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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28461
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My dog was diagnosed with heartworms two weeks ago, she had

Customer Question

My dog was diagnosed with heartworms two weeks ago, she had a fluid build up and my vet thought it to be adrenial gland problems, he gave me Lasix and I bought a new mop. This morning I carried her back for a re-check, he told me he could do surgery but he advised against it, thinking she possibly wouldn't make it through the surgery. He gave her 3 to 6 months to live, and sent us home with more Lasix and Prednisone. He says we can't treat her for the heart worms. Is there anything else we can do for this dog?
Submitted: 6 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 6 months ago.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 6 months ago.

Kay, I'm sorry to hear of this with Abby. Can you please clarify "fluid build up" for me? Are you seeing swollen limbs (dependent edema) and/or an abdomen swollen with fluid in the abdominal cavity (right-sided heart failure), or, instead, fluid in the lungfields and/or chest cavity (left-sided heart failure)?

"Adrenal gland problems" and surgical intervention are also unclear to me.

Customer: replied 6 months ago.
Swollen abdomen. On the first visit due to the fact she was drinking abnormal amounts of water and diabetes was ruled out that she may have a problem with the adrenal glands.
Expert:  Dr. Michael Salkin replied 6 months ago.

Thank you for the additional information. Her swollen abdomen is most likely due to right sided heart failure due to the heartworm infection. Regrettably, it's true that her prognosis even if treated for heartworms is poor to grave when such heart failure has already arisen. She can, however, be treated for heart failure. Her Lasix is an important part of therapy but the addition of the heart drug pimobendan, an ACE inhibitor such as enalapril or benazepril, and perhaps a vasopressor such as tadalafil can improve Abby's quality of life and life expectancy.

Pimobendan strengthens the heart beat and vasodilates which makes it easier for the heart to push blood through the blood vessels. An ACE inhibitor acts to keep blood pressure from elevating. Tadalafil can reduce pulmonary hypertension. Please continue our conversation if you wish.

Customer: replied 6 months ago.
Can you prescribe these meds.
Expert:  Dr. Michael Salkin replied 6 months ago.

I regret that we're not allowed to prescribe through this venue. Our regulatory agencies don't consider our conversation here to represent a proper client-pet-vet relationship. Mea culpa.

Customer: replied 6 months ago.
I'm sorry to hear that you are not allowed to prescribe meds and I'm sure my vet wouldn't appreciate me telling him what my pet needs.
Expert:  Dr. Michael Salkin replied 6 months ago.

You're welcome to share our conversation with your vet. He should be amenable to my recommendations. They constitute the standard of care for dogs such as Abby.

I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Expert:  Dr. Michael Salkin replied 6 months ago.
Hi Kay,

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

Dr. Michael Salkin