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Recently, on our latest episode of "Call the Vet," we tackled a heartfelt concern from a listener named Sandra, who is facing some challenging health issues with her 14-year-old Chihuahua.
Addressing these complex health episodes in our beloved pets is never easy, especially when they seem to arise unexpectedly.
This situation touches on two significant conditions: congestive heart failure and unexpected seizures, which appeared first in her aging dog. Are they two separate conditions or is there a link? And what testing will help reach a proper diagnosis so the best treatment plan can be put in place?
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I’m wondering if the congestive heart failure wasn’t caught a while back and that could be causing the seizures.
Deciphering Congestive Heart Failure in Dogs
Heart disease can be a frightening diagnosis for any pet parent. It often presents subtly and can be mistaken for other issues. Dr. Alex emphasized that a heart murmur—turbulent blood flow within the heart due to a leaky valve—is not definitive proof of heart failure, though it increases the risk. A murmur is graded on severity, with Sandra's dog at a 4 out of 6, indicating a significant issue but not definitive heart failure.
One of the best at home diagnostics and monitoring tools is observing your dog's sleeping respiratory rate. A count under 30 breaths per minute typically suggests the absence of severe heart failure, providing a simple yet effective way to monitor your pet’s heart health over time.
Addressing Seizures in Elderly Dogs
Seizures in older dogs are particularly concerning and often signal something more sinister than epilepsy, which is rare to onset in senior dogs. Dr. Alex outlined that common causes in senior dogs might include organ disease such as liver or kidney failure, hormonal imbalances, or possibly brain lesions like clots or tumors.
Interestingly, while heart issues in cats can lead to clot formation resulting in seizures or other secondary issues, this is uncommon in dogs. Hence, a direct link between heart failure and seizures in dogs is not typically on top of the list for veterinary professionals.
However, in some instances, severe heart problems could lead to fainting spells that might be mistaken for seizures. This is why recording an episode of your pet's seizure could provide critical clues to your vet.
Comprehensive Diagnostic Approach
The key to managing these health issues lies in comprehensive diagnostics. Dr. Alex suggests starting with full blood work and urinalysis, which may provide insight into any underlying diseases that could be causing seizures.
Imaging studies like X-rays and echocardiograms can also assess the heart's condition and check for any fluid buildup. If neurological causes are suspected, an MRI can be crucial in pinpointing brain lesions.
Pet owners facing such complex health dilemmas might also consider consulting specialists such as cardiologists or neurologists. These professionals can offer a more focused expertise in these areas than a general practice vet.
Moving Forward with Your Dog’s Health
Facing a dual diagnosis in your dog can feel overwhelming. However, understanding the underlying causes, potential links, and appropriate actions to take can ease the management of your pet's condition.
Regular monitoring, prompt veterinary care, and possibly specialist consultation are proactive steps that can make a significant difference. Regular vet visits and maintaining an open line of communication with your pet’s healthcare provider can help catch and manage these conditions before they escalate into more severe problems.
Full Transcript →
The following is an AI generated transcription:
voiceover [00:00:00]: Welcome to the call the vet show. The podcast that helps pet parents understand and optimize the health of their furry family so they can live the full and happy life you want for them. And here's your host, veterinarian, doctor Alex Avery.
Dr. Alex [00:00:19]: Hello, Welcome back to another episode of the show. We've got another listener question bringing a couple of common problems together. Actually, it seems like there are 2 big issues going on in this dog and help is needed. So hopefully, I can provide that. But before we get into the the meat of today's show, welcome along. If you've not listened before, then I'm veterinarian doctor Alex. I'm a GP vet in New Zealand, UK trained, but been over in wonderful Aotearoa, New Zealand for oh, well, since 2010, so it's kind of getting on in years now. As the intro says, this show is for everybody who loves their pet, everyone who wants to make sure that they are doing the best by their dog or their cat, optimizing their health in the first instance, and that's something that I really strongly believe is just incredibly important.
Dr. Alex [00:01:11]: So many things that I see in the veterinary clinic on a daily, weekly, annual basis are due to issues that could perhaps have been prevented or mitigated. I've actually got some free resources that kind of dive into that, and I'll leave links in the show notes. But if that's something you're interested in or if you've got a concern or a problem much like today's listener question, then you can actually get your question answered as well by heading to our pets health dot com slash question or again that link is in the description to this episode as well. So welcome along. It's lovely to be spending some time with you again for this episode. And without further ado, let's jump into today's question.
voiceover [00:01:56]: And now on with the show.
Cathy [00:02:01]: Hi. My name is Sandra, and I have a 14 year old chihuahua. He was recently diagnosed with congestive heart failure. Like, it came out of nowhere. The vet said he has a heart murmur at a 4 out of 6. But, basically, it's all congestive heart failure symptoms. But before that before I knew that, he started having seizures, some months ago, And he just had a really bad one tonight, his 7th one. He had one 4 days ago.
