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labouring heart


n0mad
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I was at the vet yesterday and he told me my girl's heart was "labouring". He asked me if her energy level was normal and I said I thought so, but afterward I got thinking that I don't know what normal is for a ten year old border collie; I've never had one before.

 

I know every dog is different and every collie has it's own energy level but what would be considered normal? I live in an apartment and she goes to work with me at a pet store four or five times a week where she sleeps most of the day except for about a half an hour or so where she gets to play fetch with the customers. This winter we've hardly been out for walks and other than fetch in the living room she hasn't complained much to go and do anything. She just goes and sleeps. Is this "normal"?

 

I was looking forward to this spring so we could get out and play frizbee and go for hikes in the woods, but now I'm worried about how much I should do. My vet said that at this point there isn't anything to do but to get her back in if she shows a lack of energy or starts coughing. Any thoughts would be helpful right now.

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She's only just over 35lbs, not fat at all and not too skinny. I feed Origin dog food and no treats with the exception of an occasional Greenie or freeze dried chicken snack at work. She's perfectly healthy in every other way, just this labouring heart. In fact, when I first put her on the table for the vet he forgot she was an old dog and had to look twice at her age. :)

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By labouring did he mean a herat murmor? If your vet suspects heart issues I'd want a x-ray or ultrasound done to check it out. Because if she has the beginning stages of congestive heart failure there are things that can be done before she gets to the coughing stage.

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He didn't say heart murmur, just that it was working too hard. He had me feel her heart with my hand and it was really pounding but slowly. He said he wasn't ready to send her to a cardiolagist yet but if I saw a decrease in energy or if she started coughing I was to get her back in right away.

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I don't quite understand why, if he thought her heart was "working too hard" he didn't do some additional testing. A simple X-ray would show if the heart was enlarged, and that could be a good starting point before springing for the more expensive stuff (the coughing starts when the heart becomes enlarged enough to impinge on the trachea). Personally I'd delve further now rather than wait for additional symptoms, because as someone already noted, there are medications that can help with heart issues (depending on the problem, of course) and that can actually prolong life for dogs with heart conditions. As someone who doesn't have much money, I would probably put off a visit to the cardiologist at this point, but I'd certainly pursue the simpler/cheaper diagnostics.

 

J.

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I had a dog that had an unusually slow heartbeat at age two. (BTW, not a vet myself and this doesn't trump your vet's opinion.) However, my vet thought it was possibly an issue but told me that it could just be her heart "quirk". Turned out, she was a nice working dog that didn't tire easily and lived to be 16 years. She did not even have a murmur when she was 16 and was PTS due to increased arthritis pain, nothing to do with her heart. Maybe a second opinion or at least a chest x-ray?

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I don't quite understand why, if he thought her heart was "working too hard" he didn't do some additional testing. A simple X-ray would show if the heart was enlarged, and that could be a good starting point before springing for the more expensive stuff (the coughing starts when the heart becomes enlarged enough to impinge on the trachea). Personally I'd delve further now rather than wait for additional symptoms, because as someone already noted, there are medications that can help with heart issues (depending on the problem, of course) and that can actually prolong life for dogs with heart conditions. As someone who doesn't have much money, I would probably put off a visit to the cardiologist at this point, but I'd certainly pursue the simpler/cheaper diagnostics.

 

J.

 

I've just been through similar with my 12 year old who had a strange sporadic arrhythmia spotted at his last check up.

No symptoms at all but I decided on an X ray and ecg to see if there was any medication that might help stop it getting worse.

The result was that there was nothing worth doing at present since he's fine and active in himself and the only meds that might have an effect could have unpleasant side effects. He doesn't have any congestion.

A phone call to the cardiologist by my vet confirmed my inclination to do nothing further unless he deteriorates, but at least I knew I hadn't passed on the chance to get some treatment for him that might have helped. Ultrasound would probably have given us more detail about what we now know but wouldn't have affected the recommended course of action.

