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    1. #1
      Puppy
      lauraude's Avatar
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      mitral valve dysplagia

      My 4m male chocolate lab has been dx with Mitral Valve dysphagia after a murmur was heard during his physical. Anyone had any experience with management of this problem, as there are no surgical fixes...that I've been told of. We're prepared for the long haul regardless...

      Hoping for the best, preparing for the worst.

      Laura

    2. #2
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      Halcyon's Avatar
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      Poor boy. I have no experience with this myself. Has the vet given you any advice for this condition? Do you know how severe his diagnosis is? If it has only been diagnosed through a physical, I suggest further methods diagnosis to confirm and find out the severity of the condition. This can be done with a radiograph, electrocardiogram or the test of choice (according to Mitral valve dysplasia | Canine Inherited Disorders Database | University of Prince Edward Island), an echocardiography.

      Quote Originally Posted by lauraude View Post
      Anyone had any experience with management of this problem, as there are no surgical fixes...that I've been told of.
      According to some research, surgery can be an option and it is the only option that can completely cure it. Medication can be used for management but will eventually become ineffective. Heart surgery, in which the defective mitral valve can be replaced, is expensive and risky. The prognosis and recovery for this is easier and higher in a healthy, young dog with their renal system and other vital organs in ideal functioning condition. For those who survive, there may be cured completely or the condition of mitral valve dysplasia (MVD) is stopped at that stage and stabilised with medication.

      Meanwhile, I found these articles for you to read through:

      Mitral Valve Dysplasia - Treatment Keywords: Mitral Valve Dysplasia, Mitral Valve Disease, Mitral Valve Disorder, Mitral Valve Malformation,

      Mitral Valve Disease - Management Keywords: Mitral Valve Dysplasia, Mitral Valve Disease, Mitral Valve Disorder, Mitral Valve Malformation

      http://www.cardiospecialist.co.uk/Mi...eDysplasia.pdf

      and

      Heart Failure: Heart Disease and Heart Failure: Merck Veterinary Manual.

      To begin, you need to know the stage of the diagnosis. If at Stage A (identified as high risk but no structural disorders) or Stage B1 (asymptomatic patients who have been diagnosed with the condition, typically through a "murmur of mitral valve regurgitation," but "...have no radiographic or echocardiographic evidence of cardiac remodelling in response to CVHD" do not require medical treatment. Apparently, CVHD stands for "chronic valvular heart disease" and is also known as mitral regurgitation.

      I suspect your Lab is at Stage B1 but I am by no means a trained professional nor know of the condition. This is all found via quick research. Have you considered finding a specialist?

      If at Stage B1, a veterinary cardiologist may prescribe medication aimed to reduce the stress on the heart by slowing heart rate, relaxing the arteries and decreasing blood pressure. Management involves keeping up with dental care to avoid bacteria entering the bloodstream and affecting the heart, low salt and fat diets to reduce water retention, avoiding extreme exertion and adding the supplements: Vitamin C, Vitamin E Tocopherol, CoQ130, fish oils high in Omegas 3 and 6.

      At Stage B2 (asymptomatic but have "significant valve regurgitation, as evidenced by radiographic or echocardiographic findings of left-sided heart enlargement"), medical treatment is necessary. Diuretics are drugs that work to force the kidneys to remove fluid from lungs and increase fluid excretion above what is normally required. There are significant side effects to this though which can be seen in the link. A daily mashed banana is recommended to help restore potassium and phosphorus levels.

      ACE inhibitors slow down the progression of heart failure by "relax[ing] blood vessels, lower[ing] blood pressure and increas[ing] the supply of blood and oxygen to the heart..." Side effects come with this as well.

      The above management strategies are also for this stage. Exercise is also crucial to remain healthy, but of course, care is needed to avoid extreme exertion. Breathlessness and excessive panting can indicate too much exercise. In addition, to provide comfort from fluid-filled abdomens, a comfortable bed can be used to "support the upper half of the body and relieve some of the pressure off the stomach." Furthermore, it is also important to avoid exposure to extreme humidity and temperatures.

      A good idea is to keep a journal to keep track of your the condition's progression. Take notes of your dog's behaviour and resting respiratory rates. If the resting respiratory rate is above 40 breaths per minute, contact your vet.

      I don't believe your Lab is at Stage C (have past or current symptoms of heart failure associated by the condition which may require hospitalisation and aggressive therapy) so I won't go into it here. You can read about it in the linked articles though.

      Hopefully this has been of use despite myself, not having any experience with management of this condition. I don't know how much of it is known information to you (I bet you've been doing lots of research) so I hope it didn't feel like a waste of time reading it.

      Good on you for persevering. Cherish each day with him. Shower him with love and care. Don't panic or despair. If it's only been diagnosed with a physical, there's a good chance he's only at Stage B (at best Stage B1). This is considered a mild stage and many live relatively normal lives. Furthermore, your Lab might just surprise you!

      By the way, what's his name? We love pictures too.

      Sending you good thoughts.

      ETA: I do strongly suggest seeking a veterinary cardiologist though.
      Last edited by Halcyon; 12-16-2014 at 07:28 AM.
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    3. #3
      House Broken
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      Definitely let your breeder know.


      The Dynamic Gang

    4. #4
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      Charlotte K.'s Avatar
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      I would follow this up with a visit to a veterinary cardiologist. Some innocent murmurs can be misdiagnosed; a color flow doppler may be necessary to confirm or rule out the diagnosis. This MVD is a diagnosis that is less likely than TVD in a Lab. That being said, it can happen.

