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Your questions answered

Q1

What is heart disease?

A

Heart disease is a term used to describe any disorder of the heart. This can take many forms, including a deformed heart valve or weakened heart muscle.

Around one in ten dogs have heart disease. Some are born with it, but most develop it as they get older.
Certain breeds are more prone to heart disease than others.

Over time, heart disease gradually gets worse which means that the heart becomes progressively less efficient at pumping blood around the body. Eventually, the heart is no longer able to cope and this is when the symptoms of heart failure become apparent. Detecting heart disease early, before heart failure develops, is vital to slow its progression and prolong your dog’s quality of life.

Q2

What is mitral valve disease (MVD)?

A

The most common type of heart disease in dogs is called mitral valve disease (MVD). Small to medium-sized dogs (under 20 kg) are at higher risk of developing it, especially as they reach middle-age and beyond.1

The heart is divided into four chambers, separated by valves which open and close so that blood flows in the right direction. In MVD, the valves between the two chambers on the left side of the heart gradually become thick, lumpy, distorted and leaky.

This means that when the heart beats, blood can flow in the wrong direction leaking backwards through the valve. When a vet listens to the heart with a stethoscope they will hear a heart murmur. A murmur is the sound caused by blood leaking backwards through the heart valves and is the tell-tale sign of MVD.

In the early stage of MVD there are often no symptoms. MVD gets worse over time and can lead to heart failure, which is when the heart can no longer pump enough blood around the body.

Q3

What is dilated cardiomyopathy (DCM)?

A

DCM is the second most common type of heart disease in dogs after MVD and is most prevalent in middle-aged large and giant breed dogs such as the Doberman, Boxer, Great Dane, Irish Wolfhound and Labrador Retriever, although it can also affect smaller breeds including American Cocker Spaniels, Springer Spaniels and English Cocker Spaniels.

A normal healthy heart is a strong muscular bag which pumps blood around the body. In dogs with DCM, the heart muscle becomes thin, weak, flabby and enlarged and is less efficient at pumping blood around the body.

DCM tends to worsen quickly in many dogs. It can cause an irregular heartbeat and lead to heart failure, which is when the heart can no longer pump enough blood around the body and can even cause sudden death.

The exact cause of DCM is usually unclear, but certain breeds are more likely to develop it, especially larger dogs. For example, up to half of Dobermans develop DCM in their lifetime.2

Q4

Is there a cure for heart disease?

A

While in some cases surgery may be an option, normally there is no cure for heart disease (or heart failure), but early treatment and monitoring can help slow its progression and delay the onset of heart failure so that your dog has a longer, happier life. Detecting heart disease early is vital to prolong your dog’s life.

Q5

What is the ‘silent’ or ‘asymptomatic’ stage of heart disease?

A

In DCM and MVD, the first phase of the disease is sometimes called the ‘silent’ or ‘asymptomatic’ stage. While MVD will cause a murmur and DCM may cause an irregular heartbeat, there are usually no outward symptoms that you will be able to detect and dogs will appear completely healthy.

But during this time – although it may not be visible on the outside – the disease is progressing and the heart’s ability to pump blood around the body is gradually declining.

Eventually, the disease progresses to a stage when the heart can no longer cope. Only at this point will the symptoms associated with heart failure become apparent.

Regular heart check-ups by your vet are necessary to diagnose heart disease early. Detecting heart disease early – before the onset of heart failure symptoms – is vital, because early intervention can extend the symptom-free phase of the disease, giving you and your dog more quality time together.

Q6

What is heart failure?

A

Heart failure, sometimes called congestive heart failure, is when the heart is no longer able to pump enough blood around the body. This can make your dog feel unwell, reduce their quality of life and ultimately shorten their life.

All forms of heart disease can lead to heart failure. Heart failure is sometimes referred to as the ‘clinical’ or ‘symptomatic’ phase of heart disease. The following are symptoms of heart failure:

• Increased breathing rate
• Tiredness
• Difficulty exercising
• Difficulty breathing
• Fainting/collapse

It is very important to diagnose heart failure as soon as possible, so if you notice these signs you should take your dog to the vet urgently. If your dog is found to have heart failure, your vet will discuss treatment options with you to help improve and prolong your dog’s life.