My initial reaction was to keep him wrapped in cotton wool but that soon wore off. He's active, he's happy, and it might well be counterproductive to stop him doing things he loves for the sake of a condition that we might never have found out he had.

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I second Julie's comments re simple tests that could help comfortably prolong your dog's life and quality of life. I jsut lost an lhasa to heart disease five years after he was diagnosed and I know there are inexpensive medications, low-salt diets, etc. that can help - depending on the what is wrong with your dog's heart. At the very least, I'd want an x-ray to see if the heart was enlarged and your regular vet can do that w/o the expense of a cardiologist. If your girl is in the early stages of heart disease, suggestions re diet and regular exercise may help prolong this stage.

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Thanks, I'll get back to my vet about x-rays etc. Thanks also for the encouragement, I was thinking too (up all night thinking :( ) that she wouldn't be happy if I didn't let her do the things she loved just because I was afraid. I've decided that I'd rather see her happy smiling face for a shorter time than have a sad dog for a longer time.

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^^ It's called considering quality of life. As I have a number of dogs entering (or already in) their geriatric years, I have found myself considering quality of life more and more. When my 14 1/2 year old recently hurt her back and my rehab vet said I needed to severely limit her walks, I tried to strike a balance between that recommendation and letting Jill enjoy life, and one thing she really, really loves is a walk to the river. So she gets fewer walks like that one (which are long), but still gets to go. I see no point in making one's dog live a severely circumscribed life due to old-age issues if it means the dog is no longer doing the things it loves. JMO of course!

 

More on topic, when my nearly 14 year old (2 more months) was getting an ultrasound to see if her mast cell cancer had spread internally, the person doing the US thought he saw fluid in her pericardium (she has a severe murmur and is on a couple of meds to help with her enlarged heart and what is likely a mitral valve problem**), but I was able to say to the vet that fluid in her pericardium was unlikely as she still ran with the pack, didn't cough, was out enjoying life like a regular dog and not acting like an animal with a heart in distress. It turns out that my assessment was right, something I wouldn't have known if I had decided to restrict her once I knew she had heart problems. And at any rate, I just feel better knowing that the oldsters are enjoying as much of their lives as they can. If that means they end up with a slightly shorter lifespan, to me it's worth it to know that the life they did have was one they enjoyed as fully as possible to the end.

 

**Just a note about this: When we started treating Willow for the slightly enlarged heart and heart murmur, we discussed doing ultrasound or other diagnostics, but after my vet told me although ultrasound would allow us to pinpoint a more exact cause for the murmur, a majority of dogs have murmurs that are the result of mitral valve issues, and it was sensible to treat her as if that's what we were dealing with. We put her on Enalapril, and later added Vetmedin (which lowers the blood pressure so the enlarged heart doesn't have to work so hard pumping blood). We monitor with yearly X-rays to see changes in heart enlargement. Willow may not be as wide open as she was in her younger days, but she's still going strong, and although she been treated for her heart murmur for several years now, she still isn't showing the classic symptoms (that characteristic cough) of a dog in congestive heart failure. It will come, I am sure, but by treating early, I think I have put it off some, and I haven't had to restrict Willow's lifestyle at all. (And when I was talking to my rehab vet about Jill at a recent visit, she confirmed that the Vetmedin has been shown clinically to increase lifespan, which is a good thing, because it's rather expensive--$2.25/day for Willow. The Enalapril is pretty cheap--I get it at WalMart, and it's just over $13 for a 2-month supply. And this is why I recommended at least doing some basic diagnostics--there are treatments out there that can make a real difference for a dog with heart problems, assuming your dog is suffering from something similar.)

 

J.

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Three years ago my the vet discovered a heart murmur in my then 9 y/o dog. She suggested taking her in for an ultrasound to see what was going on (xrays are good too, but there is a vet here that does the u/s at a very reasonable cost so we went that route)

 

It was discovered that she had mitral valve scarring that would lead to issues down the road but everything else with her heart looked fine at that point. So they said to just watch her and bring her back for another one a year later. She had another year of fairly normal life. The second u/s showed some enlargement in her heart so she was put on enalapril ($10/90 day supply from wal-mart). She had her third u/s last spring after a year of being on enalapril. This one showed no change since the previous year.

