With new information, it seems my titles get less exciting with each blog post. However, fear not, fearless blog reader! The information, while a little more dry, is very important to consider. Don’t worry cat-lovers, I will have a heart failure blog dedicated to the purring variety next week.
For the purposes of this blog I will be discussing the new staging guidelines for dogs and how that applies to your dog(s) sleeping on your couch right now.
Stage A – These are dogs who are at risk for developing heart disease. Cavalier King Charles Spaniels, Doberman Pinschers, Boxers, or almost any small breed dog. Why is this important? Well, if these dogs are significantly more likely to develop heart disease in the future, it is like a person with a family history of colon cancer – get scoped regularly to make sure you are clear. Fortunately for many of these dogs, all is takes is the high-tech stethoscope to monitor and screen for developing cases. It may mean being a little more diligent to monitor but we catch the problem that much quicker.
Stage B – These dogs have evidence of heart disease without heart failure. We often hear a murmur in these dogs, which is nothing more than a whoosing sound as the blood flows the wrong direction through the valves. The heart begins to change and remodel as it tries to be more efficient with the backflow of blood. Why is this important? We know that the average time most of these dogs to develop heart failure is about 2 1/2 years. No drugs out on the market do anything to significantly lengthen the time before heart failure begins, but a few have been shown to help. However, x-rays and routine monitoring can give us clues as to the likelihood of a mild murmur progressing to failure.
Stage C – These dogs are in heart failure or were in heart failure at some point. At some point the heart’s search for maximum efficiency has failed and the floodgates open. This may or may not be obviously important, but response to treatment must be monitored at this point. Careful monitoring (x-rays, blood pressure, labwork) lets us know how good of a job we are doing while we help the heart without making any other system sick.
Stage D – These dogs are refractory to treatment. We are pulling out all the stops to get these dogs just to hang on for a few more days.
Again, you may be asking yourself why this is so important. The proof in the pudding, so-to-speak, is in stage B. We know how to treat heart failure and we know to to watch for the early signs of heart disease, but we have always asked what to do in the meantime – before failure and after disease. Monitoring in the past has been lax because with no treatment possible, we just waited for heart failure. Now we know a little more about how to monitor progression and when heart failure may be more likely to come in the next 3-6 months. Narrowing this window and maybe starting medications on the verge of heart failure means better results and ideally less time in the hospital.
Resting Respiratory Rate – One of the best ways to make sure that heart failure is not imminent is to measure your pets resting respiratory rate at home. By counting the number of breaths your sleeping or resting pet takes in a minute, you can make sure that the heart/lung systems are working properly while at home. Anything under about 30-35 breaths per minute is considered normal. If you find that your pet is consistently faster than this and is in Stage B, then rechecking x-rays ASAP are indicated. There are free apps on Android and IPhone to help you chart and calculate your entries.
To be continued for cats…
– Doc Cleland