  1. Atkins C, Bonagura J, Ettinger S, et al. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009; 23(6):1142–1150.
  2. Summerfield NJ, Boswood A, O’Grady MR, et al. Efficacy of pimobendan in the prevention of congestive heart failure or sudden death in Doberman Pinschers with preclinical dilated cardiomyopathy (the PROTECT study). J Vet Intern Med 2012;26:1337–1349.

Q1

Is my dog at risk of MVD?

A

One in ten dogs have heart disease and MVD is the most common type of heart disease in dogs,
responsible for about 75% of heart disease cases.1

Although it can affect any dog, small to medium-sized dogs are more at risk, especially as they reach middle-age. The risk also increases with age.

Some breeds seem to be more at risk of developing MVD than others; Cavalier King Charles Spaniels, Dachshunds and Miniature Poodles commonly develop MVD as they get older.1

Remember, dogs in the early asymptomatic stage of MVD will appear outwardly healthy and happy. Early diagnosis can give your dog the best chance of a longer, happier life. That’s why it is recommended that all at-risk dogs should have yearly check-ups at the vets, as a minimum.

Q2

Is my dog at risk of DCM?

A

One in ten dogs have heart disease and DCM is the second most common form of heart disease in dogs, responsible for about 10% of heart disease cases.2

That’s why it is advised that these dogs have regular heart checks by your vet, at least once a year and more frequently as they get older.

Breeds at risk of developing DCM include:
• Dobermans
• Cocker and Springer Spaniels
• Boxers
• Irish Setters
• German Shepherds
• Great Danes
• Bernese Mountain Dogs
• Newfoundlands
• St Bernards
• Irish Wolfhounds
• Deerhounds
• and other large/giant breeds

Remember, dogs in the early asymptomatic stage of DCM will appear outwardly healthy and happy. Early diagnosis can give your dog the best chance of a longer, happier life. That’s why it is recommended that all at-risk dogs should have yearly check-ups at the vets, as a minimum.

Q3

If my dog is at risk what should I do?

A

Often, heart disease presents no outward symptoms until it progresses to heart failure. Early diagnosis can give your dog the best chance of a longer, happier life.

Small to medium-sized dogs, middle-aged or older, are at higher risk of MVD. This can be picked up during a routine check-up at the vets. It is recommended that at-risk dogs have yearly check-ups as a minimum.

Large and giant breed dogs, as well as some medium-sized dogs, aged three years or older, are at higher risk of DCM. You should talk to your vet about keeping a close eye on your dog’s heart health. If they are at risk of developing DCM, heart checks should be performed yearly, as a minimum.

Remember, heart disease can develop in at-risk dogs even when they seem happy and healthy. Detecting it early, before symptoms appear, can give your dog a much better outcome. Ask your vet about a heart check-up today.

  1. Atkins C, Bonagura J, Ettinger S, et al. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009; 23(6):1142–1150.
  2. A. Egenvall, B. N. Bonnett, and J. Haggstr ” om, “Heart disease as “a cause of death in insured Swedish dogs younger than 10 years of age,” Journal of Veterinary Internal Medicine, vol. 20, no. 4, pp. 894–903, 2006

Q1

How do I recognise MVD in my dog?

A

There are two distinct phases of MVD: the ‘silent’ phase where a dog with MVD shows no outward symptoms (the ‘asymptomatic’ phase) and a shorter phase when the heart cannot cope and dogs show symptoms of their heart disease (heart failure phase).

Asymptomatic MVD

A dog with asymptomatic MVD will appear outwardly healthy and have no visible symptoms indicating a problem. The only symptom that will be detectable by a vet at this stage is a heart murmur. MVD is a slowly progressive disease that gets worse over time. A dog with MVD can live for many years without having any symptoms apart from a murmur, which is caused by a back flow of blood through the mitral valve.

Over time, the back flow of blood gets worse. As more blood flows the wrong way through the heart, the murmur gets louder, and the heart is put under greater strain. To compensate, the heart becomes larger and pumps harder. Eventually, there comes a point when the heart cannot cope with the additional strain and fails to pump enough blood around the body. This is known as heart failure.