 

We'll go in for her yearly u/s in a few more weeks and see if there's any change since. But so far she is still quite happy and pretty active for a 12 y/o dog. I don't let her over exercise, but she still does a few minutes of ball or frisbee just fine, still loves to go on walks and out the barn for chores.

 

By keeping tabs on it and being proactive we can start meds as soon as we see internal changes indicating that meds would be helpful as opposed to waiting for external symptoms to pop up.

 

ETA - I totally agree with Julie that you also have the quality of life issue. I want my dog to be happy! I'm not going to let her run herself to the ground. But if 5 minutes of fetch helps to keep her happy, she's definitely going to get it!

 

I'll have to look around a bit, but I read somewhere that Vetmedin has been shown to add up to an extra year of life for dogs in the end stages of heart failure. That is pretty significant IMO. I just keep hoping they have a generic available by the time Missy needs to go on it.

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This is a long shot, but try doing a web search on "Lance Armstrong heart rate" and/or "arrhythmia Lance Armstrong" and see if that looks at all possible.

 

I've had at least two of my dogs' heart rates questioned by wonderful, attentive vets who noticed in routine check ups that the dogs' heart beats seemed slow and hard, with the second part of the contraction sounding (so I'm told) sort of muddled.

 

When it happened with the first dog, I had some money, the dog was an excellent subject, and we hooked him up and did a live modem analysis on the spot. It turned out all was well. In fact, what my (excellent!) vet had noticed was indeed somewhat out of the ordinary, but in a very good way.

 

Apparently super-conditioned athletes may have a surprisingly slow at-rest heart rate. The key is that their heart rates accelerate and then recover again faster than non-athletes. That goes for dogs and horses, as well as humans.

 

Alas, many vets seldom see a truly high fitness level in the dogs they examine. So many truly beloved family pets are portly and under-exercised (though often also very happy). I "saw the light" myself when I first started getting into performance activities (must be two decades ago now) and had to put my roly-poly cross-bred dog on a diet and exercise regime. I didn't want to believe it when I began, but it sure did make a difference, and it changed how I've managed my dogs ever since.

 

I've had many different veterinarians remark on how fit, lean and healthy my dogs have been over the years, and what a pleasure it is to handle them. I have to say that it's a lot easier keeping the Border Collies in good shape than it was with the American Eskimo/Australian Cattle Dog cross (he had a wrist-deep coat, a ribcage like a beer keg and no room in front of his hips for a "tuck" -- even when he was thin you had to put your hands on him to be sure), or the purebred ACDS. (Talk about "good keepers.") Or my goodness, the English Bull Terrier, or the Bull Terrier/Jack Russell cross. Border Collies (at least working or even performance-bred BCs) do seem to have that "natural athlete" aptitude built into their genes.

 

I'll keep my fingers crossed that even though the OP's dog is older and apparently not rigorously active any more, that perhaps an athletic earlier life has carried over and the legacy of a "super athlete" heart beat remains.

 

Best wishes and well-meant optimism emanating from South Central PA

Liz S

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Apparently super-conditioned athletes may have a surprisingly slow at-rest heart rate. The key is that their heart rates accelerate and then recover again faster than non-athletes. That goes for dogs and horses, as well as humans.

When I took my now-deceased Boy for US for possible kidney stones, the vet (an internal medicine specialist) was shocked by his heart rate. She thought there might be something seriously wrong with him. Then she had an assistant take him out and run him up and down and they rechecked. As Liz noted his heart rate increased with exercise and then dropped back quickly to its normal slow resting rate once the exercise stopped. I suspect she had not dealt with a super fit dog either.

