Reevaluate Diagnosis & Treatment for Best Results

Question:
My 5 year old beagle has a grade 4 heart murmur. She is on 3 medications: furosemide, enalapril, and spironolactone. Do all these drugs really help, or just make her gain weight and add to her lethargy? I don’t take her on true walks anymore, as she tires so easily. She has a little bit of fluid in her lungs, but as yet is not coughing and to my knowledge has not passed out.

Dr. Nichol:
I’m sad about your beagle’s struggles. The medications she is taking are often safe and effective for congestive heart failure but I am concerned about symptoms this severe in such a young dog. Side effects may be responsible but there could also be undiscovered and untreated aspects to her disease. It’s time to have her reevaluated.

There is a long list of possible causes for a heart murmur. Beagles, in particular, can have a defect called pulmonic stenosis-a narrowing in the major artery that carries blood from the heart to the lungs. For the most current information I conferred with cardiology specialist Dr. Caryn Reynolds of the Veterinary Emergency and Specialty Center. In addition to chest x-rays and an electrocardiogram she recommends an echocardiogram to determine if your dog’s heart condition is complicated by pulmonary hypertension: high blood pressure in her lungs.

Medication changes may be in order but if your girl has pulmonic stenosis her quality of life could be greatly improved with a minimally invasive technique called a balloon valvuloplasty. Her blood flow would increase significantly resulting in a much happier and more active beagle. The change would be quite noticeable-just think of all the howling you’ve both been missing.

In the meantime I advise limiting this girl’s exercise. If she is on the brink of cardiac failure she could collapse, or worst case, die suddenly. A low sodium diet will be important to help control her blood pressure. Weight management is essential to reduce the work load on her beleaguered ticker. From my perspective a 5 year old dog is too young for a life of TV, video games, and shuffleboard. Ask your veterinarian for a cardiology referral so this kid can get back in the game.