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DCM Disease Background

Emily Olson DVM is a board certified veterinary cardiologist at VRCC

In dogs affected with DCM, the heart muscle (myocardium) become weakened and enlarges, or dilates, over time.  As the heart muscle becomes weakened, the pump function (contractility) of the heart is impaired.  The major pumping chambers of the heart (the right and left ventricles) cannot eject the normal amount of blood with each heart beat.  The ventricles must dilate to accommodate this extra volume, which can lead to enlargement of the atria and eventually congestive heart failure.  Congestive heart failure means that fluid has built up within the lungs (pulmonary edema), abdominal cavity (ascites), or chest cavity (pleural effusion).

The dilated heart may cause the valves separating the ventricles from the atria (either mitral- left or tricuspid- right) to leak.  This backwards flow of blood is called regurgitation and may produce a heart murmur that can be heard with a stethoscope.  Sometimes an extra heart sound (gallop) or an abnormal rhythm may also prompt your veterinarian to recommended further work-up for DCM.

If no underlying cause can be found, the disease is referred to as Idiopathic DCM. We are not sure why this happens in some dogs and not in others, but a genetic basis is suspected given that certain breeds are predisposed.  Etiologies such as infections (myocarditis), nutritional deficiencies, or arrhythmias can also produce a type of DCM.  In cats and some dog breeds (such as Cocker Spaniels), taurine deficiency can be to blame, especially if the animal is fed an alternative diet.

Diagnosing DCM

M-mode view of the heart demonstrating severe left ventricular enlargement and decreased contractility

Your regular veterinarian may recommend having your pet evaluated by a cardiologist if abnormalities are found during routine physical examination or if your pet is displaying symptoms of heart disease.

Dr. Emily Olson is a board-certified veterinary cardiologist at VRCC.  After reviewing information supplied by your veterinarian, she will obtain a complete medical history and discuss any concerns that you may have about your pet’s health.  Dr. Olson will then perform a thorough physical examination to check for any abnormal heart or lung sounds, arrhythmias, changes in pulses, or other abnormal findings.

She may then recommend running tests such as radiographs (x-rays) of the chest, an echocardiogram (ultrasound of the heart), laboratory work, blood pressure and an ECG (electrocardiogram), depending on your pet’s needs.  These tests are non-invasive and sedation is rarely required.  All tests can be performed during the visit, and results will be discussed with you prior to taking your pet home.

Color Doppler image demonstrating mitral valve regurgitation. A small amount of tricuspid regurgitation is also present.

Treating DCM

Regular monitoring allows us to start treatment as soon as it becomes necessary. By starting treatment early, we can maximize your pet’s quality of life for as long as possible. In patients with DCM and signs of heart failure, it is common to prescribe your pet a combination of drugs. Therapy is aimed at maximizing the heart’s efficiency at pumping blood to the body and reducing the excess fluid build up in the body.

There is no known cure for idiopathic DCM.  In breeds that do not typically develop idiopathic DCM, it may be indicated to test for possible underlying causes.  If a cause can be found, different treatments may be recommended and often the prognosis is improved.

Arrhythmias, or abnormal electrical activity within the heart causing an irregular rhythm, can occur as a consequence (or occasionally the cause) of the disease.  This is especially common in large breed dogs affected with DCM.  If the arrhythmia is causing a problem for your pet, additional medications might be prescribed to improve the heart rhythm.

Prognosis of Dilated Cardiomyopathy

2D image demonstrating severe left ventricular and left atrial enlargement

It is difficult to predict the life expectancy for any individual patient with DCM. Some dogs live for months to years with minimal to no symptoms, while some dogs rapidly worsen and only live for a few weeks to months. Complications such as arrhythmias or high pressure in the lung (pulmonary hypertension) can worsen the prognosis.

Other factors influencing the prognosis in your pet include the disease severity at the time of diagnosis, response to medications, and whether any other diseases (such as kidney problems) are also present.

Monitoring Signs for DCM

Closely monitoring your pet’s symptoms and communicating with your veterinary team is extremely important.  Since this disease is progressive, it is common for an individual pet to need dosing and medication changes over the course of their disease. With your help, we can identify which changes need to be made as early as possible. If your pet is experiencing symptoms, please contact us right away so that we can ensure the optimal therapy for your pet.

