BC with heart failure - advice welcome

[prairiegirl]

Hi all. This is my first time posting, but I've been reading the forum for a long time, and have come to really respect and appreciate the collective knowledge and experience of this group.

 

I have a 10-11 year old BC (he's a pound rescue, so not sure of his age / background) that was diagnosed in December with Dilated Cardiomyopathy (DCM). I started him on Vetmedin and enalapril, and added Lasix a month later. The heart meds have really helped (I'm sure he wouldn't have survived the winter without them), but over the past few weeks, the Lasix is no longer able to fully control the fluid buildup in his abdomen. He's now up to 80 mg twice per day (his normal weight without excess fluid used to run around 55 lbs). My vet is hesitant to increase the dosage any more due to the risk of dehydration. As a next step, she's suggested physically draining the fluid.

 

While I want to do everything reasonable to give my sweet boy the best possible quality of life for the time he's got left, I don't want to cross the line of subjecting him to painful procedures in a selfish bid to delay the inevitable. The problem is that, as a first time dog guardian, I don't have the experience to feel confident that I'll know where that line is. So I would really welcome any input regarding this specific procedure, personal experience regarding treatment options for DCM in general, and/or general advice on helping my heart dog along the path during his final walk in life.

 

Thanks in advance for your help.

 

 

[urge to herd]

Prairiegirl,

 

I don't have any experience with heart failure. I just want to offer my sympathies to you and your boy for this difficult time. Hopefully someone with more information will be able to help.

 

Ruth and Agent Gibbs

[ObeytheBC]

Abdominocentesis- or tapping the abdomen to draw out fluid is actually not a horribly painful event. I know, we can't tell how much pain a dog experiences and we think of the same procedure on us and imagine how painful it is. But, I have performed several abdominocentesis and the dogs/cats actually feel relief from the procedure. If your dog is uncomfortable, your vet may give them an injection for pain or for slight sedation to make the process easier but most vets will do this on a case by case basis since we don't light to do much sedation on dogs with heart problems. An abdominocentesis is mostly putting a large needle or catheter through the abdominal wall where the fluid has accumulated and is short enough not to actually bother the intestines or any other internal organ. Some vets do this with feel and experience, others use an ultrasound to guide the needle. However, what you have to remember is that the fluid will accumulate again and this is ONLY a symptomatic relief of a side effect of DCM. It is not a solution or a treatment to the true problem.

 

Perhaps you could ask for a referal to a veterinary cardiologist who may be able to give some insight to other drugs and options for your dog. Unfortunately, problems with the heart are mostly treated, never cured. But a cardiologist (if you don't have a cardiologist, internal medicine specialists will be able to help too) can give you another opinion and will probably know if there are any other or additional therapies you can try.

 

You could also talk with an alternative medicine vet - looking at herbal treatments, how to adjust diet and lifestyle, how to support your current treatment. I do not know off the top of my head, but they would also be able to discuss if accupuncture might help as well.

 

Good luck with your dog.

[rushdoggie]

I don't have a lot to offer, my only experience with heart failure is a small breed dog who didn't have acites, only fluid on the lungs...but I just wanted to say I'm sorry, its tough to deal with.

[Donald McCaig]

Dear Heart Patient,

 

My 12 year old Luke has two bad heart valves and has been on various diuretics for the better part of a year. We take him to the vet for draining every three weeks - 8 or 10 times so far because filled up with fluid he won't eat and my vet says he'd eventually suffocate. Draining the fluid takes about an hour and Luke wanted me or Anne with him (he hates vets) at first but now he just lies there waiting for the relief. The vet drains 2- 2/12 liters of fluid each time. You have to watch for infections (we keep benydryl on hand) but he's only infected once.

 

Advantages: Luke still takes some pleasures in life and the draining makes him much more comfortable.

 

Disadvantages: It's about $100 each time. (And I think the vet is losing money on the proceedure).

 

If we couldn't drain him, we'd put Luke down. The fluid buildup is very uncomfortable and would, in not too long a time, be fatal.

 

My wife tells me that in humans it was called "dropsy".

 

Donald McCaig

[prairiegirl]

Thanks for all the input. It's good to hear a common perspective from both sides of the table (so to speak). Like Luke, my Curly still seems to find enjoyment in life, despite the limitations of his heart condition, if I can reasonably manage the fluid buildup problem.

 

I also appreciate the kind wishes from the other posters. It's sad to think about losing my sweet boy, but I just try to enjoy whatever time we've got left together and hope that I have the courage to continue looking at things from his perspective so I recognize when it's time to finally let him go.