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Canine Heart and Lung Diseases

Canine Heart and Lung Diseases Canine Heartworm Disease

Dogs acquire heartworm disease when bitten by a mosquito carrying microscopic heartworms. The microscopic heartworms injected into the dog by the mosquito grow in the dog and slowly migrate to the heart and lungs. It is at this stage, 5-6 months after infection, that they begin to cause life-threatening damage to the lungs.

Symptoms

Coughing is the most common symptom of heartworm disease. Infected dogs may also exhibit rapid or difficult breathing patterns and a decreased ability to exercise. On rare occasions sudden death can occur.

Treatment

Canine heartworm disease is usually treatable if detected early enough. Before treatment begins chest x-rays and blood tests will be performed to stage the disease and determine appropriate treatment. The most common treatment regimen generally requires the dog to be hospitalized on two separate occasions over a one month period.

Prevention

Monthly treatment with oral Sentinel, oral Interceptor (or other oral heartworm preventative medications), or topical Revolution is effective for preventative regimens. Prior to starting these medications, and once a year while on them, your dog will need to be tested to be sure heartworm disease is not already present.

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Kennel Cough (Infectious Tracheobronchitis)

Kennel cough is an infection of the airways in the lungs (the trachea and the smaller airways called bronchi). It is usually caused by Bordatella bronchiseptica, a bacterial organism, commonly accompanied by viral infection. The infection is spread by aerosol transmission (through the air) so dogs are most likely to become infected when exposed to other dogs in a closed and crowded environment (animal shelter, boarding kennel, grooming parlor, etc.).

Symptoms

A honking, harsh cough is the classic presentation for dogs with kennel cough. This may be accompanied by a nasal discharge or sneezing. The symptoms generally begin within 2-10 days of when the dog has been exposed to another dog with kennel cough. On rare occasions this can progress to pneumonia.

Treatment

Some cases of kennel cough will improve on their own, but if symptoms are pronounced or persistent an antibiotic, and possibly a cough suppressant, will be prescribed.

Prevention

Vaccination, either by injection or intranasally, is the most effective way to prevent kennel cough. It should be noted, however, that just as in the case of flu vaccinations in humans, since there are multiple organisms capable of causing kennel cough it is possible for vaccinated dogs to come down with kennel cough, though in this case the symptoms will generally be less severe.

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Bronchitis

Bronchitis, which is inflammation (with or without infection) of the small airways in the lungs, differs from kennel cough in that it is generally much more persistent (often lifelong). There are multiple causes for bronchitis and an accurate determination of the cause(s) and extent of involvement in any given patient usually requires x-rays, blood tests, and sometimes more involved procedures.

Symptoms

Coughing is the most common symptom of bronchitis. Affected dogs may also experience shortness of breath, difficulty breathing, decreased exercise ability, and restlessness.

Treatment

While treatment protocols will vary depending on the cause of the bronchitis a mainstay of treatment is use of a bronchodilator, such as Theodur, to help open up the narrowed airways. Antibiotics, cough suppressants, and anti-inflammatory drugs are also often used.

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Laryngeal Paralysis

The larynx, or voice box, is located at the back of the throat and leads to the trachea (windpipe). It closes during swallowing to prevent aspiration (breathing in) of material into the lungs and opens during breathing to allow air to pass into the lungs. Laryngeal paralysis results when the muscles that open the larynx are not working properly. This makes it much more difficult for air to pass through the larynx into the lungs and can lead to life-threatening breathing difficulties.

Symptoms

This is usually a disease with a gradual onset. Early symptoms can include panting, loud or abnormal breathing sounds, change in voice, and decreased exercise ability. These will often progress over a period of weeks or months to significantly impair exercise ability and cause pronounced difficulty breathing. It generally occurs in larger dog breeds and Labrador Retrievers or dogs with hypothyroidism seem to be at higher risk.

Treatment

Surgery is the only treatment available for this condition. Ideally the goal during surgery is to open up the larynx just enough to ease breathing without opening it so much that material can be aspirated into the lungs. It is often impossible to satisfy both of these competing demands completely so there are risks, such as aspiration pneumonia, associated with surgical repair of this condition.

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Tracheal Collapse

The trachea, or windpipe, is a tube made up of a series of cartilaginous rings (similar to the cartilage in your ears). In some dogs these rings become weakened and when the animal breathes these weakened rings collapse inward. This makes it much more difficult for air to flow into and out of the lungs. This disease occurs almost exclusively in toy breed dogs.

Symptoms

Affected dogs will often cough and may have a loud or abnormal sounding breathing pattern. Other signs include difficulty breathing, decreased exercise capacity, and collapse. All these signs are exacerbated by obesity.

Treatment

Weight loss, if overweight, is of paramount importance in managing this condition. Medical treatment may be helpful in some dogs. Cough suppressants, bronchodilators (to open or dilate the airways), corticosteroids, and antibiotics are commonly used medications. In some dogs, however, the condition is so severe that surgical intervention is the only way to treat the problem.

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Mitral Regurgitation

The mitral valve is located on the left side of the heart between the left atrium and left ventricle. Normally blood flows from the lungs into the left atrium, through the mitral valve (which then closes shut), and into the left ventricle. When the mitral valve develops a leak blood flows backwards (regurgitates) into the left atrium and eventually into the lungs. In many dogs this leak can be present for months or years before significant problems develop. Eventually, however, this backward flow of blood results in extra accumulation of fluid in the lungs and is called congestive heart failure.

Symptoms

While any breed of dog can be affected small dog breeds are affected more commonly than larger breeds. Initial symptoms can be subtle, such as an increased resting breathing rate. As the disease progresses (as congestive heart failure worsens) decreased exercise ability, coughing, rapid or labored breathing, and possibly collapse can all be seen.

Treatment

While not curable the symptoms of congestive heart failure can often be managed, to the point the dog remains comfortable, for a period of usually at least a few months. Diuretics, ACE inhibitors, and newer drugs such as pimobendan are common treatments for this disease.

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Dilated Cardiomyopathy

Dilated cardiomyopathy is a disease in which the muscular walls of the left ventricle (the right ventricle is rarely affected), the pumping chamber of the heart, becomes weakened and then stretched out (dilated). This leads to a decreased ability to pump blood out of the left ventricle and out to the body through the aorta. As a result blood begins to accumulate in excessive amounts in the heart, first in the left ventricle and then in the left atrium. After this blood begins to back up into the lungs and this results in the end stage of congestive heart failure. While any breed of dog can be affected larger breeds, especially Doberman Pinschers, Boxers, Great Danes, Newfoundlands, and Dalmations, seem to be at greatest risk. Though the cause is often genetic in certain breeds, notably Cocker Spaniels, Newfoundlands, and possibly Boxers, a dietary deficiency of essential amino acids (taurine and possibly L-carntine) can be an underlying cause.

Symptoms

Initial symptoms can be subtle, such as an increased resting breathing rate. As the disease progresses (as congestive heart failure worsens) decreased exercise ability, coughing, rapid or labored breathing, and possibly collapse can all be seen.

Treatment

Diuretics, ACE inhibitors, digitalis, and newer drugs such as pimobendan are common treatment for this disease. For those breeds in which an essential amino acid deficiency is causative a cure is possible if the congestive heart failure can be controlled long enough for the amino acids to repair the damage to the heart (this can take several months). Otherwise the prognosis is guarded which most dogs surviving for a period of months, though some dogs can survive for a year or more.

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