My nearly nine-year-old (2nd October) Dobermann, Madison, has been diagnosed with DCM (Dilated Cardiomyopathy).
We were out on a walk and she had been running around with the other dogs when she suddenly stopped coughed and collapsed, she was up within a few seconds and behaving normally.
We took her to the vet and had a scan and X-rays done where she was diagnosed with DCM she has an enlarged heart, her lefty ventricular isn't fully closing and she has some fluid around her lungs, my vet says its the early stages of heart failure, she has been put on vetmedin 5mg x 2 per day and frusimide 40mg x 3 per day.
She is doing well and is still enjoying some exercise and play each day - she is raw fed and I'm giving her 1000mg fish oil per day and 500mg L-carnitine but would like others opinions on any other supplements I could give her that may help with this horrible disease. I realise long term prognosis is not good and am heartbroken that I may not have long left with my girl, before her weekend collapse she was enjoying at least two hours exercise, sometimes more, per day, and was fit and healthy.
I have not been to a cardiologist as I don't want her to get too stressed - she doesn't like to be left away from me and when I phoned the cardiologists have told me I cannot be with her whilst she has one and a half hours of tests. I also wonder what more they can tell me even if they do the tests as she will still have DCM - so confused as to what to do for my beautiful girl.
Thanks for your time,
Melissa Malone, by email
Rebecca Barber MPhil, Dobermann Breed Council health co-ordinator advises...
Dilated Cardiomyopathy (DCM) in Dobermanns, some information for dog owners
What is DCM?
Dilated cardiomyopathy (DCM) is a common and inherited heart condition affecting Dobermanns. The disease results in an enlargement of the left ventricle (one of the chambers of the heart) which means the heart cannot contract normally to pump blood around the body. The heart chambers become progressively more dilated and blood dams back to the circulatory system from the lungs and the rest of the body. The onset of symptoms related to this is congestive heart failure. The blood dams back in the lungs and fills the alveoli. This causes breathlessness and coughing and maybe even great respiratory distress. Lack of blood flow to the body can result in muscle wasting, poor exercise capacity and weakness.
In some cases the increased pressure within the heart muscle cells can cause abnormal heart rhythms. Ventricular tachycardia can result in lack of forward blood flow and the dog may collapse on over exertion. If the normal rhythm is not restored this can result in death of the dog. The only way to detect these abnormal heart rhythms is with an electrocardiogram (ECG).
It is important to note that DCM does not only affect Dobermanns it also affects many other dog breeds, humans, some cat breeds and even the Syrian Hamster. So due to the diverse host range of the disease and the serious impacts on the host there is extensive ongoing research looking into the genes linked to this disease in order to try and find a suitable DNA test.
Screening for DCM
At the moment the best way to screen Dobermanns for this disease is to perform a heart scan (echocardiogram) and a 24 hour electrocardiogram (Holter monitor). However, these tests are expensive, time consuming and need to be repeated regularly through the dog’s life and requires you to see a specialist veterinary cardiologist. It would therefore be very convenient if a simple blood test, which your own veterinary surgeon can take, identifies those Dobermanns in which the echo / Holter testing should be carried out (focused screening for DCM).
Cardiac Troponin I Scheme
The Dobermann Breed Council (DBC) have recently established a “Dobermann Cardiac TROPONIN I (cTnI) Testing Scheme” in conjunction with the University of Liverpool and the only UK laboratory which commercially run this test.
Cardiac Troponin I (cTnI) can be measured in a blood sample, which correlates with heart muscle cell damage. This is not necessarily due to DCM, as the level can be elevated due to other diseases. Further veterinary attention or cardiology investigations are therefore indicated. A recent study by Gerhard Wess showed that cTnI may be able to predict which Dobermanns are likely to develop DCM before any changes are seen on an echocardiogram or Holter monitor.
The aim of this study is to see if there is any link between the clinical examination of your Dobermann and the levels of cTnI in their blood. We hope also that you are able to update us with any later diagnosis of a normal heart or DCM in your Dobermann.
