Vetmedin/Heart Meds.....to use or not to use!?!

Re: Vetmedin/Heart Meds.....to use or not to use!?!

Nixthevet — Fri, 18 Jun 2010 18:15:24 GMT

Thanks everyone,

Mike, thank you for your invitation...It might be possible to bring her over sometime in the next few weeks- it's about 2 1/2 hrs. Unfortunately i've recently cancelled her insurance as decided I wouldn't put her through anything major at her age, so could I ask for a ballpark figure costwise. I'd definitely be interested in a quick echo and your opinion on treatment plan as i'd like to do what I can to maintain her quality of life for as long as possible provided it's non-invasive.

nichola

Re: Vetmedin/Heart Meds.....to use or not to use!?!

Martin Atkinson — Fri, 18 Jun 2010 11:11:12 GMT

Scanning is obviously the gold standard but having been using proBNP for several years as a predictor of cardiac failure I've found it is a useful adjunct if its inconvenient/too expensive to get a scan done. Recent revisions of the collection methodology and interpretation of results has greatly improved this test as a reliable indicator in dogs and cats. Get a baseline test done and if it is in the range that suggest cardiac failure is likely I'd start treatement. If its in an equivocal range test again in 6 months and if the level has doubled cardiac failure is imminent even if there are no symptoms. Also if your dog has lost sinus arrythmia I'd start treatment. Cardiologists will say that there is no benefit in pre-emptively treating in these cases but if it were my dog I'd probably have it on pimobendan now as there is anecdotal evidence to suggest that pre-emptive treatement can delay onset of heart failure.

Re: Vetmedin/Heart Meds.....to use or not to use!?!

Mike Martin — Fri, 18 Jun 2010 09:01:22 GMT

If she were my dog, I'd scan and x-ray at this point to see how much LA dilation there was, how LV function looked and just have a nosey at that valve too. Why don't you bring her over, if you're not too far away?

Re: Vetmedin/Heart Meds.....to use or not to use!?!

Vikki Halliday LLB — Thu, 17 Jun 2010 21:03:12 GMT

I'd go for an echocardiogram too, and possibly radiography if you want to get a good marker for heart size.

Have you considered spironalactone at a low dose, as this does protect the heart muscle without causing too many adverse increases in diuresis or cardiac output.

(Ok cardios shoot me down in flames for not getting a true Dx, but the evidence so far is it's pretty good at slowing myodardial fibrosis)

Re: Vetmedin/Heart Meds.....to use or not to use!?!

Emily Nightingale — Thu, 17 Jun 2010 20:09:00 GMT

Sorry to hear your own doggy isn't well. Am sure it is worse for us to have poorly pets because we know too much already so that clouds our professional judgement.

Have you facilities to do an Echocardiogram?? Perhaps ask Mike Martin as he is uber brainy re. hearts. He is on the forum too.

Good luck