 

Mara,

Vetmedin (pimobendan) is a veterinary-only drug, so it's unlikely a generic will be made available anytime in the near future. I don't know when it was first marketed by Boehringer Ingelheim, but they will have some years of patent protection, and then, unless there's a huge demand for it, it's not likely that other companies would start producing a generic version. If it were used in humans, there would be a greater demand and making a generic form might be more appealing, but if it stays as a veterinary drug only then I'd guess there won't be a huge push to genericize it (but I could be wrong) once patent protection is lost. Sorry to be a wet blanket. :(

 

J.

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Mara,

Vetmedin (pimobendan) is a veterinary-only drug, so it's unlikely a generic will be made available anytime in the near future. I don't know when it was first marketed by Boehringer Ingelheim, but they will have some years of patent protection, and then, unless there's a huge demand for it, it's not likely that other companies would start producing a generic version. If it were used in humans, there would be a greater demand and making a generic form might be more appealing, but if it stays as a veterinary drug only then I'd guess there won't be a huge push to genericize it (but I could be wrong) once patent protection is lost. Sorry to be a wet blanket. :(

 

J.

 

That's kind of what I've been afraid of. But Vetmedin was introduced 11 years ago and the effective life of drug patents in the US is 7-12 years so I'm still holding on to a thin thread of hope...

 

Here's another question then - Will a well conditioned dog hold up beter in the face of CHF?

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My vets have commented numerous times about how slow and steady my dogs heart rates are and they are so glad of it. Even my toy poodle has a nice slow heart rate :) Many vets don't quite get the athlete dog and the fact their heart rate is normally slower and as long as it is steady there is no need to freak.

 

My rescue acd is fearful of people and going to the vet was something I dreaded but she was due for her yearly checkup. Even with how freaked out she was the vet tech and vet commented how slow her heart rate was well until they tried to draw blood. That caused major issues.

 

Anyways, I would call your vet and have him explain to you what he really meant by the heart was laboring. From there you and the vet can decide if you need to take the next step of running tests.

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Here's another question then - Will a well conditioned dog hold up beter in the face of CHF?

I don't have expertise in CHF (not on the vet level anyway), but it seems to me that a very fit, healthy heart would be able to withstand the early stages of CHF better (in that noticeable onset of symptoms related to CHF would appear later in the disease process because the heart would be in a better position, fitness-wise, to deal with an increased work load early on in the process), but I would guess that if the underlying causes of CHF that lead to heart enlargement, etc., aren't addressed then eventually even the extremely fit dog is going to have the same symptoms and outcome as there's no getting around the heart having to work harder to deal with the underlying causes. That's just my supposition though.

 

As for Vetmedin, I'd be thrilled if someone came out with a generic version. I imagine it would help Jill, too, but my pockets aren't endlessly deep....

 

J.

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Ben, unfortunately, already had chronic chf when I adopted him. He sas on Enalapril and Vetmedin, and during the last few months, lasix as well. I kept him at a good weight so he didn't receive a lot of commercial treats but he did get things he liked - such as green beans, lean pieces of meat, yogurt, etc. I made the decision to let him exercise as much as he wanted - which was basically walking about a block, racing down the driveway, circling and barking the other dogs when they wrestled, etc. I let him be a dog and I have no regrets - he died too young but I gave him a good quality life which is the best I could do.

 

Your girl is lucky to have such a caring concerned owner and I hope she does well.

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Well, it turns out that the reason my vet didn't pursue anything further with her heart was that he wasn't completely sure of what he was finding at that time. A new problem having arisen they had the opportunity to recheck her and the good news is her heart is perfectly fine. The bad news is that she is now recovering from surgery to remove a block in her stomach. The silly old girl got it into her head to eat a holey roller ball after playing with them safely for the last nine years.

 

The surgery went well though and I can hopefully bring her home tomorrow. It was quite the weekend for her. On Saturday she swelled up like a balloon after an allergic reaction to a bug bite and then spent the majority of Sunday night vomitting only to wind up on the surgery table this morning. :( Thankfully she should be fine and the vet said that because she was in such "tip top condition for a dog her age" her recovery should be relatively quick.

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