By Emily Hoppmann
Valvular heart disease is a common disease of small breed adult dogs. The most common cause is premature aging of the mitral heart valve tissue, which is usually a genetic issue. This is a perfect example of the importance of having physical exams every six months. Heart disease can be detected through hearing a heart murmur during an exam, well before any clinical signs are seen, and once clinical signs are seen your pet is often already in congestive heart failure. Heart disease is a life-long disease that will need to be managed and the sooner treatment is started, the better the prognosis for delaying or avoiding congestive heart failure. There are better medications for managing heart disease than for most other diseases.
The mitral valve is what separates the chambers of the left side of the heart. This one-way valve (door) ensure that the heart functions efficiently by not allowing the blood to go backwards when the heart pumps. With properly-functioning valves all the blood that enters the heart moves through correctly and goes out into the circulation.
It is common for a heart murmur to be a surprising or unexpected finding during a routine exam because heart valve disease is well-tolerated in its early and intermediate stages. The sound that I hear during an exam is the blood not moving through the heart correctly, but some of it going backwards because the valve is not shutting properly. If not all the blood is going forward, the heart will have to work harder to do its job and that is what leads to heart failure. The goal of the medications that manage heart disease all focus on the heart not having to work as hard, so that the disease does not progress as fast, which prolongs the onset of congestive heart failure.
Small breed dogs are most commonly affected by this condition, although it can sometimes occur in larger dogs. The heart not working correctly has two major issues - it decreases the amount of blood moving into the body’s circulation to nourish the organs and it increases the pressure inside the heart. Heart disease always gets gradually worse - meaning that more and more blood moves backwards instead of moving forward in the circulation. The body can only handle so much before the body starts to have fluid build-up within the lungs and abdomen. It is the fluid in the lungs that is the biggest cause of clinical signs of heart disease. Clinical signs of heart disease are shortness of breath, exercise intolerance and coughing, especially at night. Without prompt and consistent management and treatment of heart disease, it will be fatal.
Some tips for the general care of dogs that have heart disease include:
• Avoiding intense physical exercise and only doing lower-intensity activities, such as walks during the cool part of the day
• If your dog shows signs of exhaustion or difficulty keeping up it indicates that whatever you guys are doing is too much activity for him
• Feed a food that is low in sodium to help avoid fluid retention
• Weight-loss! The more overweight your pet is, the harder the heart has to work. I am happy to go over the goal weight for your dog and develop a weight-loss strategy for him.
Living with the Diagnosis
Myxomatous heart valve disease is a process that gets progressively worse. However, it can be years after the detection of a heart murmur before congestive heart failure occurs. Together we can make a treatment plan using different tips, life-style changes, and a variety of medications to control the symptoms. As the disease progresses, medical management will become more complex, often using additional medications and higher doses, and the need for exams will increase.
The life span of a pet with heart disease can vary from months to years, some even not having the disease shorten their lives at all. The life span of a pet in congestive heart failure is also extremely variable and depends mainly on the severity of the disease when diagnosed and the dog’s response to medication. Clinical signs of severe disease progression include trouble breathing (giving the gums a bluish or grey color), the abdomen appearing swollen because it is filled with fluid, and becoming very inactive. You may also see your pet have fainting spells.
The goal of this treatment is to find a combination that makes your dog comfortable and enjoying a good quality of life. This means always giving your pet his medication exactly as directed, keeping your pet at a healthy weight, making the food changes that are recommended, and being sure to have regular visits (at least every 2 months) with your veterinarian. Any time your dog’s symptoms become worse or reappear, an adjustment in medication dosage may be needed, so call us right away.
