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Dr. Raymond
Dr. Raymond, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 113
Experience:  Hello! My name is Dr. Kevin Raymond with 13 years of experience. I truly understand how much our furry loved ones mean to us.
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My 11 yo female pomeranian died suddenly on saturday from CHF.

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My 11 yo female pomeranian died suddenly on saturday from CHF. The ER Vet thinks it was from a rupture chordae teninae. She had hypothyroidism for years. She was dx'd with a grade2/3 heart murmur in 10/12 when she a a small spindle cell tumor removed from her leg. She was cleared for surgery and had no other issues. She started coughing off/on, usually from excitement or exercise. I thought it was a collapsing trachea and took her back in 5/13. her heart mumer was at a 3/4, lungs clear and the vet suggested putting her on enapril, but it didn't seem to be urgent. She need to have a kidney function test before getting meds. Basically, I put it off because I didn't think it was urgent. She had a syncope episode on 8/11 and I did cpr. She went into a seizure and came out of it. The rest of the week she seemed fine...eating, drinking etc. She would cough off/on and I would give her hydrocodone for the cough. On 816 she had another episode, I did cpr, but it took longer to revive her and afterwards i could her onset of pulmonary edema. i watched her for about 30 minutes, she did not get better so i took her to the ER. She was put into an O2 chamber and given IV lasix. Chest xray showed a very enlarged heart and especially the L. atrium. She died within an hour or so...she stopped breathing and heart stopped. My question is...if I would have given her the enapril back in May...would it have changed the outcome. I know it wouldn't have changed the ulimate prognosis, but would it have kept her heart from enlarging to the point of full CHF with 3-4 months. Could I have prevented her death? I feel like I missed what her subtle sighns were telling me!!
Hello, I am so so sorry to hear about Annie her recent passing. I know you must be going through a difficult time and my heart goes out to you. Losing a family member is never easy, but take comfort in knowing you did everything you could for her, I promise you that. Many clients won't do oxygen therapy and all the treatment and love you gave Annie. She was a lucky girl to have a family like you. My name isXXXXX and I have been treating dogs and cats in California for 13 years. Please rest easy, we really don't know if starting enalapril or benazapril when a dog is not showing clinical signs of CHF with a hear murmur actually helps or not. Heart murmurs are seen in at least 25% of the older dogs vets see every day and most don't need treatment just like in humans. In fact it can cause some serious side effects to the kidneys, so most vets that I know and from my experience would not start an ace inhibitor like enalapril unless they were showing signs of CHF on x-rays or severe coughing. I have managed many dogs with both mitral valve disease (which causes the enlarged left atrium) and a collapsing trachea and they are very hard to manage (usually seen in toy breed dogs too) as both conditions can cause syncope and coughing and unfortunately the prognosis when having both is very poor. I lost one my kitties from heart failure and I know what you are going through. It is very natural to question if you did everything right ( I know I did) from what you described it sounds like you did everything you could for her and it was just her time. Annie was blessed to live 11 years in a good family. I have seen Pomeranians die just from severe collapsing trachea. I highly doubt that starting the medication would have made a difference and again you gave her more of a fighting chance than most people do in my experience. I know the grieving process is hard and if you ever need to talk please reach out to me. My thoughts are with you in this difficult time, Dr Kevin

NOTE: This information does not replace an in person consultation with your veterinarian and is for information purposes only. Thank you!
Customer: replied 4 years ago.

Thank you Dr. Kevin. How fast do you think her heart enlarged before the full CHF episode? She did nothave an echocardiogra, so I know the anser will be more vague, but hyptheically...if the heart murmur was a 2/3 last October and this May it was a 3/4...does that mean she was in severe decline then? When she coughed it would be hard for 5-10 secs...then she would be fine. We gave her table scrapes...some steak, chicken..roast beef sometime...could the salt made her heart enlarge faster? When I gave her cpr during the syncope episode, I felt her stomach expand...did i put to much air into her and I do more damage? After the episode I heard fluid in her lungs as she breathed...if I would have taken her to the er vet within 15 minutes vs 30-45 minutes, could they may have saved her because she would have been in an O2 chamber and have IV lasix in to push out the fluid?


Hello again, It would be impossible to tell how fast her heart enlarged before getting CHF. If you did get an echo done of Annie's heart it likely would not have changed that much in prognosis. I have had patients with severe loud 6/6 murmurs with no CHF and only subtle enlarged hearts on x-rays so the intensity of the murmur does not always correlate with severity of heart disease. I doubt that getting Annie there any quicker would have made that big a difference. what usually causes severe worsening is when a tendon holding the valve to the heart ruptures causing untreatable and fatal CHF. I am so sorry again for your loss and all these emotions and questions you are feeling are very normal. Hope to hear from you soon and you should rest easy knowing you did all you could for her. Best regards, XXXXX XXXXX
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Hello again, I was checking in on you and seeing how you are holding up. I know Annie is missed deeply and my thoughts are with you. If you ever need to talk let me know. Thanks, Dr. Kevin Raymond