Animal HealthCare Center
CASE OF THE MONTH -FEBRUARY 1998
China is a 12 year old Pekinese who has had a history of heart disease for several years.  Unfortunately there is not a cure for heart disease in dogs.  China has a heart valve that leaks badly which allows blood to flow backwards against here mitral valve.  This abnormal flow direction causes the mitral valve to vibrate resulting in a heart murmur.  The heart is made up of four chambers. When blood flows backwards in the heart it causes an overload in that chamber.  This stretches the heart muscle and weakens it to the point that it cannot pump blood out to the body. When this happens, fluid builds up in the lungs and other body tissues.  This is why heart disease is often associated with a cough.

We know we cannot repair a failing heart but we can use medication to help the heart pump more efficiently.  China's heart condition has been controlled for several years  Initially she was started on two medications:  Enacard and lasix.  Enacard is a medication which reduces the blood pressure in the body so that when the heart pumps, it doesn't have to push as hard to pump blood to the body.  Lasix is a diuretic (some people call them water pills).  Diuretics are prescribed to stimulate the body (in particular the kidneys) to eliminate any excess fluid that happens to build up in the lung tissue.

China came to us in acute distress.  She was very weak, stopped eating and had trouble even standing.  Typically in this situation we expect to hear fluid in the lungs causing breathing difficulties.  In China's case she had been on lasix so her lungs were not filled with fluid.  We took an X-Ray of her chest to evaluate her lungs and her heart.

The X-Ray showed a very large heart typical of one that was failing but the lung tissue was relatively clear.  Her blood work showed a very high white blood cell count which indicated she also had a severe infection.  China's condition was caused by a continued weakening of the heart muscle's ability to contract.  It is unclear if the infection caused a progression of the heart condition or if the heart condition compromised her health to the point an infection could gain access into her body.  We knew we had to treat both problems at the same time.

China was prescribed both and a medication to strengthen her heart's contractions called digoxin and an antibiotic to help her fight the infection .   Her recovery has been slow (several weeks) her blood cell count has returned to normal and she is fighting the odds and  continues to improve every day.