Heart failure

Symptoms of heart failure can initially be quite subtle. But as the disease worsens the heart’s function deteriorates and the symptoms become more severe. Symptoms of heart failure include:

• Increased breathing rate
• Difficulty breathing
• Tiredness
• Difficulty exercising
• Fainting/collapse

Not all dogs with MVD develop heart failure. Dogs with MVD who go into heart failure are those with enlarged hearts as a consequence of their disease. Typically, dogs with both MVD and an enlarged heart will develop heart failure within two years.

Q2

How is MVD diagnosed by my vet?

A

When your vet examines your dog, they may find signs relating to heart disease. Listening to your dog’s heart with a stethoscope will allow a vet to detect a murmur and they may recommend further tests to establish if your dog has an enlarged heart.

There are two non-invasive tests your vet may use to determine if a dog with MVD has an enlarged heart:

Ultrasound

An ultrasound of the heart allows your vet to visualise and assess the inside of the heart, enabling them to take measurements to assess heart size.

X-rays

A chest X-ray enables your vet to assess the overall size of the heart as well as checking for any fluid build-up in the lungs. Fluid in the lungs would indicate the presence of heart failure.

Q3

How can my vet tell if my dog’s heart is enlarged?

A

If your vet suspects your dog has heart disease, they will usually perform tests to find out if your dog’s heart is enlarged as a result of the condition. There are two main ways to do this:

• Ultrasound scan
• Chest X-rays

Neither test is painful, but they may require your dog to go into the practice for a few hours or see a heart specialist.

If your dog has an X-ray or an ultrasound scan and their heart is of normal size, this is a good sign. This means that your dog has a lower risk of developing heart failure within two years.

But MVD and DCM are diseases that get worse over time. Your vet will recommend that your dog has these tests repeated regularly (at least yearly) to monitor how their heart disease is progressing.

Q4

Why is it important to find out if my dog’s heart is enlarged?

A

Finding out whether your dog has an enlarged heart is very important, as this will allow your vet to:

• monitor the progression of your dog’s disease
• provide you with a more accurate prognosis (a forecast as to what might happen)
• design a management plan for your dog
• identify when treatment should be started

Q5

How is DCM diagnosed?

A

Since DCM is usually asymptomatic until the dog has reached the stage of heart failure, it can be challenging to spot. Yearly heart checks at your vet increase the chance that the disease will be diagnosed early, before your dog shows any outward symptoms.

Early diagnosis can give your dog the best chance of a longer, happier life. That’s why it is recommended that all at-risk dogs have yearly check-ups at the vets, as a minimum.

Examination

When your vet examines your dog, they may find signs relating to heart disease and heart failure. Listening to your dog’s heart with a stethoscope will allow a vet to pick up any heartbeat irregularities if they are present.

Your vet may also detect harsh sounds when listening to the lungs and may also pick up other signs that your dog’s heart is not working well, such as fluid in the abdomen and poor pulses. As a result, your vet may recommend further tests to help determine the cause of your dog’s problem. These may include:

Blood test

Blood tests may be recommended to check your dog’s health to see if they are suitable for medication and to check that the rest of their body is healthy. They will also likely check specific heart-related markers in the blood such as proBNP.

If your dog has an abnormal proBNP blood result, your vet will then usually conduct an ultrasound scan to examine your dog’s heart and see if it is stretching or enlarging. This is a non-invasive and painless procedure. From this, your vet can then make a formal diagnosis.

X-ray

X-rays are very useful to assess your dog’s heart and lungs. Commonly when a heart is having problems it will get larger and fluid may build up on the lungs. Both of these can be detected with X-rays.

Cardiac ultrasound (Echocardiogram)

This is an ultrasound scan of the heart and can be used to assess it while in action. The heart’s walls, chambers, valves and blood vessels can be accurately observed in 3D.

While ultrasound is the most accurate method of diagnosing heart disease, it may not be necessary in some of the more straightforward heart disease cases.

Electrocardiogram

Electrocardiograms (ECGs) can record the electrical activity of the heart and can be used to diagnose rhythm problems.

Regular veterinary visits are very important for early detection of heart disease or to monitor the treatment of a dog with heart disease.

Q6

What is a proBNP test?

A

A proBNP test measures the level of a hormone called proBNP in the blood. This is released by the heart muscle cells in response to increased stretch of the heart wall. The test is an effective screening tool to indicate potential DCM heart disease.

