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Richard Rawling
Richard Rawling,
Category: Veterinary
Satisfied Customers: 731
Experience:  Veterinary Surgeon at Tameside Veterinary Clinic
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We have three generations of Yorkshire terriers. One of them

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Hello. We have three generations of Yorkshire terriers. One of them is now a month away from sixteen. Her name is***** has been diagnosed with a bad heart that is called "soplo" un Spanish. Fluid enters her lungs and she has been taking a deuritic for several years now. She ask suffers from syncopy. She had one attack of that fainting over a month and a half ago and then recovered fine. She then had another attack a week ago and this one was followed by 5 other similar faintings where she would lose consciousness for 30 seconds. And make a loud noise while throwing her head back. Then she would recover, but be extremely fatigued. After that day of 6 faintings she no longer has any for four days. However two days after that day she got diahrrea and had several noises coming from her stomach. We gave her medicine to coat the stomach from our vet. This eliminated the diahrrea and her stools have become much better. During four days she slowly regained her appetite and seemed a lot better. She received oxygen therapy at the vet when we took her after she had her faintings. We then got our own oxygen chamber and have been using it to stabilize her. Yesterday (four days after her initial bad day) she once again had a string of syncopes faintings. About 6 or 7. We put her in oxygen to stabilize her again. But it she has not really fully recovered. Today she ate only a small amount. And pood as well as peed and drank water. But she is very weak. Her stomach is bloated. They ran an EKG and her heart is beating properly. Her lungs currently have no liquid. She has a bad heart but it isn't fatal. Vets are recommending to put her to sleep if her attitude does not improve. She can walk but she wobbles. She falls and sits. We are ready to put her to sleep.but we want to make sure that we have exhausted all options. Let us know as soon as possible what you think.
JA: I'm sorry to hear that. The Expert will know if Nikki will be able to digest that. Is there anything else the Veterinarian should be aware of about Nikki?
Customer: She just drank a lot of water. She has been drinking a lot of water the past few hours. Way more than normal. Her stomach may be bloated with water. She does still pee however. And it is voluntary, not involuntary.
Customer: replied 1 month ago.
Update a few hours later: she has eaten more. Not great but she has eaten a little bit of everything. She has gotten up and walked a lot more. Smelling and looking for the food. Though she is a very picky eater. She has needed any oxygen and has not had any more syncope attacks. She seems a lot more alert.

Hi, i`m Richard, a Veterinarian from the UK. Hopefully I can help today.

Is she receiving any medication other than the diuretics?

Customer: replied 1 month ago.
We have been giving her nutri-plus gel. And we also give her a heart medicine called renitec. The vet prescribed which she has been taking along with the deuritic which is called alcadone for the past few years. She is a small Yorkie so she can I only handle fractions of the pills. We gave here the heart medicine, the deuritic and the nutri plus gel yesterday. This morning she is sleeping soundly, no attacks. Her breathing is 29 breaths per minute. The breathes are not normal however, it does seem that her body has to effort itself to make them.

Ok, great. She may have some fluid accumulation on her lungs.What dose of the Alcadone is she currently taking?

Customer: replied 1 month ago.
They saw her lungs the day before yesterday and she had no liquid in the lungs. She has 1/8th of a pill of alcadone. She weighs only 2 kilograms. A few months ago they raised the amount of deuritic but that nearly killed her because she stopped eating entirely. Upon lowering the dosage she ate once again and lived normally for several months up until last week. I should also note that she has had a cough for the longest time in the past two years or so. But last week after her syncopes and her time in the oxygen chamber both at home and at the vets her regular cough ( a few coughs two or three times a day) have completely stopped. She has not coughed at all now for a whole week and counting.

So her cough has improved but her syncopy has increased in frequency?

Customer: replied 1 month ago.
She has only had the two days of synchopy. One last week on Thursday and then this week on Tuesday. Each of those days she had 6 or 7 of them throughout the day spread apart by an hour and each lasting no more than 15 or so seconds. The synchopy would only happen those days when she got up to walk. Yesterday she got up to walk several times but never got a synchopy.
Customer: replied 1 month ago.
But before she would only have synchopy once a month and recover quickly. Or even once every three months.

In that case the syncopy may be a sign that her heart is struggling more. It may be wise to talk to your vet regarding additional heart medication such as pimobendan if it is available in your country.

Customer: replied 1 month ago.
Would we give her that in addition to the heart medicine she is already taking? Or would we instead replace it with that. It is available in Mexico. What would the dosage be? I can also attach a sheet of blood work they did on Thursday of last week if that helps. As I mentioned, the vet here has signed off on her already. But her condition is getting better at the moment. She seems a lot more alert this morning than she was yesterday morning. Still sleeps a lot. But she is walking well and sitting up and looking around.
Customer: replied 1 month ago.
Here are the blood test results.

Yes, it can be used in addition to her current meds. The recommended dosage would be 0.2mg/kg twice daily. From the bloods it looks like her kidneys may be starting to struggle also. It may be an effect of the diuretics, but that would be something to carefully monitor also.

Customer: replied 1 month ago.
They prescribed azodyl for the kidneys. We gave it to her once last week but then she got diahrrea a day after. We don't know if it was from the azodyl or not. The vet said to stop with the azodyl until the diahrrea had finished so we did. We are not sure if we should give her the azodyl again or not now that she is a bit better and eating a little bit at a time. Is azodyl known to cause diahrrea or make her stomach bad? She also tends to lick a lot of the food we offer and lick her chaps but she only eats a small amount of it. It looks like she is hungry but is perhaps afraid to eat more than a little bit at a time. Rambo, her brother who is 15 has been on azodyl for over a year now and has had no side effects and eats very well. He began with kidney problems earlier.
Customer: replied 1 month ago.
Also is there a possibility that her syncope is not heart related? (considering her EKG was not as bad as they thought) And that the episodes are instead being triggered by some other disease? Or does the fact that they are mostly triggered when she was walking indicate that her circulatory system is slowly failing thus not providing enough oxygen to her brain and therefore causing the syncope whenever she has had too much walking or stress. (A visit to the vet seriously stresses her out, makes her tremble and depresses her a lot) would an ultrasound of the whole body be useful once she is feeling better? Thank you for all your help. We have 7 other dogs to care for also so we always appreciate the help.

It would be worth trying the azodyl again, try her back on a half dose initially to see if the diarrhea returns.

Considering it happens when she is more excited, I think the syncope is almost certainly heart related.

Customer: replied 1 month ago.
Thank you. We will order the new heart medicine and give her the azodyl. We will let you know how her condition progresses.
Customer: replied 1 month ago.
Hello again, she still has a very full stomach despite eating very little. She is very active. She already urinated and made some poo. Her poo was solid and brown. What is she full from or why is her stomach feel full? I'm thinking this is why she won't eat as much as she usually does. I also wanted to ask. Since we already have the oxygen chamber and mask. When should we place her in the chamber? Or use the mask? Should we do it preemptively? Or only do it if she seems out of breath or is extremely weak? At what pressure level should we administer the oxygen? (Vets said to do level 2 if she is ok and 4 if she is in very bad condition) and for how long? Thank you.

The full appearance of her abdomen can be due to accumulation of fluid (ascites) It may be an indicator that she would benefit from a higher dose of diuretics.

She should use the oxygen chamber if she seems to have labored breathing Level 2 should be fine to assist her breathing if her signs are mild. She should remain in the oxygen chamber until her breathing improves. They can get very hot in an oxygen tent, so she should not be in there for extended periods without careful monitoring.

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