Cathy [00:02:36]: But before that, he didn't have one for 6 weeks. He was running tonight and all hyper and all excited, and then all of a sudden, he just fell over and had the seizure. I'm wondering if it was because he got so out of breath and then his heart, you know, maybe acted up and then it caused that, like, maybe no oxygen getting to the brain because he was having a hard time breathing. So, but you mentioned if a a dog is older, it's and he starts having seizures, it's something else. I'm wondering if the congestive heart failure wasn't caught, you know, a while back and that could be causing the seizures. Thank you so much, and I hope you can answer my question. Thank you.
Dr. Alex [00:03:21]: Hi, Sandra. Sorry to hear that your dog is struggling and and is dealing with potentially a couple of different issues. I do have a few thoughts that hopefully can help you, and your old, Chihuahua out. I think if we tackle each, potential condition at a time, and then try and tie them in together, that's going to really be the most, benefit because while, you know, an older dog, you know, and 14 year old Schwab is is getting up there in age, although our smaller breeds do tend to live, you know, a bit longer than our than our larger breed dogs, When we've got 2 conditions that appear around the same time, then it's much more likely that they are linked. Clearly though we can have separate conditions occurring in the same individual that may be present at different times, or may actually kind of evolve just everything built up at around the same time. But if we take the the heart murmur, heart failure to start with, I mean, the first thing I'd say is that, heart disease, and heart failure, it it it can be over diagnosed, and that can be quite a common thing because a heart murmur isn't always an indicator of overt heart failure. What a heart murmur is, it's it's turbulent flow within the heart. So a leaky valve, means that the blood is not flowing as it should be, and we can hear that with our stethoscope as a murmur.
Dr. Alex [00:04:48]: Now it may well be that although that heart murmur is present, actually, the heart is still functioning well. It's still pumping, blood around the body in a sufficient to a sufficient degree that is able to cope with the demands that the the body requires for for oxygen, oxygen delivery primarily. A heart murmur does mean that a dog is more likely to develop heart failure at some point in the future than a dog without, a heart murmur, but it doesn't mean that they're always going to be developing heart failure. And certainly, the presence for murmur in and of itself doesn't mean that heart failure is present. Now you said it's a grade 4 out of 6, so, that's a way of kind of grading the severity of our murmur and and the higher the number, the the more severe the murmur. And from that point of view, the more likelihood there is is that it is causing some problem, and heart failure may be present. But there are other clues other than just that grade, that loudness, of the murmur and where that murmur can be heard when the stethoscope is placed on the chest. So those clues can be the heart rate, and rhythm.
Dr. Alex [00:05:52]: So heart rate would normally be elevated as the heart is trying to cope with its inefficiency effectively. The rhythm would normally be a regular fast rhythm. You can also have arrhythmias develop as well where it sounds just very irregular. Listening to lung sounds again with that stethoscope can be a clue that there is starting to be fluid building up in the lungs. One of the consequences of heart failure is that you get pressure changes within the veins of the body, and depending on where that failure is taking place within the heart, we can get fluid building up, either within the lungs and we hear that as kind of like crackling, noises when we put our stethoscope on the chest, or you can also get fluid building up actually in the abdomen so their their belly can start to grow and fill with fluid. Gum color, pulse quality, or other things that are in an exam may indicate that the heart is is really struggling. Now how we're diagnosing that, you know, we're taking our clinical, our physical examination, and the history as well, exercise intolerance and not being able to do what they once, you know, once did becoming tired very quickly, Collapse and fainting can be something, and and that can actually be mistaken for seizures, which we'll come on and talk about in just a little bit. But, diagnosis, we can in a very kind of a very effective, although it seems crude, measure that you can do at home is actually to count the sleeping respiratory rate.
Dr. Alex [00:07:23]: So this is where we, when our dog is asleep, we let them, you know, be sound asleep for 20 minutes or so so they're in a nice deep sleep, you know, not lying next to a fire and cooking themselves, in a what we'd call a thermo neutral area, so just normal, you know, normal room temperature. We count the number of breaths they're taking in a minute. If it's under 30, then the chances are there is not severe heart failure present. For all dogs with a murmur, this is a great thing that we can do to measure to to sort of monitor over time whether there is a problem developing. So we can it may be that your dog is, you know, has a murmur and they're tracking at 16, 20 breaths per minute normally when they're asleep, but then that starts to climb and that's a consistent increase, then that might be a sign even though we're under that kind of cutoff of 30, it could be a sign that we're starting to get a little bit of fluid on the lungs, and and that heart is starting to decompensate. So that's something that you can really easily do at home, and I definitely encourage you to do that and to keep doing that because even when we're under treatment, hopefully, that sleeping respiratory rate should come down, if the treatment is being effective. So it's a way of judging how effective the treatment is being is that's being given and whether dose adjustments need to be made, but also heart disease is something that does deteriorate over time. And if you notice things start to climb again, you can jump in, at the early stages before things are are hopefully really bad.