Just a small amount of blood is needed, which is then sent away to a specialist lab. The result is usually received by your vet after just a few days. If you are concerned your dog may be at risk of heart disease, speak to your vet about the test.

If your dog has high proBNP, your vet will then usually carry out an ultrasound scan to examine your dog’s heart and see if it is stretching or enlarging. This is a non-invasive and painless procedure. From this, your vet can then make a formal diagnosis.

Q1

What is a heart murmur?

A

A heart murmur is the sound of turbulent blood flow in the heart. When a vet listens to a normal heart beat with a stethoscope, it will make a sound similar to ‘lub dub’. This is caused by two sets of valves in the heart opening and closing in sequence. An irregular blood flow will sound like ‘lub shhh dub’ – the ‘shhh’ is the sound of blood flowing the wrong way and is known as a murmur.

If your dog is small to medium-sized and your vet detects a heart murmur, it could indicate a type of heart disease called MVD which affects the heart’s valves.

Q2

What are the symptoms of MVD?

A

Apart from a heart murmur, MVD is usually asymptomatic until it progresses to heart failure. This is known as the ‘silent’ or ‘asymptomatic’ phase of MVD. But, during this time, the disease gets worse, putting more pressure on the heart. That’s why early diagnosis is vital to help protect your dog’s heart.

A heart murmur can be picked-up during a routine check-up when the vet will use a stethoscope to listen to your dog’s heart. If MVD progresses to heart failure, the symptoms are more obvious, and include:

• Increased breathing rate
• Tiredness
• Difficulty exercising
• Difficulty breathing
• Fainting/collapse

If you notice any of these symptoms you should take your dog to the vet urgently.

Q3

What are the symptoms of DCM?

A

The first phase of DCM often shows no symptoms, making it especially hard to spot. But your vet can perform specific heart screening tests to help diagnose disease at its early stages. If your dog is at-risk, it’s advised that your dog has a heart check-up at least once a year, as a minimum.

As the heart’s pumping ability worsens, this is when you may start to notice signs that your dog is unwell, and their quality of life is affected. If DCM progresses to heart failure, the symptoms are more obvious, and include:

• Increased breathing rate
• Tiredness
• Difficulty exercising
• Difficulty breathing
• Fainting/collapse

If you notice any of these symptoms you should take your dog to the vet urgently.

Q1

My dog has been diagnosed with MVD. What now?

A

If your dog is diagnosed as having MVD, there is a lot you can do to help. We now know that by identifying MVD early (before outward symptoms are even visible) we can slow the progression of the disease, giving your dog more time living life to the full.

Your vet will discuss treatment options with you to help manage any symptoms and slow the disease progression. They may also discuss ways to adapt your dog’s exercise regime and diet if they feel this is necessary. Much of this will depend on your individual dog and the progression of the disease.

As MVD gets worse over time, your vet will recommend that you closely monitor your dog at home and come back for regular check-ups. This is to ensure that when your dog’s heart starts to deteriorate, it is detected and treated as early as possible.

If your vet diagnoses heart failure they will most likely recommend that your dog starts treatment in order to slow progression, reduce symptoms and ultimately prolong your dog’s life.

Q2

My dog has been diagnosed with DCM. What now?

A

If your dog is diagnosed as having DCM, there is a lot you can do to help. Your vet will discuss treatment options with you to help manage any symptoms and slow the disease progression. Your vet may also discuss ways to adapt your dog’s exercise regime and diet if they feel this is necessary. Much of this will depend on your individual dog and the progression of the disease.

As DCM gets worse over time, your vet will recommend that you closely monitor your dog at home and come back for regular check-ups. This is to ensure that when your dog’s heart starts to deteriorate, it is detected and treated as early as possible.

If your vet diagnoses heart failure they will most likely recommend that your dog starts treatment in order to slow progression, reduce symptoms and ultimately prolong their life.

Q3

How do I monitor my dog’s heart health at home?

A

If your dog has been diagnosed with heart disease or heart failure, you may be advised to monitor their heart at home. You can monitor your dog’s heart at home in two ways:

1) Measure your dog’s breathing rate when they are resting. To do this, count the number of breaths they take in a minute, known as their resting respiratory rate (RRR). If your dog has a RRR higher than 40 breaths a minute, or it gradually increases over a few weeks, then it could be an early sign that your dog has a heart problem and you should see your vet.