• One easy way to monitor your pet at home is by checking their resting respiratory rate.  When your pet is sleeping or resting quietly (not panting), count how many times they take a breath in one minute (or count the number of breaths taken in 30 seconds and multiply by 2).  In most pets, this can be done by watching or feeling their chest rise and fall with each breath.  This should be done 2 to 3 times per week, and the rate recorded in a log. If you notice a trend that the rate increasing and is repeatable on several occasions, your pet may need to be evaluated.
• In addition to respiratory rate, please monitor your pet for clinical signs such as coughing, decrease in activity level, decreased appetite, unexpected weight loss, collapse, or swelling of the abdomen (belly).
• If you ever notice that your pet is having difficulty breathing or appears unable to catch their breath, collapses, or otherwise appears to be in distress, please seek immediate veterinary care.
  

  VRCC is open and staffed with a veterinarian 24 hours a day, 7 days a week, in order to care for your pet in any emergency.

  Call 804.784.8722 (804.784.VRCC)

  See our Emergency Vet Page and download the admission form

  Get directions to VRCC Veterinary Emergency Room

Cavalier King Charles Spaniel is a breed that often suffers from CDVD

Chronic Degenerative Valve Disease (CDVD) is the most common cause of heart disease as well as congestive heart failure in dogs.  It is also known as Mitral Valve Disease, Myxomatous Valvular Disease, and Endocardiosis, among other names.  Most patients affected with this disease are middle aged to older small breed dogs, although it can also affect younger and larger animals.

CDVD Disease Background

In dogs affected with CDVD, the structural components of the heart valve degenerates over time.  While we do not know the exact cause for the disease, it is likely that there is a genetic basis. This degeneration of valve tissue most commonly affects the mitral valve (which separates the left ventricle from the left atrium), though it can affect any of the heart valves.

2D image demonstrating severe left ventricular (top) and left atrial (bottom) enlargement. The affected mitral valve separating the two chambers is thickened and prolapses into the left atrium.

As the tissue in the valve degenerates, the leaflets become thickened and irregular. Instead of coming together and creating a tight seal, gaps form between the valve leaflets. Each time the left ventricle contracts, some blood can leak backwards into the left atrium through these gaps. This backwards flow of blood is called regurgitation. Over time, the valve continues to degenerate and the amount of regurgitation increases.

This regurgitation of blood produces turbulence within the heart which can often cause a heart murmur that your veterinarian can hear with a stethoscope.  In some patients, this turbulence is severe enough to cause the chest wall to vibrate which can be felt as a palpable thrill.  The left atrium will enlarge as the amount of regurgitation through the mitral valve increases.  Eventually, the left atrium may not be able to compensate for this extra volume of blood.  This can cause fluid to build up within the lungs, a condition known as congestive heart failure.

Fortunately, this disease process usually occurs gradually over the course of several years. Most animals can compensate for the disease for a long period of time and may never develop signs of heart failure. However, once we identify a patient with this disease, regular monitoring is essential so that we can begin medication at the appropriate time.

Diagnosing Mitral Valve Disease

Emily Olson, DVM, is our board certified cardiologist

Your regular veterinarian may recommend having your pet evaluated by a cardiologist if abnormalities are found during routine physical examination or if your pet is displaying symptoms of heart disease.

Dr. Emily Olson is a board-certified veterinary cardiologist who works at VRCC.  After reviewing information supplied by your veterinarian, she will obtain a complete medical history and discuss any concerns that you may have about your pet’s health.  Dr. Olson will then perform a thorough physical examination to check for any abnormal heart or lung sounds, arrhythmias, changes in pulses, or other abnormal findings.

She may then recommend running tests such as radiographs (x-rays) of the chest, an echocardiogram (ultrasound of the heart), laboratory work, blood pressure and an ECG (electrocardiogram), depending on your pet’s needs.  These tests are non-invasive and sedation is rarely required.  All tests can be performed during the visit, and results will be discussed with you prior to taking your pet home.

Treating Mitral Valve Disease

Color Doppler image demonstrating a large volume of mitral regurgitation (same view as image above)

In most cases, no treatment is needed until a patient starts to show signs or the disease becomes severe. Regular monitoring allows us to start treatment as soon as it becomes necessary. By starting treatment early, we can maximize your pet’s quality of life for as long as possible. In patients with CDVD and signs of heart failure, it is common for your pet to require a combination of drugs. Therapy is aimed at maximizing the heart’s efficiency at pumping blood to the body and reducing the excess fluid build up in the body.

Arrhythmias, or abnormal electrical activity within the heart causing an irregular rhythm, can occur as a consequence of the disease.  This is especially common in large breed dogs affected with CDVD.  If the arrhythmia is causing a problem for your pet, additional medications might be prescribed to improve the heart rhythm.