Dr. Alex [00:08:53]: X rays, they're really important to look at the the size of the heart, look for the evidence of fluid buildup, and we can do an ultrasound scan. Now that is typically done by, a referral ultrasonographer. Certainly there are some GP vets that are very good at doing an echocardiogram, which is looking at the heart with ultrasound, but it is definitely a a a skill set that not every vet does. I certainly it's not something that I'm able to do. I refer my patients that need to have this to, to the nearest, nearest big city where there is that option available. So that's kind of our our heart side of things, if you like. We've then got our seizure side of things. So as you say in an older dog, you know, epilepsy isn't normally the cause.
Dr. Alex [00:09:38]: So the most common cause of recurrent seizures in in all dogs, I guess, is epilepsy, but, it normally starts we normally get that first seizure between the ages of one and 6. So in an older dog who's never had seizures, never had any history of seizures before, he suddenly starts to have seizures, the chance of it being epilepsy is is very very low. The other causes are clearly trauma and poisoning, you know, trauma, you would have noticed something going on there. Poisoning, we wouldn't tend to get a repeat, you know, repeat. That would tend to be just a single, seizure event or a dog being unwell and having, you know, several seizures, and then depending on the poison either unfortunately, succumbing to that toxin and dying or recovering and for kind of by and large that recovery is normally, pretty comprehensive without any ongoing problems, again depends on the severity and depends on the the the cause. So really then what we're thinking about is either organ disease, so thinking here like liver failure, kidney failure, some kind of hormonal imbalance, you know, like, some problem with the pancreas. There's a little tumor maybe that's producing lots of insulin, so the blood glucose is going very very low and that can cause seizures, And then we can have a central lesion, so that's a lesion within the brain, and here we're thinking either a clot, or a tumour, a growth that is causing those seizures. So those are the most common, common causes, I guess, in an older dog.
Dr. Alex [00:11:08]: Now if we're thinking about clots, heart failure, heart disease in dogs doesn't normally cause clot formation, which then has a thromboembolic events. Now that's quite different to cats, which you may have heard about and come across about in kind of googling and doing doing research is that cats they do form clots within their heart when they have heart disease, bits of clot then break off and tend to lodge in places that cause problems. Normally, that's actually the blood going to the back legs, but it can be anywhere and and but but dogs don't don't tend to to get that problem, so really the link between kind of heart failure and seizures is certainly in my mind not very readily apparent. I mean, I'd hate to say it's a complete impossibility, but it's not one that I really think about, and it's not certainly something that is very common at all it may be that there's some weird and wonderful conditions and you know a cardiologist or neurologist would be more appropriate to, you know, ruling those in and out completely. But as I said, collapse and fainting in a heart failure dog can be mistaken for seizures as well. So I think a really useful tool that we now all have that we didn't when I first qualified, is our cell phones and we're able to record videos of these events so I appreciate they can be, quite traumatic sometimes and sometimes they can be quite short lived as well, but if at all possible, then actually record, a video of that seizure event, to show your vet because a picture or a video really does paint a 1,000 words and can be really helpful there. With that in mind, I guess, you know, what are our next steps? You know, I'm not sure, Sandra, what, what tests have been run on your dog, but we need to certainly consider some diagnostics, you know, full blood testing and urine testing that can include kind of hormonal evaluation as well, imaging if it's safe and, you know, your dog is stable enough to do that, so that's chest x rays, that's, an echocardiogram, a heart ultrasound scan, you know, we can think of doing an m r a MRI brain scan looking for lesions within the brain, and then also, you know, if we're doing these things, if if we seem to have answers or if the answers aren't clear, you know, I should say if the answers aren't clear or if we seem to have answers but your dog's not responding to treatment as would be expected, then, you know, complicated conditions like this, where, consideration of referral to, you know, in this case, a cardiologist or neurologist potentially, is, you know, is absolutely appropriate because they are the best people to unpack more complicated more complicated cases. You know, that's what they've trained to.
Dr. Alex [00:13:54]: They spend all day every day dealing with a very narrow, narrow realm of pet health rather than kind of myself as a GP vet where, you know, we have to be, you know, dealing with with anything and everything that walks through the door. So, yeah, certainly, kind of consider referral if that is something that is available to you after clearly discussing this with your vet.
voiceover [00:14:17]: Helping your pet live the happy, healthy life they deserve.
Dr. Alex [00:14:23]: So I hope that helps, Sandra. I've also got some, other bits of information that are related to, you know, to heart failure and also to to seizures, and I will leave links to that in the show notes which you can find at callthevectororg or you can find linked down in the description to this episode as well. All that's left for me to say is remember to hit that subscribe or follow button on whatever, podcasting app or if you're listening to this on YouTube, just so that you make sure that you don't miss out on any future content. You can get your question answered at our pets health dot com slash question. And until the next episode, I'm veterinarian doctor Alex. This is the Call the Vet Show because they're family.
voiceover [00:15:08]: That's it for this episode of the call the vet show. Be sure to visit call the vet dot org to join the conversation, access the show notes and discover our fantastic bonus content. We'll see you next time.
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