2) Measure your dog’s heart rate when they are resting. To do this, feel your dog’s heartbeat with your hand on your dog’s left side of its chest, behind the front leg, or the inside top of your dog’s hind leg. Count the number of beats you feel in a minute and repeat a few times to get an average, as it can vary slightly. Healthy large adult dogs have a resting heart rate of around 60 – 100 beats per minute, while adult small dogs have a heart rate of around 100 – 120.

In the early stages of heart disease, your dog will not show any symptoms of their underlying condition and so home monitoring will not pick up the disease. It’s therefore really important to visit your vet for annual heart checks especially if your dog has a higher risk of developing heart disease.

Q4

Is there a cure or treatment for DCM or MVD heart disease?

A

Normally, there is no cure for MVD or DCM. But there is still plenty you can do to help prolong and maintain your dog’s quality of life. Your vet will be able to discuss treatment and management options with you that are appropriate for your dog.

By giving your dog medication before they start to show symptoms of heart failure it is possible to:

• Slow disease progression
• Extend your dog’s symptom-free time before the onset of heart failure
• Improve your dog’s quality and length of life

It’s important to remember that MVD and DCM are diseases that get worse over time, so it is likely that your dog will need treatment for life. Your vet will want to see your dog for regular check-ups to monitor how the disease is progressing.

Q5

Will my dog develop heart failure?

A

It’s not easy to predict how quickly a dog will go into heart failure from the ‘silent’ asymptomatic stage of MVD or DCM. It depends on your individual dog and how early they were diagnosed.

While not all dogs with MVD develop heart failure, those who have developed an enlarged heart are more likely to progress to heart failure within two years.

Your vet will monitor your dog’s condition and advise you further on this stage.

Q6

Can my dog still exercise if they have heart disease?

A

Every dog is different, and so the answer will depend very much on how much the heart disease has progressed, your type of dog and their overall health. You should speak to your vet before making any changes to your dog’s exercise regime.

At the stage of heart failure, it is thought that controlled exercise is safe. But the heart has to work harder than normal, and the harder it works the higher the risk of sudden death. Some dogs, such as Dobermans are more prone to this than others.

Most dogs with heart failure tend to limit their exercise themselves, which is usually significantly reduced compared with before they were diagnosed. If you are concerned, you could consider walking your dog on a lead rather than letting your dog run freely.

At the end of the day, most dogs get a lot of enjoyment out of exercise and you may prefer that your dog continues to enjoy their life as much as possible, rather than restricting their exercise due to a potential health risk.

If you are unsure about how much exercise you should allow your dog to take, then speak to your vet.

Q7

Do I need to adapt my dog’s diet?

A

It is important that any dog eats a healthy balanced diet, especially those with heart disease.

If your dog has heart failure, their appetite may be reduced, and they may start to lose weight (a condition called cardiac cachexia). As a result, your dog may need more calories and more high quality protein than other dogs. But if your dog is eating and maintaining weight then you probably do not need to make significant changes.

Another factor to consider is the restriction of salt. When in heart failure, the body tries to retain salt, which increases the volume of blood and can make symptoms worse. It is important to think about restricting any very salty treats and titbits from the table.

Finally, it is a good idea not to allow your dog to become overweight, as this can cause the heart to work even harder. Veterinary diets are available specifically for dogs with heart disease. You should speak to your vet before making any changes to your dog’s diet.

Q8

Are there any supplements that could help my dog?

A

There is limited research on nutritional supplements in dogs with heart disease. But research shows that omega-3 fish oils may help dogs maintain a healthy weight and support heart health.

Taurine is an amino acid that is very important for heart function, found naturally in raw fish and meat, particularly offal. Taurine deficiency is sometimes seen in dogs eating non-standard or low protein dog food. Your vet can test for deficiency and recommend a supplement if needed.

Always talk to your vet before introducing a supplement into your dog’s diet.

Q9

Where can I get more information about heart disease or heart failure in dogs?

A

If you have any questions or concerns about your dog and their risk of heart disease or heart failure, it is best to speak to your vet.

  • Be aware of the risk.
  • Educate yourself on the options.
  • Assess at the vets.
  • Talk to your vet.
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