Dear Dr. Dog: My Pit Mix friend Betsy is now ten years old, and I know heart issues can crop up in senior pets, just like it does in people. Can you describe the kinds of cardiac problems dogs generally develop and tell me what I can do to keep her heart healthy? —Trevor in Fairfax
Trevor, you’re absolutely right – older dogs deal with heart diseases, just like people. The types of diseases are different, but the general principles, clinical signs, and treatments are very similar. Heart disease in dogs is a very complicated topic, so we will only scratch the surface here. For more in-depth and specific information on dog (and cat) heart disease, and for ways to help people dealing with them, you can visit www.bigheartsfund.org. In this article we will discuss signs of heart disease in dogs, common heart diseases in dogs, and what you can do to help keep Betsy’s heart at its best.
How can I tell if my dog has heart disease?
Dogs can’t tell us they feel tired easily or have chest pain or “shortness of breath.” Fortunately, your family veterinarian can help discover signs of heart disease during a physical examination. He or she will use a stethoscope (and their “ears” of experience) to discern heart murmurs, irregular heartbeats, or abnormal lung sounds that may indicate heart disease. Findings suggesting heart disease may prompt further testing to determine their significance. Tests include chest radiographs (X-rays), EKG, blood pressure measurements, and echocardiography (ultrasound of the heart).
What should I look for at home?
There are no easy-to-spot signs of heart disease in dogs, which can make things very difficult for owners (and veterinarians!). The following are some frequent signs of heart disease:
- Weakness
- Exercise intolerance (may be confused with arthritis or aging)
- Lethargy
- Coughing
- Difficulty breathing (emergency!)
- Collapse (emergency!)
Your veterinarian is a great source of information and can help determine the significance of any of these signs. Often, it will require an examination and/or diagnostic tests to look for other indicators of heart disease. The two most common acquired heart diseases in dogs are mitral valve degeneration and dilated cardiomyopathy. They both may result in congestive heart failure, which is a serious and life-threatening condition.
What is mitral valve degeneration?
Mitral valve degeneration (MVD) is diagnosed when the normally smooth and thin valve becomes thick and knobby. This causes leakage, which creates a murmur. It also elevates pressures in the circulation and can eventually result in congestive heart failure (CHF). CHF means that fluid has accumulated in the body and always requires treatment – and it can be deadly.
Fortunately, MVD is relatively easy to diagnose, as the leakage creates a characteristic heart murmur early in the disease process. We generally recommend evaluation of severity by chest X-rays in these dogs. In larger breed dogs like Betsy, we also recommend echocardiography. Treatment is instituted once severe heart enlargement and/or CHF has occurred, and is based on drug therapy in the majority of cases.
Almost all dogs will develop some degree of MVD if they live long enough. It is also somewhat breed dependent, in that smaller-breed dogs (such as Cavalier King Charles Spaniels, Chihuahuas, and Dachshunds) are more commonly affected by severe MVD. The age of onset of severe disease is variable, but is commonly in the eight- to twelve-year-old range. It may, however, affect much younger dogs.
What is dilated cardiomyopathy?
Dilated cardiomyopathy (DCM) is a primary disease of the heart muscle resulting in an enlarged and weakened heart. The weakened pump cannot effectively eject and receive blood, and low blood pressure and/or congestive heart failure can result. This disease is more common in large and giant breed dogs – especially purebred dogs like Doberman Pinschers, Boxers, and Newfoundlands – however, mixed breed dogs can be affected as well. The disease is so prevalent in Doberman Pinscher that annual screening is recommended past two years of age. In other breeds, fortunately, the prevalence is much lower.
Dilated cardiomyopathy is difficult to detect at an early stage. Often, no murmur, arrhythmia, or other signs of heart disease are present until the disease is advanced. Congestive heart failure and sudden cardiac death are possible.
While mitral valve degeneration and dilated cardiomyopathy comprise the vast majority of heart diseases in older dogs, other diseases (other cardiomyopathies, cardiac cancer, arrhythmias, and infections) may occur. Referral to a veterinary cardiology specialist, identified by the credentials “DACVIM (Cardiology),” is often helpful in these cases.
What can I do to help?
The most important thing you can do to ensure Betsy’s heart is working properly is to take her in for regular examinations (at least yearly) by your family veterinarian. Taking her to the vet if any of the above signs are present is also very important, as early treatment is often more effective (and less costly) than delaying care.
A high-quality diet and regular activity are also important, as is maintaining a healthy body weight (not too fat and not too skinny). Finally, if heart disease is identified, dogs often benefit from referral to a veterinary cardiologist who has trained extensively and specifically in the treatment of cardiac diseases in dogs. This specialist can help educate pet parents, diagnose specific diseases, and help ensure dogs live as long as possible with a good quality of life.
Dr. Justin Allen is a board-certified specialist in cardiology at VCA Bay Area Veterinary Specialist and Emergency Hospital in San Leandro, where he and Dr. Rick Kienle offer cardiology services six days a week. Dr. Allen recently moved to Fremont with his wife Kimberly, their dog (Jasmine), their four cats (Peeps, Ganon, Creamy, and Peanut), and their first child, due later this year.
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