Heart Like a Dog

The Good, the Bad, and the Oh My God of living with dogs!

Canine Arrhythmia – Part 2

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Last week, when I was looking through the blog for a resource to link to another post.  I read through some posts from a couple of years ago, and it made me really sad when I realized I use to be super funny.

I wonder if it has to do with my stint where I had trouble posting, or more along the aging of my dogs, and me not finding any of it amusing?

When you blog about aging dogs that have joint problems, vision problems, adrenal growths and heart issues, I guess you lose your funny.

During a routine exam, Delilah was diagnosed with a heart arrhythmia. It was severe enough to send us to the cardiologist for an ultrasound and echocardiogram of her heart.

At the first visit, the cardiologist discovered a shadow in the tricuspid valve of Delilah’s heart. She strongly felt it wasn’t a heart tumor, just the design of Delilah’s heart. But the only way to know, was to bring her back in 45 (or so) days. The belief was, if it was a tumor, it would have changed within that time period. In the meantime, she put her on some heart medication, and wanted to use a Holter monitor to get a good idea of what the arrhythmia was doing over a 24-hour period.

Yesterday was the ’45’ day follow up. I put that in quotes, because truthfully, it was more like 53 days, due to scheduling.

The first part of the exam is what I call….triage. The vet tech takes Delilah’s blood pressure, weighs her, listens to her heart and takes her temperature. Since Delilah never learned to hold a thermometer under her tongue, the temperature is taken rectally. Like many of us, sticking something up that area of her anatomy, makes Delilah want to poop. Thankfully, once the mean ole thermometer had been removed, Delilah ceased squatting, making both the vet tech and myself breathe a sigh of relief.

Delilah getting her blood pressure cuff on. You’re welcome it’s not her temperature being taken.

When the vet tech asked how Delilah had been, I had to inform her, Delilah has missed two major deadlines in the last week. I say deadlines, but they are more like highlights to Delilah’s day.

The first thing that happened was 9:00 pm came and went, and Delilah slept through it. She only got up when she heard me open the freezer door to get snack.

The second event, also happened within the last week. Most mornings, Sampson and I get up, and Delilah gets up, checks things out and goes back to bed. By the time Sampson and I get back from our walk, Delilah is at the door waiting. But one morning, she wasn’t. She was still in bed.

It’s hard to determine if it’s related to the arrhythmia or not. I mean, we’ve been in the midst of a heatwave (no-one wants to move), Delilah is 12 1/2, she started a new medication for her heart. How do you know if it’s related to any these changes?

When the cardiologist listened to her heart, she said something didn’t sound right, and got her right up on the table. I asked if I should be freaking out, and she told me, “What’s the point of freaking out, if you don’t know why you’re freaking out.”

I said, “You don’t know me, I can freak out over anything.” 🙂

At least she’s honest. **Deep dog sigh**

The good news is, the shadowy part of Delilah’s heart, hasn’t changed. The Dr. said she could measure it, but we both agreed, if it was a heart tumor, it would have grown significantly since the last ultrasound.

The bad news is, the arrhythmia is still going fairly strong. So the 3/4’s of a tablet of Sotalol that Delilah has been getting twice per day, has been increased to a full tablet, twice per day. The Holter is still recommended, but she’d like to get the arrhythmia under control with medication, before putting on the Holter, as it should give us a better idea of what might be going on.

Naturally, I expressed my frustration. You know, I want it fixed, and I want it fixed NOW.  Don’t get me wrong, I’m ever so grateful to have ruled out the dilated cardiomyopathy as well as the tumor, but I want to know WHAT is causing it.

The cardiologist confessed, that 80% of the time, they never find the cause of an arrhythmia.

I’m thinking, maybe I should have been a cardiologist, or a weather person, they only get the weather right 20% of the time too. 🙂

When Pee on the Floor Makes You Happy

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Sunday morning, my day to sleep in, Delilah woke me up at 4:00 am, to go outside. I took her out, she peed and then we went back inside. I’d just settled into bed, when she barked at me again.

I swore at her, but got up and took her out. This time she just stood at the door, nose in the air, sniffing.

I called her back in, coaxed her onto the bed, and tried to go back to sleep. After about 10 minutes, she seemed calm enough, so I thought I’d turn over.

That pissed her off, she growled at me and jumped off the bed.

Needless to say, I didn’t get a whole lot of sleep after that. I lay awake thinking what was the reasoning behind this? Was there something outside? Was something wrong with Mom? Did Delilah have a UTI?

I dozed off and married those two ideas in my dreams. Which equates to something wrong with Mom and Delilah peeing on her.

Don’t feel bad, I’m shaking my head here too.

I watched Delilah intently on our morning walk. She squatted frequently, but very little came out.

I’ll just sleep through this bit, if you don’t mind.

Crap! I wondered if she had a UTI.

