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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23817
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog has been on lasix,vetmetin and elanopril weeks and I

Customer Question

My dog has been on lasix,vetmetin and elanopril for 3 weeks and I see little improvement. She is 13 years old and has taken thyroid med for 11 years but has had no issues until she developed CHF. I am afraid she won't pull through the CHF if I don't see improvement. Vet says it could take a little time. Anything I can do.
She is also taking Coenzyme Q10 and B vitamins.
Submitted: 3 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 3 months ago.

I'm sorry to hear of this with Ruby. If she can respond to those medications she should have done so long before now. Have you been told why she's in congestive heart failure; in other words, does she suffer from myxomatous valve disease ("leaky valves"), cardiomyopathy (heart muscle disease), and/or cardiac arrhythmia (irregular heart rate)?

Customer: replied 3 months ago.
She has an enlarged heart. Her symptoms are classic but her response has not been. I just want a heads up before we return to the vet so I know what to expect
Expert:  Dr. Michael Salkin replied 3 months ago.

An enlarged heart can result from any cause of heart failure. You need to have that cause clarified because while the combination of Lasix, Vetmedin, and enalapril is appropriate for something like leaky valves, cardiomyopathy and arrhythmia might be treated very differently. If you're assessing her poor response to no improvement in her coughing, the first drug to reach for is her Lasix. The dose of Lasix should be doubled and be given thrice daily until she can be attended to by her vet once again. Please continue our conversation if you wish.

Customer: replied 3 months ago.
Thanks. Her cough is soft and dry and really not at the top of her symptoms. Her main issue is constant panting and lethargy. Her appetite is very good and she drinks water. She goes out to void herself but it wears her out. Does that sound like d
Something different to you.
Expert:  Dr. Michael Salkin replied 3 months ago.

Thank you for the additional information. Her symptoms are consistent with heart failure but they don't identify the cause of the failure. If auscultation and X-rays haven't been confirmative, you can expect Ruby's vet to recommend having an echocardiogram (ultrasound of her heart) performed. An echocardiogram is the most specific and readily available imaging modality for my patient's heart. It can "see" less common heart disorders such as a pericardial effusion (fluid between the heart muscle and pericaridum/lining of the heart), heart base tumors, and changes in the heart muscle indicative of cardiomyopathy.

Expert:  Dr. Michael Salkin replied 3 months ago.
Hi Sara,

I'm just following up on our conversation about Ruby. How is everything going?

Dr. Michael Salkin

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