A simple blood sample can be taken by your vet and submitted to the elected laboratory for testing, the result will indicate if your Dobermann has a normal value cTnI level or an increased level. If the results come back with an increased level of cTnI than normal the next step would be to get an Echo and Holter so that screening is more focused. It is important that Troponin I (cTnI) testing should be done annually, it is a relatively inexpensive test. If the owner of the dog is a member of a DBC member club then the DBC will pay upto £50 towards the testing in return for making the test results available for publication on the DBC website. You will require the appropriate forms for your Veterinary Surgeon a Request Form can be downloaded from www.dobermannbreedcouncil.co.uk or Mrs L Wilkes, 4 Sir Stafford Close, Parc Avenue, Caerphilly, Mid Glamorgan, CF83 3BA email dbcdobe@btinternet.com.
What is DCM?
Dilated cardiomyopathy (DCM) is a common and inherited heart condition affecting Dobermanns. The disease results in an enlargement of the left ventricle (one of the chambers of the heart) which means the heart cannot contract normally to pump blood around the body. The heart chambers become progressively more dilated and blood dams back to the circulatory system from the lungs and the rest of the body. The onset of symptoms related to this is congestive heart failure. The blood dams back in the lungs and fills the alveoli. This causes breathlessness and coughing and maybe even great respiratory distress. Lack of blood flow to the body can result in muscle wasting, poor exercise capacity and weakness.
In some cases the increased pressure within the heart muscle cells can cause abnormal heart rhythms. Ventricular tachycardia can result in lack of forward blood flow and the dog may collapse on over exertion. If the normal rhythm is not restored this can result in death of the dog. The only way to detect these abnormal heart rhythms is with an electrocardiogram (ECG).
It is important to note that DCM does not only affect Dobermanns it also affects many other dog breeds, humans, some cat breeds and even the Syrian Hamster. So due to the diverse host range of the disease and the serious impacts on the host there is extensive ongoing research looking into the genes linked to this disease in order to try and find a suitable DNA test.
Screening for DCM
At the moment the best way to screen Dobermanns for this disease is to perform a heart scan (echocardiogram) and a 24 hour electrocardiogram (Holter monitor). However, these tests are expensive, time consuming and need to be repeated regularly through the dog’s life and requires you to see a specialist veterinary cardiologist. It would therefore be very convenient if a simple blood test, which your own veterinary surgeon can take, identifies those Dobermanns in which the echo / Holter testing should be carried out (focused screening for DCM).
Cardiac Troponin I Scheme
The Dobermann Breed Council (DBC) have recently established a “Dobermann Cardiac TROPONIN I (cTnI) Testing Scheme” in conjunction with the University of Liverpool and the only UK laboratory which commercially run this test.
Cardiac Troponin I (cTnI) can be measured in a blood sample, which correlates with heart muscle cell damage. This is not necessarily due to DCM, as the level can be elevated due to other diseases. Further veterinary attention or cardiology investigations are therefore indicated. A recent study by Gerhard Wess showed that cTnI may be able to predict which Dobermanns are likely to develop DCM before any changes are seen on an echocardiogram or Holter monitor.
The aim of this study is to see if there is any link between the clinical examination of your Dobermann and the levels of cTnI in their blood. We hope also that you are able to update us with any later diagnosis of a normal heart or DCM in your Dobermann.
A simple blood sample can be taken by your vet and submitted to the elected laboratory for testing, the result will indicate if your Dobermann has a normal value cTnI level or an increased level. If the results come back with an increased level of cTnI than normal the next step would be to get an Echo and Holter so that screening is more focused. It is important that Troponin I (cTnI) testing should be done annually, it is a relatively inexpensive test. If the owner of the dog is a member of a DBC member club then the DBC will pay upto £50 towards the testing in return for making the test results available for publication on the DBC website. You will require the appropriate forms for your Veterinary Surgeon a Request Form can be downloaded from www.dobermannbreedcouncil.co.uk or Mrs L Wilkes, 4 Sir Stafford Close, Parc Avenue, Caerphilly, Mid Glamorgan, CF83 3BA email dbcdobe@btinternet.com.
