

Chronic heart failure is the most likely diagnosis based on what your are saying, but there are other causes of cough as already mentioned, even in dogs with all the symptoms of a heart failure dog (often little poodles can have collapsing trachea, allergic bronchitis etc. that will NOT respond completely to the meds you have your pet on). Pets often need to be on multiple treatment plans to treat the various causes of cough. Orbax, an antibiotic, might be used to treat a bronchitis or pneumonia, but probably is the least important of the meds mentioned above.

By the way, Pimobendan, Furosemide and Enalapril are the classic meds to treat a small heart failure dog and are very well accepted and often well tolerated meds (rarely had a problem with ANY of these meds except the Furosemide, which will be a bit taxing to the kidneys over time). Enalapril is one of the safest medications you can give your pet, for any reason (has a lot of other uses aside from heart failure) and though not every pet will survive forever while on Enalapril, the incidences of 'toxicity' (excepting overdoses) are extremely rare (I have used the drug in my patients for 26 years now and cannot think of a single problem with any of them… many eventually died of course as heart failure and age alone eventually lead to death… but most improved a lot and had a fairly decent quality of life far above what they were experiencing before their treatment). Hearts tend to continue to worsen, though, and eventually all the meds in the world cannot save your pet's heart. But every pet is unique and all fail at different rates. Best of luck to you and your pet!
 
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