Everyone enjoys a good surprise. I am no different, as a surprise birthday party was organized by my husband to celebrate a milestone. On the pretext we were going to dinner with my siblings, 30 friends greeted me in surprise! It was a wonderful occasion to celebrate life and the blessing of family and friends.
In my garden, each day of summer provides the element of blissful joy to see the unfurling of new flowers on the lilies with their delicious and intoxicating scent.
Many visitors to my garden delight in the constant fluttering of the butterflies that come on my Joe Pye Weed flowers.. All if these constant changing and evolving " eye candy" are highly anticipated and gorgeous portions of the summer experience in the piedmont summer in the Carolinas.
Last week, I came home to the surprise of a lawn mower photo shoot being shot in my yard. I was overwhelmed by the amount of equipment and number of people ( check out 15+ cars) to take a picture of a riding law mower.
As my garden travels included a side trip to the Chelsea Flower Show in London, I was surprised by the side trip to the British Museum to see the spectacular beauty of the Elgin Marbles in the British Museum. Sometimes unscheduled events have huge visual surprises.
Unfortunately, some surprises are unexpected and not pretty, namely failure of the heart muscles to effectively pump blood called dilated cardiomyopathy.
WHAT IS DILATED CARDIOMYOPATHY OF DOGS?
Dilated cardiomyopathy (DCM) literally means “a disease of heart muscle characterized by ventricular chamber (lower section) enlargement." It is one of the most common acquired heart diseases in dogs.
WHAT HAPPENS?
Initially, the chambers of the heart enlarge and the walls stretch to compensate. Eventually, this leads to leaky heart valves and a backlog backing up to the lungs if the left side is not pumping effectively. The belly becomes full of fluid if the right of the heart fails.
WHAT ARE THE MORE COMMON BREEDS OF DOG THAT HAVE THIS DISEASE?
Cocker spaniels, Doberman Pinschers, Golden Retrievers, Newfoundlands, Boxers, Dalmatians, Portuguese Water Dogs, Labrador Retrievers, and Great Danes have a risk for the disease. Testing is available for genetic risk assessment for many of these breeds.
I HAVE HEARD THAT SOME CANCER CHEMOTHERAPIES CAN INDUCE THIS DISEASE? ANY OTHER RISKS?
Yes, it can also be found in cancer patients being treated with IV cancer drugs, such as doxorubicin/Adriamycin, that have a toxic effect on heart muscle. Infections such as protozoan Trypanosoma cruzi can insult the heart muscle (myocarditis), a parasite commonly found in South and Central America. Also, low thyroid levels (hypothyroidism) can lead to heart disease. Parvo virus induces heart muscle damage in many puppies that current immunization (vaccination) protocols have significantly lowered the risk.
NAME SOME DIET RISKS ASSOCIATED WITH DILATED CARDIOMYOPATHY?
Nutritional cardiomyopathy has been reported predominantly in American Cocker Spaniels, Boxers and Dalmatians on urolytic diets such as Hills Prescription Diet u/d. Recently, taurine (a protein/amino acid) deficiency has been reported in several other breeds, including Golden Retrievers, American Cocker Spaniels and Newfoundland, especially if eating a vegetarian diet. In Boxers, another protein/amino acid deficiency, carnitine, has been noted that responds to supplementation. These amino acids are essential for normal heart muscle function.
ARE THERE MORE COMMON SIGNS?
Lethargy, exercise intolerance, weakness, and cold feet can develop surprisingly quickly. This can be followed with coughing and a greatly distended belly (ascites). Most owners report a loss of appetite and difficulty breathing by this time.
CAN YOU LIST SOME TESTS NEEDED TO CONFIRM THIS DIAGNOSIS?
X-rays of the chest and abdomen, electrocardiogram, sound waves of the heart (echocardiogram), blood work, thyroid levels, and possible testing taurine levels (an amino acid).
MOST COMMON TREATMENTS UTILIZED?
-Diuretics such as furosemide
-ACE inhibitors to dilate vessels and help reduce fluid retention
-Pimobendin to slow heart rate and improve efficacy of each heart beat
-Digoxin to slow very heart rates associated with an ECG abnormality called atrial fibrillation
-Beta blockers to slow an extremely fast heart rate.
-In severe cases, draining of the "life threatening" fluid accumulation of fluid in the belly to relieve pressure on the diaphragm that makes breathing difficult.
WHAT IS THE PROGNOSIS?
Generally animals will live three months to a year depending on the severity of changes at presentation.
IN BREEDS AT RISK, ARE THERE SOME SCREENING TESTS?
Yes. Discuss the value of NT-proBNP, Troponin levels, genetic screening, diet review, Electrocardiograms, and Echocardiograms of breeds at risk with your veterinarian.
Betsy T. Sigmon DVM, Diplomate American Board of Veterinary Practitioners, Canine & Feline Practice
Hospital Director, Creature Comforts Animal Hospital
Cary, NC
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