A Scary Diagnosis, But She's Doing Well Now

Paisley

While we were enjoying our week away at Grayton Beach State Park last month, Paisley started having some problems.  Mid-week, she started coughing, especially at night, and breathing harder than usual, sometimes noisily.  It was worrisome, but since we were away from "home" and without a car, rushing her to a local vet would not have been easy.  And she still seemed happy, was eating fine, and enjoying walks around the campground, so it didn't feel quite like an emergency.

My immediate thought was that she might have picked up Kennel Cough (which can linger in places infected dogs have visited for a day or two) or Canine Influenza, both of which cause coughing.

In the back of my mind, though, I worried that it was her heart.  

Paisley had her tenth birthday this past Groundhog's Day, and she had been diagnosed with a Grade 3 heart murmur (out of six grades) at her last regular vet appointment in April 2017.  Never having a dog with heart issues before, we really didn't know what the implications of that were -- or that it could progress to heart failure.  The vet asked if she was coughing, and at that point, she wasn't.  But just knowing that she did have a murmur made me worry.  Were things progressing?  

I realized that unless things changed quickly for the better I would have to find a local vet when we returned to our current home RV park in Winter Garden.  Since we've been RVing, we've taken her to a vet in North Carolina, and had only had one other vet emergency in Florida when she was bitten by another dog last fall in a different RV park, suffering a puncture wound in her neck area.  In that case, I called a mobile vet, who did a great job patching her up and dispensing medications, and Paisley recovered quickly.  But I thought this was possibly too serious for a mobile vet to handle.

I chose a local vet less than 1.5 miles from our RV park and gave them a call as soon as we returned from our trip.  They were able to get Paisley in that morning.  Since we didn't want her to have to walk that far, we took her in Barry's bike basket, and she did just great!

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The vet, Dr. Valentine, couldn't have been nicer or more thorough.   Unfortunately, the diagnosis was not what I wanted to hear, but what I feared:  Congestive Heart Failure (CHF).  This had caused fluid to build up in her lungs, thus the coughing.  An x-ray revealed that Paisley's heart was enlarged, and her respiration and heart rate were elevated.  On the positive side, the EKG showed no arrhythmia, and she is "only" ten years old, on the younger side for CHF in a small dog.  Her complete blood work also revealed no abnormalities. This was excellent news since it means that her liver and kidneys are still in good shape at this point and thus could handle the medication load.

Dr. Valentine gave Paisley oxygen for a bit and administered a diuretic injection to help her rid her body of the excess fluid.  She also sent us home with several medications and food.  Paisley will need to be on a very low-sodium diet for the rest of her life to keep her blood pressure low.  No more jerky treats she loves...sigh!  We were to bring her back to the vet the following afternoon for a re-check.

When we got back to Pearl, she was already doing noticeably better.  She had stopped coughing and was much calmer.  It was obvious that her heart rate and respiration were lower.  She was like a different dog at the next day's recheck, calm and yet full of energy.  Seeing how she recovered so dramatically on the meds, we realized that she had been slowly declining for awhile,: sleeping more and needing more rest when we took her on walks.   We just didn't realize it was her heart condition worsening versus simple aging since it was a gradual process, until our week at the beach.

We had a second vet re-check a week later, and she was doing very well.  She really was like a new dog, and Dr. Valentine was pleased.  The medications she'll have to be on for the rest of her life have been very successful in dogs with CHF and have bought many of them significant amounts of additional time -- from months to years.  

Here are the "miracle meds" Paisley is taking daily:

• Vetmedin (pimobendan) - This medication increases the ability of the heart to pump blood.
• Furosemide (generic for Lasix) - This medication is a diuretic to treat fluid retention.
• Benazepril -- This medication is an ACE inhibitor used to lower blood pressure.

For her first week, Paisley was only allowed to go outside to do her business, no longer walks or play, to allow her heart to rest.  She wanted to walk a lot more than I was able to let her, though.  At her one week re-check, Dr. Valentine said she could do modest exercise, nothing intense, and to be careful with heat.  This works out fine as we've always done her longer walk or play time (ball fetching) after dinner because of living in warm places.  And I stick to walking her in shady areas when she has to go out mid-day.

It was hard to keep her down during her week of prescribed inactivity.  It was obvious that she was feeling a lot better!  She was sleeping less and bringing us various toys to play with.  Once we were allowed, we started taking her to the small dog park in the campground and throwing her ball for her a few times after dinner (and in the shade), as she loves to retrieve and always has.  She is leading on walks again rather than lagging behind.  What a wonderful change!

She has another vet re-check at the end of the month, and after that, assuming all is still well, she won't have to go to the vet as frequently.

We're so thankful for Dr. Valentine, who really knows her stuff and has taken such good care of Paisley.  This was an unexpected and big expense, but Paisley is totally worth it to us.  We don't know how long she'll be with us, but at least with appropriate treatment, we'll have her to entertain us for awhile longer -- and we'll treasure every day!

Here are some resources for canine Congestive Heart Failure I found useful while learning about this disease:

• What You Need to Know about Murmurs and Heart Disease in Senior Dogs (Veterinary Practice News)
• Dietary Consideration for Heart Disease - Sodium Content of Foods (Bay Area Veterinary Specialists)
• Congestive Heart Failure – Treatments for Pets with Heart Disease (Tufts Cummings School of Veterinary Medicine).

Paisley feeling much better, April 2018