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Hi, i`m Richard, a Veterinarian from the UK. Hopefully I can help today.
What medication is your dog currently receiving? What investigations has he had done so far?
has he had an ultrasound scan to confirm the diagnosis?
echo is a heart ultrasound so it sounds like he has had a thorough work up. Do you have specific concerns regarding his treatment. As for his meds and investigations, it sounds like your vet has done a very thorough job. My staple treatments for these cases are pimobendan and lasix, occasionally diltiazem or fortekor if they are not coping well.
My apologies. I have misunderstood and thought you were concerned about his heart treatment.
Yes, we can often be in this situation with these patients. They are often on such a cocktail of meds and the very fact that the meds are in the food can put them off it. Do you have any problems giving him the pimobendan before food?
You are right, bitches in heat can dramatically affect local males so this could be a factor also.
If it makes him vomit on an empty stomach, he is better having it with food. It is claimed to have better absorption on an empty stomach but that is of little use if he is not keeping it down. I would try and limit his medications initially. Maybe try and stick to his pimobendan and lasix with his meals initially. If he is eating better then try and give him the other meds after he eats. This will help tell if he has reduced appetite simply to avoid the meds in his food.
If his appetite remains reduced, especially if he has vomiting episodes, it would be worth ahving his blood work checked again to make sure his liver issues are not worsening.
You can try offering a light diet which is tasty to try and encourage him to eat - plain boiled chicken and rice, a little scrambled egg, plain white fish or light cottage cheese.