Signs of a Urinary Tract Infection:

  • Urinating frequently
  • Peeing in the house
  • Blood in the urine
  • Dribbling pee
  • Crying when peeing
  • Straining to urinate (this can be tricky, because dog straining and people straining are two different things. With dogs this simply means they are squatting often, but nothing is coming out. When humans strain…let’s just not go there, okay?)
  • Obsessive or frequent licking of the genitals

I watched her when we got home, but there was no urgency, or frequency to go out.

Again I asked myself, WTF?

On our evening walk, I watched her again. Again she squatted frequently, and again only drops came out.

My WTF turned to what the actual fuck?

Before smart phones, I would have called Jen, or my vet’s office. OR I would have called Jen while waiting for my vet’s office, but instead, I pulled out my phone and consulted Dr. Google. Can dogs have urinary blockages?

Turns out they can. Now my watching bordered on obsession. What happens if a dog can’t pee? Bladders aren’t balloons,  I mean, that little tiny bladder can only hold so much? Will her body start absorbing her pee? Can her bladder pop?

Signs of urinary tract blockage:

  • Straining to urinate
  • Urine stream can be interrupted or cloudy.
  • Your dog may feel lethargic.
  • Vomiting may occur.
  • Lack of appetite.
  • Crying out when trying to pee.
  • Soreness or tenderness in the abdomen.

I read the signs to watch for, and while I was rubbing her belly I took the time to gently push it see if she had any discomfort.

She looked at me like I had just sniffed her ass, but she didn’t seem uncomfortable.

I decided to take the wait and see approach, and instructed Hubby to watch her when she peed, to make sure she had a good stream.

At dinnertime, everything seemed fairly normal. She was bouncing around like a fool, waiting for me to dish it up. After their food, I gave them their pumpkin and started working on Sampson’s “go-go” juice. Suddenly Delilah darted to the door. This is unusual because she typically waits around to make sure she gets her applesauce, and then she licks Sampson’s bowl. Sometimes she licks the bowl between each course, so running to the door is rare.

“SHE HAS TO GO OUT,” I shouted to Hubby.

He opened the door, and out she ran.

I kept working on Sampson’s juice, then I put Delilah’s applesauce in her bowl, and waited for her to come back.

“Did you see her pee?” I asked him.

“No, she was too quick, she ran out and around the corner.”

She’s just too fast for his old bones.

When I went to pick up her applesauce bowl, I turned on the light, and that’s when I noticed it.

She HAD peed.

On the floor. And it was a good amount.

She has peed on the floor before, and (knock wood) it happens at dinnertime. I think she’s too focused on food, then all that jumping around and it’s too late, she just can’t hold it.

Oh, she tries to get to the door, but the trouble with that is she’s already peeing…so there’s a trail. If only I could teach her write her name while she was peeing.  Wouldn’t that be something?

For the record, I said to Hubby as we were standing on a towel trying to absorb the pee, “Well at least we know she peed.”

One day, I’ll make a list of things I never thought I’d be happy for. Pee on the floor will be right there at the top.

Disclaimer: I am not a vet. I don’t play one of TV, and I did NOT stay at a Holiday Inn recently. The symptoms listed above are not written to provide you to self-diagnose a urinary blockage in your dog. If you even suspect your dog may have a blockage please take them to licensed veterinarian AS SOON AS POSSIBLE. Delaying diagnosis and treatment can be the difference between life and death.

 

Canine Heart Arrhythmia – What Does It Mean?

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I cannot stress enough the value of taking your pet to the vet, at least once per year. If you have senior pets, twice a year at a minimum.

At Delilah’s ‘annual’ exam, our vet discovered she has a heart arrhythmia. Truthfully, I wasn’t alarmed, because Sampson has had an arrhythmia for about three years now. So when Dr. Soutter asked if she could do an EKG, I said, “Of course!”

The EKG showed Delilah has an arrhythmia affecting all four valves of her heart.

Dr. Soutter wanted to confirm the irregularity, so she asked me to bring Delilah back the following week to repeat the EKG. The repeated test showed the same result.

What is a heart arrhythmia?

To put it simply, an arrhythmia is an irregularity in the heart beat. In a normally functioning heart, your heartbeat is like this : thump-thump-thump-thump-thump etc.

For Delilah’s arrhythmia the heartbeat was like this : thump-thump-thump-thump thump thump thump thump-thump. She has a number of extra beats in there.

The next step was an Echocardiogram to see if we could determine the cause of the arrhythmia.

At this point, I was given two options. Wait for the internal specialist to come down, or consult with a cardiologist.

I chose the cardiologist for two reasons. 1) I wanted someone who only deals with the heart. 2) The cardiologist we chose requires I stay with Delilah the entire time. This was a no brainer for me.

Before we left, I (of course) asked Dr. Soutter what could be causing the arrhythmia. The answers were scary. Dilated Cardiomyopathy or a heart tumor.