      Breed clubs often have cardiology clinics where it is lower cost. You may wish to go with your breeder.

      The diagnosis is not necessarily a death sentence. In Cavaliers, more likely to have this early onset diagnosis, the dogs sometimes have a normal lifespan, sometimes not.

      Let us know what else you find out.

    5. #5
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      Charlotte K.'s Avatar
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      I found that there is a cardiology and eye clinic at the Western Washington dog shows in Puyallup WA in January: Go to page 15 of the following link:
      https://www.barayevents.com/docs/838/document_3151.pdf

      The good news is that it gives your pup a few weeks to maybe outgrow the murmur, if that is going to happen. It certainly could be an innocent flow murmur: it happens in kids and puppies, too!

      The clinics are first come, first serve. Bring records and cash, usually, as well as your dog's registration number and any microchip information. The fees are usually lower than at the office of the cardiologist, but I am not familiar with prices in your area.
      HEALTH TESTING CLINICS FIRST COME, FIRST SERVE ONLY ON ALL CLINICS
      Heidi N. MacLean, DVM, MS, DACVIM (Cardiology) Pacific Veterinary Cardiology, LLC
      Genetic Heart Screening/CERF exams – $35.00 per dog
      ($30.00 for Dr. plus $5.00 per dog for building rent)
      Echocardiograms – $265.00 per dog
      ($260 for Dr. plus $5.00 per dog for building rent)
      Last edited by Charlotte K.; 12-16-2014 at 10:00 AM.

    6. The Following 2 Users Say Thank You to Charlotte K. For This Useful Post:

      Annette47 (12-16-2014), windycanyon (12-17-2014)

    7. #6
      Best Friend Retriever
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      I agree with a cardio doing an Echo to confirm dx. Prayers he outgrows it or it is manageable with meds.

    8. #7
      Puppy
      lauraude's Avatar
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      He was a re-homing situation a month ago...and they have not been helpful with breeder information. I do have his AKC papers and have sent a letter of concern to AKC explaining the situation to which I both found the puppy and now the health problem. That makes me frustrated, but trying to just focus on the now

      We went to Seattle Veterinary Specialist last week for both a 2nd opinion as well as an ECHO if necessary. The murmur is a systolic murmur and the ECHO was how we were given the dx of mitral valve dysplagia. We have no signs or symptoms of heart failure, but I am trying to learn as much about this before that happens. Both to prevent unnecessary damage and to not be caught off guard.

      I was told any surgical option was too dangerous and not yet reliable at this point. We discussed using an ACE inhibitor early in his treatment but not yet. We are scheduled to return for follow up in 6-8 months, unless something else comes up.

    9. #8
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      Quote Originally Posted by Charlotte K. View Post
      I found that there is a cardiology and eye clinic at the Western Washington dog shows in Puyallup WA in January: Go to page 15 of the following link:
      https://www.barayevents.com/docs/838/document_3151.pdf

      The good news is that it gives your pup a few weeks to maybe outgrow the murmur, if that is going to happen. It certainly could be an innocent flow murmur: it happens in kids and puppies, too!

      The clinics are first come, first serve. Bring records and cash, usually, as well as your dog's registration number and any microchip information. The fees are usually lower than at the office of the cardiologist, but I am not familiar with prices in your area.
      HEALTH TESTING CLINICS FIRST COME, FIRST SERVE ONLY ON ALL CLINICS
      Heidi N. MacLean, DVM, MS, DACVIM (Cardiology) Pacific Veterinary Cardiology, LLC
      Genetic Heart Screening/CERF exams – $35.00 per dog
      ($30.00 for Dr. plus $5.00 per dog for building rent)
      Echocardiograms – $265.00 per dog
      ($260 for Dr. plus $5.00 per dog for building rent)
      Thanks for bringing that to my attention (since I'm in WA too), but most of our cardiologists (and opththamologists) who do clinics do NOT want to be presented w/ known health issues at these lower cost clinics. Whenever there is a known health issue, you really need to go to the office where they can spend more time with the patient.

      I have chaired many such health clinics here in Yakima, and we've had a couple of these misunderstandings in the past so have had to add statements to that effect. In fact at our last cardiac clinic we had a vet refer a patient and the cardiologist had to explain that this was a routine screening for breeding clearances only.
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    10. #9
      Senior Dog
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      Quote Originally Posted by lauraude View Post
      He was a re-homing situation a month ago...and they have not been helpful with breeder information. I do have his AKC papers and have sent a letter of concern to AKC explaining the situation to which I both found the puppy and now the health problem. That makes me frustrated, but trying to just focus on the now

      We went to Seattle Veterinary Specialist last week for both a 2nd opinion as well as an ECHO if necessary. The murmur is a systolic murmur and the ECHO was how we were given the dx of mitral valve dysplagia. We have no signs or symptoms of heart failure, but I am trying to learn as much about this before that happens. Both to prevent unnecessary damage and to not be caught off guard.

      I was told any surgical option was too dangerous and not yet reliable at this point. We discussed using an ACE inhibitor early in his treatment but not yet. We are scheduled to return for follow up in 6-8 months, unless something else comes up.
      Laura, if you have the AKC paperwork, the breeder's name should be on it. If you'd like to email me, I know a lot of the breeders and maybe we can help you get some information... windycanyonlabs@hotmail.com

    11. #10
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      But also know, AKC registration has nothing to do with health concerns with a puppy you get out of AKC registered parents. Congenital defects happen all the time.
      Jen & Tickle!
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