Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Diagnosis In-depthDiagnostic tests may be needed to recognize chronic valvular heart disease and exclude all other diseases, including:
Complete medical history and physical examination. Special attention is paid to auscultation (stethoscope examination) of the heart. Heart murmurs, abnormal heart sounds, and irregular heart rhythms may indicate a problem with the heart.
Thoracic radiographs (X-rays of the chest) can identify heart enlargement and fluid accumulations in the chest. Chest X-rays can also be useful in excluding a number of other diseases.
An electrocardiogram (EKG) is often abnormal in dogs with serious heart disease, it can be normal in some dogs with heart disease.
Arterial blood pressure measures hypertension (a complicating disease) or low blood pressure.
An echocardiogram (ultrasound examination of the heart) is the diagnostic test required for establishing the diagnosis of VHD and is especially useful when the diagnosis is in doubt. Important examination issues include the severity of valvular changes, the size of the heart, and heart muscle function. This examination often requires referral to a specialist.
Additional diagnostic tests may be recommended on an individual basis:
A complete blood count (CBC). This blood test may be needed to identify anemia or other problems such as infection or inflammation.
Serum biochemistry tests. These blood tests are especially important if there is heart failure or complications in other organs.
Thyroid function tests are necessary if there is evidence of hyperthyroidism.
Urinalysis. This urine test may be recommended to better evaluate the kidneys and bladder.
Treatment In-depth
Treatment for chronic valvular heart disease may include one or more of the following:
Treatment of canine valvular heart disease must be individualized. It is based on the severity of the condition and other factors that must be analyzed by your veterinarian. If your dog has only mild or moderate valvular heart disease without symptoms, no treatment is currently recommended or proven beneficial. In this situation, regular follow-up visits to your veterinarian are important to detect disease progression that might prompt treatment. Once heart failure develops, medications are dispensed to improve the heart function, reduce the regurgitant blood flow, and control fluid retention.
If congestive heart failure does occur, initial hospital treatment may include oxygen, diuretics (furosemide) and possibly vasodilator medications such as nitroglycerine, nitroprusside or hydralazine. Hospitalization is mandatory in cases of severe valvular heart disease associated with uncontrolled fluid accumulation in the lung or chest cavity (congestive heart failure), abnormal heart rhythms (arrhythmias), kidney failure or hypotension (low blood pressure).
Chronic home therapy of heart failure caused by mitral regurgitation includes a diuretic to prevent fluid retention, dietary modifications, such as a sodium-restricted diet, and an angiotensin converting enzyme inhibitors such as enalapril (Enacard) or benazepril (Lotensin). The ACE inhibitors reduce the activity of harmful hormones and minimize salt (sodium) retention. Advanced heart failure is also treated with digoxin, a drug that increases heart muscle contraction and helps restore balance in the autonomic nervous system. A cough suppressant may be needed if there is mechanical compression of the bronchus by the left atrium.