Neither one has a good prognosis.

Luckily for Delilah, the cardiologist has emergency appointments, and a newly diagnosed arrhythmia is considered emergent. I was able to get her an appointment, in just over three weeks.

The first thing they did when we arrived, was listen to her heart, take her blood pressure and take her temperature. I’ll let you decide which of the above was the least tolerated by Delilah.

Get it off me! Get it off me!

Then we went in to the echocardiogram room, and saw the cardiologist.

Dr. Morris putting the lubricant on the wand.

The vet tech lifted Delilah up, and put her on a table that was just over waist high for me. This impressed the hell out of me, considering the last time I tried to lift Delilah, I peed my pants. That tech got some STRONG pelvic floor muscles. 🙂

The vet tech has her body against Delilah’s back, and is holding her legs so she lies still.

The table itself was padded, and it had a hole in the center where the echocardiogram wand fit through, so the Dr. was able to move it about and get the best view.

You can see the hole in the table, and the Dr’s hand. Also…shaved nipple.

In order to do this, they had to shave an area around her top two nipples. They also clipped some wires to her legs, but thankfully, they didn’t need to shave her legs.

My hand on her head. I was so grateful I could stay with her, to bring her comfort.

I stood at the end of the table, just holding her head, or stroking/kissing her and telling her it was okay. After they viewed one side of her heart, they repositioned her to get the other side.

After that, we were done, and we went to wait for the cardiologist to give me the results.

Can you see those very pronounced lines? Those are the arrhythmias.

The normal beats per minute for a large dog with a healthy heart, is 60 to 100 beats per minute. (Source) During those times when the arrhythmia was happening, her heart was actually beating almost 300 times per minute!  To give you some perspective, if a dog’s heart were to beat at that rate continuously, the dog would be dead in two to three weeks.

Scary.

So what is causing the arrhythmia?

The results of the echocardiogram ruled out Dilated Cardiomyopathy, which is great news.

But there was a dark spot in one area of one of the valves/chambers.

Ruling out a heart tumor

The actual diagnosis says, she has mild leaks in her mitral and tricuspid valves. Her right atrial is normal and her left atrial is normal to slightly enlarged with some subtle thickening. These could be secondary to the arrhythmias or she may be developing degenerative valvular disease. Overall mild findings with respect to structure and function. She didn’t see any obvious mass, but there is a prominent tricuspid valve annulus on free wall, which juts further than she typically sees in the right atrium. She suspects it to be normal for Delilah, but it could be a developing mass.

The cardiologist didn’t think Delilah has a heart tumor, BUT, there is that prominence in her right tricuspid. The way I understand it, the heart attaches to the chest with some fibrous muscles which hold it in place. One of these was slightly more prominent than the other. The recommendation was to do another echocardiogram in 45 days. Her exact words, “IF it were a tumor, WHICH I DON’T THINK IT IS, it will have gotten bigger and we will know.”

If it is a tumor, it will be ugly. It will be fast growing, have metastasized to other organs, can’t be treated by chemo…etc. If it is a tumor….well, I just can’t wrap my head around it. I have never seriously considered I could lose Delilah before I lose Sampson.

Never.

We were sent on our way with Sotalol (80 mg) for her arrhythmia, and she also wanted Delilah’s thyroid checked to be sure the dosage was correct. We made a follow-up appointment for 10 days later, to check and see how the Sotalol was working.

Later that day I spoke with Dr. Soutter, and I expressed my frustration, with not having a diagnosis. The exam, testing and medication was almost $600, and despite this, I still did not know what was causing the arrhythmia. Dr. Soutter was empathetic, she was frustrated herself, but also thrilled we had ruled out the Dilated Cardiomyopathy, and almost 100% ruled out a tumor. She reminded me that many times in veterinarian medicine, we cannot get a clear diagnosis of an illness, but instead rule out what it’s not.

10 days later we went back, and the EKG showed her arrhythmia was down to two irregularities in a three minute period!

Progress!!

They did want to use a holter, which is a heart monitor that gets strapped to Delilah for 24 hours. I declined because 1) I was worried she might chew it off (they assured me it hasn’t happened, BUT I needed to sign a waiver stating I would replace the $1,400 machine IF she did.) 2) It’s hot and humid out, I’d much rather do this in the fall when it’s cooler. So my plan is to take a Friday off, take her up there and get the monitor on, so I can monitor her on the monitor. 🙂

Of course….we still have to get through the next 27 days until the next echocardiogram.

And so we wait.

DISCLAIMER: I am not a veterinarian. I do not play one on TV, and I haven’t stayed at a Holiday Inn Express lately. This post is about MY dog, and the experiences we are having with heart arrhythmias. It is not meant to be or be used as a diagnostic tool. If you suspect your pet is having heart issues, please take them to aa licensed veterinarian.
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