Prognosis for dogs with Chronic Degenerative Valve Disease

The life expectancy for any individual patient with this disease is difficult to predict. Some dogs live for years with no or mild symptoms, while some dogs rapidly worsen and only live for a short time. Complications such as rupture of the chordae tendineae (structures that attach the mitral valve leaflets to the left ventricle), arrhythmias (abnormal heart rhythm), or high pressure in the lung (pulmonary hypertension) can worsen the prognosis. Your pet’s prognosis is also dependent on the severity of the disease when it is diagnosed, how they response to medications, and whether any other health problems are also present.

Monitoring Signs for CDVD

Monitor your pet’s symptoms and communicating with your veterinary team is extremely important in dogs with CDVD.

Your pet’s medications and dosages often need to be adjusted as the disease progresses.  Your communication and at-home monitoring is imperative to allowing us to determine if and when changes need to be made as early as possible to ensure the optimal therapy for each animal.

• One easy way to monitor your pet at home is by checking their resting respiratory rate. When your pet is sleeping or resting quietly (not panting), count how many times they take a breath in one minute (or count the number of breaths taken in 30 seconds and multiply by 2).  In most pets, this can be done by watching or feeling their chest rise and fall with each breath.  This can be done two or three times per week, and the rate recorded in a log. If you notice a trend that the rate increasing and is repeatable on several occasions, your pet may need to be seen.
• In addition to respiratory rate, please monitor your pet for clinical signs such as coughing more than normal, unexpected decrease in activity level, decreased appetite, weight loss, or swelling of the abdomen (belly).
• If you ever notice that your pet is having difficulty breathing or appears unable to catch their breath, faints or collapses, or otherwise appears to be in distress, please seek immediate veterinary care.

VRCC is open and staffed with a veterinarian 24 hours a day, 7 days a week, in order to care for your pet in any emergency.

Call 804.784.8722 (804.784.VRCC)

See our Emergency Vet Page and download the admission form

Get directions to VRCC Veterinary Emergency Room

Emily Olson DVM is a board certified veterinary cardiologist

Hypertrophic cardiomyopathy (HCM) is the most common heart disease affecting cats, and in rare cases can occur in dogs.  Most cats with HCM are middle-aged to older, although all ages can be affected.

Thousands of gene mutations are known to produce HCM in people, however at this time only two mutations have been found in certain cat breeds (Maine Coons and Ragdolls).  The disease can range in severity from benign (causing no problems throughout the cat’s life) to life-threatening or even fatal.  Many different factors determine how severe the disease may become in an individual animal.

Early recognition of heart disease and its consequences are key to preserving your cat’s quality of life. VRCC is open and staffed with a veterinarian 24 hours a day, 7 days a week, in order to care for your pet in any emergency.

HCM Disease Background

HCM is a primary disease of the heart muscle which impairs the function of the heart.  The muscular walls of the heart (myocardium) become too thick.  This increased thickness affects mainly the left ventricle, making it difficult for the heart to relax appropriately.  Less blood is able to fill the cavity of the left ventricle, which can increase pressure in the left atrium. Ultimately this can lead to congestion within the lungs (pulmonary edema) or development of fluid within the chest cavity (pleural effusion), a process known as congestive heart failure.  The abnormal heart muscle may also affect the electrical activity of the heart, producing an arrhythmia that can be discovered during physical exam or on an electrocardiogram (ECG or EKG).

2D image demonstrating severe enlargement of both the left and right atria. A large clot (thrombus) can be seen within the left atrium.

Another common and serious complication of HCM in cats is arterial thromboembolism. Blood flow in the enlarged left atrium becomes sluggish (possibly seen on echo as “smoke”) and is prone to the formation of clots (thrombi). These thrombi can break off and travel through the arteries, often causing obstruction of the vessel. Large thrombi can obstruct the final portion of the aorta, commonly referred to as a “saddle thrombus”.

As a consequence, the blood supply to the rear part of the body is partially or completely blocked.  Affected cats can present with sudden onset of pain, weakness or inability to walk (paresis or paralysis), or sudden death. Please seek immediate veterinary care for your cat if you notice any of these signs as this is an emergency situation.

Hypertrophic Cardiomyopathy Diagnosis

Most cats do not show clinical signs until their heart disease is advanced.  Your veterinarian may recommend further work-up with a veterinary cardiologist if a heart murmur or extra heart sound (gallop) are found during routine physical examination, or if your pet is showing signs that could be due to heart disease.

Dr. Emily Olson, a board-certified veterinary cardiologist who works at VRCC, is available to perform the tests necessary to diagnose and treat patients with HCM.  After reviewing the information provided by your veterinarian, Dr. Olson will obtain a complete medical history and discuss any concerns that you may have about your pet’s health.  Dr. Olson will then perform a thorough physical examination to check for any abnormal heart or lung sounds, arrhythmias, changes in pulses, or other abnormal findings.

