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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26178
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Our 9 1/2 yr. old Irish Setter ' s heart enzymes are 950.....vet

Customer Question

Our 9 1/2 yr. old Irish Setter ' s heart enzymes are 950.....vet wants to consult w/ cardiologist. ....lately he tires easily during periods of hot muggy weather....He is normally active in cooler temps...loves to run & play....cost of cardiologist approx. $1,500.00. What would u suggest.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking with Dr. Michael Salkin
I believe that you're referring to the NT-proBNP blood test which may be useful in screening for cardiac disease in selected asymptomatic populations of dogs. Evaluation may help differentiate if clinical signs suggestive of heart failure (e.g., dyspnea/difficulty breathing, tachypnea (increased respiratory rate), exercise intolerance, weakness, collapse/syncope/fainting) are related to heart disease versus other noncardiac etiologies. More recently, data suggest that trends in asymptomatic dogs with chronic valve disease may help identify dogs at increased risk of developing heart failure.
Based on current data, normal values for dogs are less than 800 pmol/L. However, this is an evolving area of research and current interpretive criteria provided by the diagnostic laboratory (IDEXX) should be used when interpreting test results in individual patients. I show less than 900 pmol/L at IDEXX labs currently but some dogs can jump 1.3X after exercising. The significance of a 950, then, is questionable.
Your dog appears to be symptomatic - tiring during periods of hot muggy weather - but the great majority of dogs will tire during such periods. His chest films were normal. Was his heart rate normal? Is there an audible heart murmur?
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the additional information. (I marked your new post as a duplicate so you wouldn't be charged twice.)
I would question the need for a $1500 consult when no murmur has been heard and X-rays reveal a normal sized heart particularly if a normal heart rate and no arrhythmia (irregular heart rate) were noted. Why was the NT-proBNP blood test performed - because of his tiring lately?
I see two reasonable manners in which to proceed. You can simply "watchful wait" and see if additional symptoms arise. You can ask to have a traveling ultrasonographer come to your dog's vet hospital to perform an echocardiogram (ultrasound of his heart) which will be far less costly and likely suffice to rule heart disease in or out.
Please continue our conversation if you wish.
Customer: replied 1 year ago.
Having an electrocardiogram done on Mon. morning. ....thanks for your help.....
Expert:  Dr. Michael Salkin replied 1 year ago.
That's a sensible test when arrhythmia has been detected upon auscultation. I'd be pleased to continue consulting with you following that test if you wish.
Customer: replied 1 year ago.
Will contact you after the cardiologist exam....thanks, ***** *****
Expert:  Dr. Michael Salkin replied 1 year ago.
Sounds good. I'll watch for your next post.
Expert:  Dr. Michael Salkin replied 1 year ago.
Hi Liz & Tony Ricigliano,

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

Dr. Michael Salkin