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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
Signs of the Aging Dog and Cat
Part 5:
Organs of the Chest: Valve Disease of the Heart
by Kathleen M. Carson, D.V.M |
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Continuing with the theme of signs of aging in our dogs and cats, over the next few months I will discuss changes to look for in the organs of your older animal’s chest. The chest, or thoracic, organs I will discuss are the heart, lungs, and an internal lymph node called the mediastinal lymph node. This month and next, I’m going to concentrate on the heart.
As you’ve probably noted by now, aging animals often develop conditions similar to what affects us humans as we age. Heart disease is certainly a condition that we both share as we get older. First - a difference - animals don’t develop plaque in their blood vessels, so they don’t have heart attacks as we humans do when the vessels which nourish the heart muscle become blocked. However, two other parts of the heart may develop problems in older dogs and cats (and humans). This month I’ll be discussing valvular disease or valvular insufficiency. I’ll mention signs for you to look for after I describe this condition.
The valves are little flaps of tissue dividing the internal chambers of the heart and the junction between the heart and two large blood vessels called the aorta and pulmonary arteries . These valves are designed to stop blood from flowing back into the chamber from which the blood was just pumped by the heart. In other words, they’re designed to keep the blood flowing in one direction only.
Let me first describe the blood circulation in the body very briefly. The heart has a left side and a right side. Each side has a top chamber called the atrium and a bottom chamber called the ventricle. Blood is pumped from the left ventricle of the heart out through the large artery called the aorta to the body. After the blood has passed through the body’s tissues, leaving oxygen and various nutrients, it then moves back to the heart from the lower body until it reaches the large vein called the vena cava, which empties the blood back into the right atrium of the heart. The returning blood is very low in oxygen (which has been taken up by the body’s tissues and organs), so, after the blood goes from the right atrium (upper chamber) of the heart into the right ventricle (lower chamber), it is pumped to the lungs through the pulmonary artery. In the lungs it receives oxygen again, and this oxygenated blood then flows back through the pulmonary vein into the heart’s left atrium (upper chamber) and then into the left ventricle (lower chamber). The heart then pumps this oxygenated blood from the left ventricle out to the body, starting the process all over again.
This is where the valves are in the heart: there is a valve separating the right atrium from the right ventricle; it is called the tricuspid valve. The valve separating the left atrium from the left ventricle is called the mitral valve. There also is a valve between the right ventricle and the pulmonary artery; it is called the pulmonic valve. Lastly, there is a valve between the left ventricle and the aorta; it is called the aortic valve.
The animals most likely to have valvular disease/insufficiency are the small and medium breeds of dogs, especially the Cavalier King Charles Spaniel, Dachshund, Poodle, Yorkshire Terrier, Schnauzer, and Cocker Spaniel. It is less common in large dogs and fairly rare in cats. As the affected dogs age, fibrous deposits form on their heart valve(s). These deposits don’t allow the valve to completely close. After blood is pumped through a valve with fibrous deposits, part swirls backward instead of going forward. This makes a noise which we call a heart murmur.
Animals with a heart murmur from valvular disease can live for years without obvious problems; in fact, in some, it never causes a problem. However, in others, it eventually causes a life-threatening condition called congestive heart failure or CHF.
What is CHF? It is a serious condition in which the heart fails in its job of pumping all the blood around the body, resulting in congestion, or fluid buildup, in one or more parts of the body.
How does CHF come about? As discussed above, in an animal with valvular insufficiency, not all the blood is pumped forward as the heart contracts. Some of it washes backward because one or more of the valves can’t close properly. As the condition progresses, less and less blood is pumped out of the heart with each stroke, and more and more washes backward. This leads to fluid buildup in the organs and tissues from which the blood was pumped. Most of the time the valve which is diseased is the mitral valve, the one dividing the left atrium from the left ventricle. As we saw above, blood comes into the left atrium from the lungs. Thus, when the mitral valve doesn’t close properly, fluid buildup occurs in the lungs; this is called left-sided heart failure.
There are far fewer cases involving disease of the tricuspid valve, which divides the right atrium from the right ventricle, but when this does occur, the fluid buildup is in the abdomen (called ascites) since the blood emptying into the right atrium comes from the lower body. This less common condition is called right-sided heart failure.
What signs would you see if your dog has valvular disease? Initially, you would see nothing, but your veterinarian would be able to hear a heart murmur when he/she puts a stethoscope to your dog’s chest during your dog’s annual or semiannual checkup. If/when your dog develops CHF, however, there are signs you could see. The initial signs may be subtle: your dog won’t want to walk quite as far or play as often with other dogs or humans. Since conditions such as arthritis or obesity could cause the same exercise intolerance, if you note the above signs, it’d be a good idea to have your veterinarian check out your dog. If he/she has heart failure, early intervention is best.
As heart failure progresses, signs such as heavy breathing (dyspnea) or excess panting will occur, especially after exercise and at night. Your dog may be restless. Eventually, your dog will start to cough. With more time you may notice a decreased appetite and weight loss. Less commonly, your dog may have a fainting episode (syncope), in which he loses consciousness for a period of time.
Since lung disease such as bronchitis or emphysema can cause similar signs, a trip to your veterinarian is necessary. If left-sided heart failure is present, your veterinarian will hear not only a murmur, but also the moist crackling (rales) from fluid in the lungs (pulmonary edema) when listening to your dog’s chest. If there is free fluid in the chest (pleural effusion) the heart and lung sounds will be muffled, especially in the lower chest (thorax). Less commonly, your vet may hear heart irregularities (arrhythmias).
If your dog has right-sided heart failure, in addition to exercise intolerance and possible decreased appetite and weight, you would notice swelling of your dog’s abdomen and possibly swelling of the lower legs.
Your veterinarian will want to do further testing to rule in/rule out CHF. These would include some or all of the following: X-rays (radiographs), electrocardiogram (EKG or ECG), and ultrasound (echocardiogram).
Treatment is multifaceted. Treatment programs are tailored to each individual CHF patient, depending on how far advanced the condition is and what other diseases are present. Included in a CHF treatment program are some or all of the following: a low sodium diet, a weight loss program if obesity is present (obesity puts much more strain on the heart), restricted exercise, drugs which remove fluid from the body (diuretics), drugs which strengthen the heart, and drugs which enlarge blood vessels so that there is less resistance to the blood as it is pumped around the body (thus making the heart work less hard).
If your dog’s heart disease is complicated by lung disease, then treatments to help the lungs will be needed. This in turn will ease the burden on the heart.
If you have a holistic veterinarian, acupuncture, herbs, homeopathic remedies and/or supplements will also be used.
Unless the CHF is very advanced or severe, treatment will add months or even years to your dog’s life.
Next month I’ll discuss disease of the heart muscle, called cardiomyopathy.
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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