Thank you so much for your reply. It's really helpful and I'm so glad that Chance is doing well because you got him the right treatment. What kind of surgery did he have?
The Vet who saw Sophie yesterday is a Cardiologist who works two days a week at our General Vet Practice however unfortunately my Dad had to pick Sophie up from the Vets as I was caring so I didn't get to hear all the details. I am unsure about the Cardiologist's decision not to treat her condition yet (he will re-scan in 3 months).
Sophie has some significant symptoms including:
- blueish/grey gums and back of tongue but only at times,
- tiring easily and sometimes lying down very suddenly (like a collapse but no loss of consciousness),
- a visible pounding of her heart at certain times when lying on her side,
- a visible jugular pulse in her neck
- noisy breathing but again only at times
Although I took Sophie to the Vets the first few times and requested the Echocardiogram and ECG (the regular Vet didn't hear a murmur), I do not know whether my Dad gave an accurate representation of her symptoms this time because he had thought there was nothing wrong.
So now I'm unsure what to do! My options are:
1. Leave it, wait 3 months and have her re-scanned then. In the mean time let her exercise freely and eat what she normally does.
2. Request an appointment to discuss the situation either with the Cardiologist or our general practice vet.
3. Ask for a referral for a second opinion e.g. to the specialist centre you mentioned
Reading up on it, it sounds as though in humans early treatment can help so I don't think the wait and see approach is necessarily the best one.
My other major concerns I have are that she does have a very fast heart beat at times- the Vet felt that this was just a normal puppy thing but I'm really not sure. Also I do wonder if she has a slight arrhythmia that could on be detected with 24 or 48 hour Holter ECG monitor. I would like to ask for this. The Vet felt that her collapsing episodes were just normal puppy exhaustion but I'm not sure of that.
I hope it's ok to ask some questions- Did Chance have heart failure when he was treated? Was his heart enlarged by the condition? What medication was he given?
Also can I just ask what advice you were given regarding exercise? and diet?
Thank you so very much for your help.
You have a lot on your plate. I will answer your questions and tell you my opinion based on my experience with Chance.
Chance's heart murmur was due to a congenital mitral valve malformation - similar, but not exactly the same as your pup's.
The only option for Chance was open-heart surgery. My guess is also that your cardiologist does not do this type of corrective surgery hence the wait and see approach. At the time of Chance's diagnosis, his cardiologist told us there were only 2 places in the U.S. that perform the type of surgery Chance needed. We had to travel 1,900 miles to Colorado (from NY) for the surgery. At the time, it wasn't exactly experimental surgery but it was limited.
I'm not surprised that your vet didn't detect the murmur on initial exams. My vet didn't either. Puppies do a lot of panting at the vets office and even the cardiologist has to listen very closely with very experienced ears. I have learned a lot about that in the 10+ years we have been bringing Chance in to the cardiologist for exams.
The symptoms you list are concerning. I would limit your pup's exercise. Once diagnosed, while we were waiting for the surgery (7 weeks), this is what we were told to do. He was diagnosed at the end of February and operated on April 19. In this time, Chance's heart had enlarged to double its size and he had 2 collapsing episodes.
2 weeks after the surgery, Chance's heart was back to its normal size.
Pre-surgery, he was put on a medication that would slow the heart in prep for the surgery but there really wasn't a medication for treating it - it needed surgery.
Post-surgery, Chance has been on a low dose of metoprolol and enalapril.
I'm sorry for being long-winded, I am just recalling so many details.
Before doing anything, see if you can speak directly to the cardiologist with your questions written out. I agree with your gut feeling that her collapsing episodes are NOT just normal puppy exhaustion. Also ask if you can get a copy of the written cardiologist's report.
Here is a another link to an article about Chance's surgeon Dr. Orton going to England to train surgeons at the Royal Veterinary College.
I am hoping you can get a referral there. CSU cardiology team takes open heart surgery to the UK
If you have any other questions, let me know.