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Long term vet diagnosed 13 yr old mini doxi with stage 3-4…

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Long term vet diagnosed 13...
Long term vet diagnosed 13 yr old mini doxi with stage 3-4 congestive heart failure, placed on Vetmedin & Lasix 120mg daily, began throwing up some blood. Got 2nd opinion, team of 3 vets told me no heart murmur, no swollen heart or fluid around heart. Discontinued meds, now 3 months later & he has a progressive dry hacking cough along with what I think is reverse sneezing. Very scary; getting worse. Cough comes from deep in his chest. I gently press nostrils together to stop reverse sneezing. So worried about the deep hacking cough. Very little exposure to other animals; doubt kennel cough. Could 1st vet be correct? Is it possible to misdiagnose murmer/heart failure? Help please, any definitive tests? Taking Denamarin 225 mg tabs for allergies; tests show no congestion in sinus cavities; some thick clear discharge from nose after sneezing. any advise? so confused. Worried a/b quality of life; not sure if he's in distress. Any advise for tests or general advise? THKS FOR YOUR HELP
Submitted: 8 years ago.Category: Dog
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Answered in 20 minutes by:
6/14/2010
Dog Specialist: Candy, Veterinary Technician replied 8 years ago
Candy
Candy, Veterinary Technician
Category: Dog
Satisfied Customers: 11,626
Experience: Practicing Veterinary Technician for 26 years.Former Veterinary Practice Owner, Technician Trainer
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Hello and Thank You for contacting JustAnswer
I am sorry to hear your baby is having trouble.

 

 

Can you tell me what tests the first vet did to diagnosis Mitral Valve Disease Insufficiency

 

Wat tests were run by the second vet

 

What lead you to get a second opinion

 

When were the last tests done on the heart

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Customer reply replied 8 years ago
Hi Candy,
1. For 1st vet, on 12/10/09, he performed the following which is the first invoice I see with what appears to be cardiac related.
(.50) Survey X-Rays Large (2)
(1) Sedation for X-Rays
1 Examination
1 Vetmedin 1.25mg (start of cardiac medication I think)
30 Lasix 12.5 (doesn't this mean fluid in his heart/chest cavity?)
12/18/09 - started TheoDur 100mg
1/29/10 Notes from visit:
1 Examination
.50 Survey X0Rays Regular (2)
Lasix 40mg., Enalapril 5mg., already on Vetmedin 1.25mg
Notes from my visit: told he had cardiomyopathy (Mitral Valve Disease Insufficiancy), no fluid in chest or abdomen, heart is still enlarged but same as 12/10/09 (stage 3 with stages being 1-5), lungs are clear, no cough today, thought he may have coughing from leash, but we always use a harness, no arrhythmia, increased dosage of lasix. told one of the meds can cause kidney problems, and he has had the Bun test done since then.



2. The 3/12/10 invoice for 2nd vet indicates they peformed a physical exam, an electrocardiogram and 3 X-Rays.. It also states 1 Dexamethasone Injection and prescriptions for cough tablets (don't like the generic labeling and will call for real name when they open this morning) and zeniquin 25mg. I think the x-rays were taken because Oscar was sneezing alot and had a good bit of mucus coming out of his left nostril. . My notes include the following: no heart murmur, no CHF, no fluid in chest, EKG normal, there was a green dishcharge from his nose, allergic component likely. I was concerned Oscar had a cardiac cough, but they said no. I believe they took x-rays of his nasal cavaties. Since then he's gone back to vet a few times; invoice says physical exam without annual. On 5/6, he had a Physical Exam, a Chem 20 and a CBC w/Diff.

3. Oscar was vomiting blood, probably from all the toxic meds he was on, and the gasping was really bad. I was later told the gasping was reverse sneezing, nothing to really worry about. I was seriously thinking about putting him down. My good friend, coincidently the first vet's sister-in-law, insisted I seek a 2nd opinion. Vet #2 said to take Oscar immediately off of all that medicine. He and his associates could not hear a hear murmur after repeated attempts. I was told it's impossible to diagnose a murmur when there's not one there.

4. The last and only electrocardiogram was done on 3/9/10, along with the other tests mentioned. I'm not sure if the other ones have to do with his heart or ability to breath. One 5/6/10, as mentioned above, he had a chem 20, physical exam and CBC with Diff. I just spoke with the vet assistant who said the bloodwork could be related to his heart/coughing condition. I made an appointment for 12:30pm today to see the main doctor. Can you give me your take on if I'm going to the right vet? I promise I won't hold you liable for any outcome. I'd just like a professional opinion. Vet #2 has a larger practice with more doctors and equipment.

I was told that if we wanted a definite prognosasis, a cardialist from LSU comes to New Orleans every 2 weeks to perform an echochardiograph. It cost about $300, and unfortunately we didn't and don't have that money, My other cocern is that Oscar is so old that I don't want to put him through the procedure only to shortly die of old age.

