| Dilated cardiomyopathy (DCM)
is a disease of the heart muscle which causes
the heart to enlarge and not function properly.
The disease usually afflicts larger breeds
of dogs such as the Doberman pinscher, Scottish
deerhound, boxer, Newfoundland, golden retriever,
Labrador retriever, and the Irish wolfhound.
However, it can also affect both the English
and American cocker spaniel and rarely, other
small breeds of dogs. The occurrence of dilated
cardiomyopathy increases with age and typically
has an age of onset between 4 and 10 years.
The cause of DCM in dogs is still unknown;
however, many factors suggest a genetic cause.
Dilated cardiomyopathy usually affects
both the left and right sides of the heart
with either side being more severely affected.
Typically, both the ventricle (lower chamber)
and the atria (upper chamber) enlarge and
the ventricle loses its ability to contract
and pump blood out to the body or the lungs.
The consequence of the heart failing in
its ability to pump blood can be compared
to a simple mechanical pump. If the sump
pump in your basement fails, water backs
up into the basement; if the left heart
fails, fluid backs up into the lungs and
if the right heart fails, fluid backs up
in the abdomen or space surrounding the
lungs.
Long term prognosis for dilated cardiomyopathy
varies considerably. Unfortunately, most
dogs with signs of heart failure at the
time of diagnosis die as a result of the
disease within 6 months to two years. Unfortunately,
some dogs, especially certain breeds with
a more severe form of the disease may survive
only weeks to a couple of months.
Treatment of dilated cardiomyopathy is
aimed at both improving the heart's function
and controlling the signs of congestive
heart failure. Drugs such as Lanoxin (Digoxin,
Digitalis) are used to help the heart contract
better and to slow the heart rate down if
certain arrhythmias exist. Once your dog
is started on Lanoxin, you will be asked
to watch for signs digoxin toxicity that,
although uncommon, include loss of appetite,
vomiting, diarrhea, and lethargy. These
adverse signs can hopefully be avoided by
having a blood test run by your regular
veterinarian 7 to 14 days after the drug
is initiated. To check for appropriate levels
of Lanoxin in the bloodstream, a blood test
must be drawn 6 to 8 hours after your dog’s
morning dose of the Lanoxin. However, if
any of these signs do occur, please call
our office or your regular veterinarian.
If these signs are severe, you can stop
the Lanoxin and then call us; however, if
the signs are mild, the ideal situation
would be to go to your regular veterinarian
and have a Digoxin level drawn so that we
can be sure that the drug is causing the
problems and the signs are not
related to something else.
Diuretics are also used to help both control
and prevent accumulation of fluid in or
around the lungs. Lasix (Furosemide) is
usually the drug of choice. Potential side
effects of diuretic use include increased
thirst and potentially increased urination.
Another essential drug that is used in the
treatment of dilated cardiomyopathy is termed
a balanced vasodilator. This helps the heart
pump more effectively against the pressures
of the arteries and veins. Examples of this
drug include Vasotec, Enacard, Zestril,
Prinavil, and Lotensin. These drugs are
usually started gradually with a low dose
and then building up to your dog's required
dosage. These drugs can occasionally interact
with the kidneys. For this reason, you will
be asked to see your regular veterinarian
in 7 to 10 days, in 4 weeks, and then every
three months to have a chemistry blood panel
checked to assure that kidney function is
preserved.
Other drugs utilized in the treatment of
dilated cardiomyopathy are aimed at controlling
cardiac arrhythmias (electrical disturbances
in the heart). Arrhythmias can be very problematic
in some cases of DCM and can even be life
threatening. Certain breeds are more predisposed
to this additional problem. If possible,
it is a good idea to buy an inexpensive
stethoscope to monitor your dog's heart
rate and rhythm. Keep a journal of these
records and if you are seeing a progressive
increase or decrease in your dog's heart
rate or hear an irregular heartbeat, please
call our office.
It is also important for you to monitor
your dog's overall attitude and outward
signs. If you notice any heavy/labored breathing,
coughing, fainting spells, restlessness,
or profound lethargy, please call us or
see your regular veterinarian as soon as
possible.
Finally, your observations at home and
your dedication in administering the prescribed
medications in conjunction with our advice
is what will help your dog the most. You
know your pet the best. If you feel there
is something wrong or you have any questions,
please don't hesitate to call our offices.
|
FCI
Dobermann Standard:
