Is there a treatment for heart failure caused by dilated cardiomyopathy? Successful CHF therapy is always based on a good collaboration between pet owner and veterinarian. Assessment of regional systolic and diastolic myocardial function using tissue Doppler and strain imaging in dogs with dilated cardiomyopathy. JVIM 9 (4), 253-258 PubMed. There are a few different treatment plans that a veterinarian might use to help alleviate the dog’s DCM symptoms. There are at least two distinct phenotypes of DCM: one that is characterized by systolic dysfunction and histopathological evidence of attenuated wavy fibers; and one characterized by ventricular tachyarrhythmias and histopathological evidence of myocyte degeneration, fibrosis and fatty infiltration. Your veterinarian may perform additional blood tests, however, including the following: NT-proBNP assay: This test detects a protein that is released by cardiac muscles in response to stretching, allowing early detection of heart disease. Therapy of symptomatic dogs varies in composition and intensity depending on severity of clinical signs and presence of arrhythmia, but chronic therapy should preferably include furosemide and pimobendan ± ACE-inhibitor. Tapeworms (Dipylidium caninum) in Dogs and Cats . Initial stabilization usually depends on the first two. In 2018-2019, many pet owners developed a new awareness of DCM. Mildly symptomatic dogs or those with stabilized CHF may be managed at home. Carvedilol improves echocardiographic and neurohormonal variables in dogs with DCM over a 4-month treatment period. In dogs that are already showing signs of heart failure, enalapril is given to dilate blood vessels. For the asymptomatic patient, the challenge lies in differentiating normal variation and cardiac or non-cardiac pathologies from DCM. Secondary DCM can be caused by exposure to a toxin, deficiencies in certain nutrients (especially taurine), muscle diseases (such as muscular dystrophy), and certain infections. The diet is changed to reduce sodium intake. A significant (85%) reduction of number of ventricular complexes is considered a therapeutic success, but it is not proven that this leads to improved survival. Diet Recommendations for Dogs A diet change is recommended for any dog diagnosed with DCM and that is eating a BEG, vegetarian, vegan, or home-prepared diet. There are several drugs that can be used to address symptoms either individually or in combination, depending on what your pet needs. 5. Furosemide dosing may require adjustments, because treatment requires carefully balancing the need to remove excess fluid with the need to prevent dehydration. Pimobendan helps the heart beat more strongly and dilates blood vessels (allowing blood to flow through the body more easily). : Dogs that are diagnosed with DCM often benefit from treatment with pimobendan. Treatment of DCM is aimed at both improving the heart’s function and controlling the signs of congestive heart failure. Many dogs with diet-associated DCM return to normal with a dietary change. Egenvall A, Bonnett B, Häggström J. In the case of ventricular tachycardia in boxers or Dobermans, commonly used antiarrhythmics include sotalol (2 mg/kg q12h), amiodarone (8-10 mg/kg q12h and reduce to 5 mg/kg q24h after 6 months; should be used with caution due to irreversible hepatoxicity), or a combination between mexiletine (5-8 mg/kg q8h) and a low dose atenolol. Access our library of professional veterinarian resources. In a proportion of boxers and Dobermans (not all), ventricular tachyarrhythmias may cause fainting and weakness, whereas the cardiac dilatation and systolic dysfunction is not apparent. The ventricles are the heavily muscled chambers that pump blood away from the heart. 7. DCM is more common in large breed dogs with a few exceptions such as Cocker Spaniels and Dalmatians. Taurine deficiency may contribute to the development of DCM in some dogs, particularly Golden Retrievers who may have a genetic predisposition to deficiency. When the hearts ventricle does not pump enough blood into the lungs, fluid begins to accumulate in the lungs. The minimal database required for managing the symptomatic DCM patient includes, in addition to echocardiography, a complete case history (including previous diagnostic tests and previous/current medication), a thorough physical examination, thoracic radiographs (to identify cardiomegaly and pulmonary edema and exclude other disease), abdominal radiographs and ultrasound examination in case of ascites, ECG recording (to identify and characterize an arrhythmia), and routine hematological tests and urinalysis (to exclude other disease and identify prerenal azotemia and disturbances in the fluid electrolyte balance). Although reasonable, there is very little evidence that these drugs are beneficial at this stage. In dogs with cardiac dilatation, ACE-inhibitors (0.5 mg/kg q12-24h is the usual dose for most of the ACE-inhibitors) and/or the inodilator pimobendan (0.25 mg/kg q12h) are often introduced. Some dogs with DCM do well with treatment for a period of time; however, some dogs will never resume a normal lifestyle. Diet-associated DCM can be prevented by feeding a well-balanced, complete dog food. There are very few studies addressing the potential benefit of treating preclinical DCM. Treatment & Aftercare Treatment is tailored based on clinical presentation of each individual patient. Once started, these medications are typically continued for the remainder of your dog’s life. It is used to alleviate signs of congestive heart failure, as well to delay the onset of heart failure in dogs not yet showing signs of heart failure. Prospective screening for occult cardiomyopathy in dogs by measurement of plasma atrial natriuretic peptide, B-type natriuretic peptide, and cardiac troponin-I concentrations. This disease is rarely diagnosed in cats or small-breed dogs; however, it is a common cause of heart disease in large and giant breed dogs, and usually occurs more in those that are middle- to older-aged. If arrhythmias are not controlled with the above medications, antiarrhythmic drugs may be added in cautiously. Kramer G K, Kittleson M D, Fox P R et al (1995) Plasma taurine concentrations in normal dogs and dogs with heart disease. Treatment of Dilated Cardiomyopathy (DCM) in Dogs In advanced cases leading to congestive heart failure, drug therapy with a diuretic, angiotensin converting enzyme inhibitor (such as enalapril or benazepril and/or digoxin is prescribed. A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy. J Vet Intern Med 2007;21:719-730. The treatment your dog needs will depend on what stage of DCM they have. Spironolactone at a dose of 2 mg/kg q 12-24h and/or hydrochlorothiazide at a dose of 2-4 mg/kg q12h may be added in cases where the fluid retention is refractory to furosemide alone. Treatment: Cardiac medications are delivered by injection in emergency situations and orally in stable patients. However it appears that abnormalities in diastolic function do not appear to precede the systolic dysfunction or changes in chamber dimensions in dogs developing DCM, which makes it less informative in screening for DCM. If DCM is caused by a dietary deficiency, it can usually be corrected by addressing that deficiency. Guidelines for the Diagnosis of Canine Idiopathic Dilated Cardiomyopathy; The ESVC Taskforce for Canine Dilated Cardiomyopathy. Talk to your veterinarian about the best food for your pet. The most common acquired heart disease of dogs, this is a progressive disease of the heart ventricles: early diagnosis and treatment is key. Great Pet Media does not provide medical advice, diagnosis, or treatment, In 2018-2019, many pet owners developed a new awareness of DCM. Cardiac dilatation may also present with an arrhythmia, most commonly atrial fibrillation, but the histopathological findings include myocytes that are thinner than normal with a wavy appearance that are separated by a clear space, indicating edematous fluid that is generally free from cellular infiltrates; there may also be diffuse infiltration of subendocardial fibrosis. There are a number of different medications used to treat DCM in dogs. ACE inhibitors also help improve general blood flow, which is another benefit for a dog suffering from DCM. Updated June 27, 2019. Antiarrhythmic medications: In rare cases, dogs with DCM may develop significant arrhythmias that require treatment. Changing the dog's diet and supplementing taurine has led to a reversal of the DCM in some instances. Antiarrhythmic medications: In rare cases, dogs with DCM may develop significant arrhythmias that require treatment. Treatment; Prevention; Introduction. These changes interfere with the heart’s ability to pump normally, limiting efficient blood flow throughout the body. Many experts initiate antiarrhythmic therapy once an arrhythmia, such as atrial fibrillation or ventricular tachycardia, is discovered. She currently splits her time between part-time clinical practice and freelance writing, as well as serving on her county Board of Health. DCM (Dilated Cardiomyopathy) is a disease that affects the heart muscle, causing it to become thin and weak. Dept of Clinical Sciences, Faculty of Veterinary Medicine and Animal ScienceThe Swedish University of Agricultural SciencesUppsala, Sweden, Dilated Cardiomyopathy in Dogs: Diagnosis and Treatment, World Small Animal Veterinary Association World Congress Proceedings, 2008, Jens Haggstrom, DVM, PhD, DECVIM-CA (Cardiology), Dept of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, The Swedish University of Agricultural Sciences. A portion of DCM cases, however, are considered secondary in nature—which means they are linked to another cause. The most common is genetics and there are also other underlying medical conditions. Dilated Cardiomyopathy (DCM) is one of the most common acquired heart diseases in dogs. : This test detects a protein that is released by cardiac muscles in response to stretching, allowing early detection of heart disease. Once the disease is present, it will most likely continue to progress. Vet Clin North Am Small Anim Pract 2004;34:1187-1207. Summary: Dilated cardiomyopathy is a disease of predominantly large and giant breed dogs that results in progressive heart muscle dysfunction, chamber dilation, and eventual congestive heart failure or death of affected patients. Although D… Dr. Cathy Barnette is a small animal veterinarian with 13 years of clinical experience. Dogs with DCM underwent echocardiography, ECG, thoracic radiographs, and neurohormonal profiling, followed … In July 2018, the FDA announced that it had begun investigating reports of canine dilated cardiomyopathy (DCM) in dogs … Treatment for DCM in Dogs. Signs, Symptoms and Treatment for Dilated Cardiomyopathy (DCM) in Dogs. Because of the two histopathological phenotypes, dogs of different breeds are screened differently for preclinical disease. DCM is a disease of a dog’s heart muscle and results in an enlarged heart. Dogs, however, are able to synthesize it from other nutrients. In the case of amino acid or enzyme disturbances, supplementation (for example taurine) has been shown to help improve changes that are occurring in the heart. Summerfield N, Dukes-McEwan J, Swift S, et al. With DCM, both the upper and lower chambers of the heart become enlarged, with one side being more severely affected than the other. The most common acquired heart disease of dogs, this is a progressive disease of the heart ventricles: early diagnosis and treatment is key. At this time, it is suspected that many of these cases may be diet-associated, although much is still unknown. While there are likely multiple factors that combine to produce clinical DCM, the fact that the disorder occurs at a higher incidence in specific breeds has always suggested that there is a heritable genetic component to this disease, says Cornell University College of Veterinary Medicine . The dose should be slowly titrated upwards starting with approximately ¼ to ½ of the recommended dose. 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