If you can give me any advice before my 12:30pm appointment, I would be so greatly appreciatevice. Thanks . . . looking forward to hearing back from you. I'm so torn over
this. My heart is breaking.
Dog Specialist: Candy, Veterinary Technician replied 8 years ago

Ok,

 

I just want to clarify some things

 

The first vet says they see an enlarged heart on x-ray while the second says there is not correct.

 

In all the testing that has been done was a heartworm test included

 

Has he been on heartworm prevention

 

Is an x-ray the only way they have viewed the trachea

 

Have you been able to video tape these episodes or have either of the vets actually witnessed that coughing

 

Do you know what if any abnormalities appeared in the blood work



Edited by Candy on 6/14/2010 at 3:23 PM EST
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Dog Specialist: Candy, Veterinary Technician replied 8 years ago

You have not responded to my additional questions however I know you have an appointment shortly so I wanted to send you some additional information

 

Lasix is commonly used to remove fluid build up associated with heart disease in dogs. However it can help in other ways.

With mitral valve insufficiency, the valve ages and shrinks and fails to completely close off the area on the left side of the heart between the two chambers. The left ventricle is very strong, and with mitral valve insufficiency, it easily forces a portion of the blood backward into the left atrium with each heartbeat.

Since Lasix also works as a vasodilator in the heart and kidneys; dilating the blood vessels of both organs so that blood flows more freely and the organs become more functional is commonly used for these cases.

 

My concern is the two totally different diagnosis in this case especially since there were x-rays done in both cases.I can completely understand your frustrations as this is somewhat frustrating to me as well.

A cough as you have described could very well be associated with a problem with the heart however this is also seen with a collapsing trachea which is not always identifiable on x ray. It is also common to see an increase in reverse sneezing in cases of collapsing trachea.

Read more here

http://www.peteducation.com/article.cfm?c=2+2096&aid=410

 

As much as I hate to say this but in my opinion a third opinion by a vet is needed. You do this several ways. First you can ask that all x-rays be viewed by a veterinary radiologist. This is there area of expertise and all they do is x-rays. You can collect all of your information and the it to a cardiologist for a consult or you could take all of your records and see a third vet. I normally would not suggest the frustration of a third opinion but the diagnosis are so different.

 

Here are some videos I would like you to view to see if any of these look like what your baby is doing.

 


http://www.youtube.com/watch?asthema

 

http://www.youtube.com/watch?collapsingtrachea

 

Please reply back if you have the additional information I requested, please let me know how things go at the vets today.

Candy

 

 

 

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Customer reply replied 8 years ago
Dear Candy,

Yes, the 2nd opinion vet had a completely different diagnosis, essentially giving my dog a new lease on life. This vet is the owner of a practice that has six vets that discuss challenging cases as a group. Three of the doctors presented their finding in my presence, prompting me to take Oscar off of all the harsh medications, and most importantly not put him to sleep. I still haven't said anything to Vet #1 because he is a family friend and my parents' neighbor. Oscar is up to date on his heart worm test and monthly meds. Vet #1 went into Oscar's throat with a some kind of tube and assured me his trachea was open and firm. I thought it was collapsing as well.

When I brought him to Vet #2 today, I was told that an alarming amount of animals are being brought to their practice with the same hacking cough. They believe it is due to the dispersant, Corexit, which is being air dropped into the Gulf of Mexico. So far they've used over ONE MILLION gallons of Corexit, which is four times more toxic than the oil.

(I believe it's important to BP to use this specific dispersant because it attaches to the oil and makes it drop into the gulf. Then the public doesn't get to see how much oil there actually is. Strong efforts by the public and the EPA to use readily available less toxic dispersants. Anyone who is interested in how the oil spill is being handled can easily do research online.)

It will break your heart, both for the people of Southern Louisiana and the wildlife we have lost and will continue to lose. The vet tested Oscar's urine, blood and a well formed fatty deposit (benign!) and gave him 2 shots - 1 dexamethasone injection and convenia injection. The shots are supposed to help the cough. He also gave me a prescription of a cough tablets (Dextromethorephin/Guaifenesin-spelled wrong). I do feel better since seeing the vet. He assured me that additional tests weren't necessary because Oscar's heart is fine. His liver enzymes were a bit elevated due to harsh meds from Vet #1. Still, he didn't think Oscar was having a "quality of life" issue. So, I'll cross my fingers and pray that this medicine works. And I'll pray to God that this oil slick and it's consequences don't drive me and my dog from the state I've living in and loved all my life.
Dog Specialist: Candy, Veterinary Technician replied 8 years ago

I am glad they again said nothing is wrong with his heart.

I am not surprised to hear that products being used to control the oil spill is causing problems. I am on both state and federal animal disaster teams and I have heard of a few of the humans that were dispatched out on a ship complain of a dry hacking cough since returning. I will have to mention your vets suspicions to them.

 

I am above all glad to hear they do not think Oscar is suffering and he still has may more days to spend with you.

 

Please keep in touch and let me know how he is doing it seems as if vet #2 is doing what he can to make Oscar more comfortable.

 

Best Wishes

Candy

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