Category Archives: Cardiology

The Difference Between Heartworm Treatments

The Difference Between Heartworm Treatments

My friend is fostering a dog through a rescue and the dog is heartworm positive. I was wondering what is involved in slow kill treatment for dogs with heart worms? This rescue seems to be preferring the slow kill treatment while the foster is unsure of the slow kill treatment. I’d like to ask your expert opinion on what is involved in the slow kill treatment.
Brilliant question.

Here are the actual facts on heartworm treatments.

  • Slow kill has a 1:1,000 Chance to kill the patient with anaphylaxis
  • Slow kill has a 1-out-of-2 chance to cause further damage however slight, to the heart valves, and function over 18-24 months.
  • Slow kill has a 1:200 chance of embolism and death over 18-24 months.
  • Fast kill is organic arsenic. It’s just a ‘different’ delivery system than the older IV Caparsolate.
  • Fast kill is a risky and carcinogenic compound.
  • Fast kill has a 1:500 chance of anaphylaxis but only for the first 3 weeks.
  • Fast kill has a 1:200 chance of further consequential damage to the dog, at the heart or organs.
  • Fast kill has a 1:200 chance of embolism and death, but only over 6 weeks.
Conclusions:
The Difference Between Heartworm Treatments
The Difference Between Heartworm Treatments

Slow kill is a long process which leaves the door open to embolism and heart damage. But it’s unarguably safer.

Fast kill closes the door on long term issues by ‘wrapping up’ the infection in weeks instead of years, but on the very short term, doubles the chance for problem of consequence.
My decision would be based on the value of the dog sentimentally or economically, the age of the pet, and the pet’s realistic activity level and “years-left-to-live.”
My dog Ajax is 3 years old (2019) and I love him so, so much. If he contracted heart worms I would perform an electrocardiogram and find out if it was a heavy burden. If his heart was compromised in any way I would give him Fast Kill via Immiticide.
If the case were a rescue and costs were always a factor, I would let Slow Kill do the job. That would be predicated on whether I trusted the foster to give the preventative without fail.
Doc Johnson

Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain

Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain

These images animate but it takes a minute or two, then they are smoother. 

Hallmarks of Syncope:

  1. Blue tongue while down
  2. Very short events
  3. They get up pretty fast
  4. Eyes don’t dart back and forth
  5. They don’t chew or paddle
Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain
Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain
bradycardia
Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain
Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain
Syncope Videos Cardiac Arrhythmia Suspends Blood Flow To Brain

Heart Murmurs in Dogs

I will be pulling down some statistics from private practice. Kind of like “what I see“ and I am not going to go back to some literature of global norms.

Heart Murmurs in Dogs

A heart murmur “happens” when one of the valves in a dogs heart doesn’t fit. So it leaks, and that makes an audible ‘murmur’. Murmurs are graded on a scale of one, to five. (1-5)

Every grade of heart murmur costs the dog 10% of its cardiac function. Some clinicians use a scale of 1 to 6 and some people use a scale from 1 to 5. Either way, by the time the dog is down to 50% cardiac function it’s in pretty sorry shape.

The top ‘grade’ of heart murmur is “when you can literally feel the rushing of the murmur with your fingertips through the chest wall.”

The number one cause of heart murmurs in dogs is germs from the mouth.

The number one reason heart murmurs get worse is more and continued germs from the mouth.

When a heart murmur shows up in an old dog, I don’t get very excited. Many times it shows up when the dog is 11+ years old and the owner has given up on the teeth for fear of losing the dog under anesthesia*.

*I’ve never lost a dog under anesthesia.

In large breed dogs a heart murmur speaks to a drastically shortened life. In small breed dogs, it starts a three year countdown. On average.

It could be said that every dog with a heart murmur has four years to live, minus one year for each 25 pounds it weighs.

A dog under 25 pounds with a heart murmur will very likely live three years depending on the severity and how fast it progresses.

Factors influencing how fast a murmur ends a SMALL dog:

  1. Age of dog at time of diagnosis
  2. Severity of murmur when found
  3. Speed at which it goes up in grade
  4. Weight of the dog
  5. Degree of dental disease during progression
Heart Murmurs in Dogs
Heart Murmurs in Dogs are a short term problem for large dogs.

As you can see, subtracting a year for every 25 pounds a dog weighs means that a dog that weighs 100 pounds is unlikely to make it one year.
A large breed dog that is quite overweight, that gets a heart murmur in it’s later years is (usually) not destined to last long.

Heart Murmurs in Dogs

A heart murmur that shows up in a dog under eight years old should be promptly evaluated by a specialist with what is called an echocardiogram. They look at the heart with an ultrasound machine and take measurements, to keep track of the progression, and they can tell you whether or not that heart murmur will be a story-ender or something the dog can live with, even, something the dog was born with.

The number one cause of heart murmurs in dogs is germs from the mouth.

Another prognostic feature of heart murmurs is how fast they progress. If a heart murmur takes a year to worsen by one grade level, that’s pretty normal. But if a heart murmur goes from a grade one to a grade 5 in one or two years, it might be a good idea to intervene.

If money grew on trees, all heart murmurs would be assessed by echocardiogram in the event that antibiotics, or blood pressure medicines or even calcium channel blocker‘s might slow down the progression

Blood Pressure In Veterinary Medicine These Days

Blood Pressure In Veterinary Medicine These Days

Vets Notes

Checking blood pressure isn’t as difficult as it once was. Central venous pressures are still being run, but there’s also a way to use a Doppler and a blood pressure cuff. In the following document I uploaded for my future reference, it’s discussing everything from how and why to monitor blood pressure and more.

https://drjohnson.com/wp-content/uploads/2019/09/Blood_Pressure_In_Veterinary_Medicine.pdf

Positive Inotropes In Canine Medicine

Positive Inotropes In Canine Medicine

Medicines that cause the heart to beat more forcefully, and with a more regular rhythm. This article is fully annotated and I didn’t write it, obviously. How smart do you think I am? This is on here for my ready reference and hence, appears in my Vet Notes section.

https://drjohnson.com/wp-content/uploads/2019/09/Positive-Inotropes-Pharmacology-Merck-Veterinary-Manual-1.pdf