Treatment
If your dog has been diagnosed with DCM, depending on the type of DCM that your dog has, there are treatments that are available. These treatments cannot cure the disease but they can help to prolong the dog’s life. The treatments are either directed against the congenital heart failure signs or to control the arrhythmias. The drugs available to help with congestive heart failure are ACE Inhibitors, Frusemide and Pimobendan (more commonly known as Vetmedin). The drugs available to control arrhythmias are Digoxin and Diltiazem (more commonly known as Sotalol, Mexiletine and and Amiodarone) and Beta Blockers may also be considered.
Further Information
The primary cardiologist working on DCM in Dobermanns is Dr Jo Dukes McEwan at the University of Liverpool, more information on her research, other research being done outside of the UK and on the disease itself can be found on the DBC website http://www.dobermannbreedcouncil.co.uk/cardio.html. Alternatively you can contact me on r.barber@liverpool.ac.uk and I will be happy to give you any further information or pass you onto Dr Dukes McEwan if you wish to get your dog clinically examined.
We really need as many dogs as possible to take part in our Troponin I Scheme, the knowledge gained from this will lead us towards hopefully finding a suitable test for DCM which would be a substantial breakthrough in our breed. So, if you are at all interested please do not hesitate to contact either myself or the DBC secretary (email address above) or go to the DBC website and download the forms. Your help would be greatly appreciated.
DCM plagues our Dobermans :(
ReplyDeleteI don't have firsthand experience with it (knock wood), but I'm a member of the forum at Doberman Talk, and even if you never sign up to post there, there is A LOT of information written by people whose dogs have had DCM disgnoses, and lived with it for a time.
Hi Melissa,
ReplyDeleteI am really sorry to hear about your dog. My colleague (another Burns Nutritionist) lost a dog to DCM a few years ago. However, her dog (a springer spaniel) was given 3 months to live and with diet and non restricted exercise she actually lived over 2 years! She kept a diary of all the supplements and things she did. It may be beneficial for you to contact her? Becka@burnspet.co.uk
Kind Regards
Fiona (Burns Nutritionist)
I had a bull terrier diagnosed with this at the age of 2 years, she did go to a cardiologist, he had a better scanner and far more knowledge of heart problems. She could have had surgery but as she also had skin problems cross infection was a possibility and we just didn't want to take the risk. I honestly don't know whether her life was lengthened by going there but I felt I had done everything I possibly could for her. Luckily she thoroughly enjoyed going to the vets though, it was her favourite day out! Maisie lived for 8 years after diagnosis which was nothing short of a miracle as her heart was grossly enlarged on both sides and the walls thin as tissue paper. For a bull terrier she was a sensible dog and we allowed her to do whatever she wanted to, if she wanted to run she did, if she wanted to take it easy she did. We didn't take her to places that we knew would over tire or over excite her though. I hope you and Madison have plenty of quality time left.
ReplyDeleteSo sorry to hear your news. Obviously I don't know the details of your dog, but my old jack russell was diagnosed with an enlarged heart in 2004 and put on Fortekor initially. By 2006 it had worsened to a Grade II murmur and he was additionaly given Vetmedin twice a day. He continued on these medications and led a very full and active life until late 2010. By July 2011 he started to find things a struggle and additionally had arthritis in his back hips so we made the decision to put him to sleep. However after diagnosis, he had another 7 years. We did keep an eye on his exercise levels and particularly in hot weather when we were quite careful. We did bits of training and tricks which he enjoyed. However, 3 years after diagnosis he was still leading us a merry dance chasing squirrels!! We didn't get the option of a cardiologist, our vet seemed very clued up and I am confident that my old boy got very good care from the two vets who looked after him. Good wishes to your girl and you, it is important, I think to treasure the time you have with her.
ReplyDeleteI had a dog with DCM. (Flatcoated retriever) when the vet school saw him the vet told me that he didnt think that my dog would last more na few months. I was devastated. However my Brachen surpeised everyone by living another 2.5 years. he was on meds of course. Digoxin & Frusmide. My dog chose not to go out on walks, he obviously knew his limitations. but he still had a good life. in the end I had to have him given sleep. the vet that helped had a listen to his heart and i was told that his heart was ok, the old lad had just had enough, he could not have given me more. I kept his weight good and did my best for him. i wish you luck. i however would see the heart specialist. it is in your dogs best interest to be seen by the best. X
ReplyDelete