Short-axis image of the left ventricle of a cat with HCM. The heart wall (grey circular shape) is severely thickened and the chamber size (black) is reduced.

She may then recommend running tests such as radiographs (x-rays) of the chest, an echocardiogram (ultrasound of the heart), laboratory work, blood pressure and an ECG, depending on your pet’s needs.  Radiographs can sometimes show that the heart is enlarged; however normal radiographs do not guarantee that the heart is normal.  Radiographs are most beneficial to look for signs of congestive heart failure.  An echocardiogram (“echo”) is an ultrasound of the heart that allows us to look for changes in the heart muscle thickness, atrial enlargement, and other changes to the heart.

Color Doppler image demonstrating mitral regurgitation and left ventricular outflow tract obstruction due to systolic anterior motion (“SAM”) of the mitral valve. This occurs in some cats with HCM and often requires additional therapy.

An echo is necessary for diagnosis of HCM, as well as for monitoring disease progression and response to therapy.  Additional tests such as blood pressure measurement and thyroid levels (T4) are usually necessary to make sure other conditions are not the cause for the abnormally thickened heart muscle.

These tests are non-invasive and sedation is rarely required.  All tests can be performed during the visit, and results will be discussed with you prior to taking your pet home.  Because HCM is a progressive disease, a normal echo does not guarantee that HCM will not develop in the future.  In cats at increased risk for HCM (family history, certain breeds, etc.), repeated examinations and periodic echos may be recommended to screen for the disease.

Hypertrophic Cardiomyopathy Treatment

Unfortunately, there is no cure for this disease.  Treatment is aimed at decreasing congestion in or around the lungs with diuretics, helping the heart muscle to relax and fill more easily, reduce this risk of clot formation, and treat any arrhythmias if necessary.  Medications can allow many cats with congestive heart failure to live comfortably for months to even years.  Other cats may not survive their first episode of congestive heart failure or thromboembolic event.

Prognosis is highly dependent on the severity of the disease at time of diagnosis, as well as other concurrent diseases the cat may have (such as kidney disease, diabetes, or high blood pressure).

Early recognition of heart disease and its consequences are key to preserving your cat’s quality of life.  Your cat should be monitored for any sign of difficulty breathing, change in behavior (hiding, decreased activity), decreased appetite, change in gait or inability to walk, weight loss, or collapse.  Please contact your veterinarian should you notice these signs, or seek immediate medical attention if your cat appears to be in distress.

VRCC is open and staffed with a veterinarian 24 hours a day, 7 days a week, in order to care for your pet in any emergency.

Call 804.784.8722 (804.784.VRCC)

See our Emergency Vet Page and download the admission form

Get directions to VRCC Veterinary Emergency Room

The National Weather Service is predicting temperatures in the Richmond area to exceed 80 F for for the first time this year during March 14, 15, 16. Animals with the following respiratory diseases could be susceptible to significant exacerbation of disease:

• Laryngeal Paralysis
• Pulmonary Fibrosis
• Chronic Bronchitis
• Bullous Emphysema
• Asthma

Please make sure that all animals have access to constant shade or air conditioned space. Please contact an emergency veterinarian immediately if you observe your pet to exhibit persistent open mouth breathing, increased respiratory effort, loud or high pitched inspirations, purple mucous membranes, or collapse.

In order to receive the award, businesses must maintain excellent customer ratings throughout the year, among other requirements, so here’s a big “Thank You!” to all of those who gave us rave reviews and continue to share the positive experiences they’ve had at VRCC with others. We love to hear your feedback on Angie’s List and on other platforms like Facebook, so keep your pictures of your pets, success stories, questions, and other comments coming!

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• Let guests know the rules concerning your pets. If you let guests know what is and is not acceptable when it comes to your pet, you decrease the risk of your guests doing something that could harm your pet. Don’t just assume that because they have a pet they’ll know what is good or bad for yours.
• Don’t share table scraps with pets. Many common foods which people eat can cause serious harm to pets. Raisins and grapes are known to cause renal failure in dogs. Macadamia nuts can cause short-term hind-limb paralysis and chocolate can harm the central nervous system, heart, and kidneys.
• Keep holiday plants away from pets. Many of these plants are known to be poisonous to animals, such as lilies, holly, amaryllis, and mistletoe. Don’t worry about the poinsettias, though. Once thought to be poisonous, poinsettias have proven to be benign.

If you think your pet has ingested something which may be hazardous to their health, contact your veterinarian or animal emergency hospital IMMEDIATELY!