Jun 15, 2015
Chihuahua, F, S, Black/White, 3 years
Onset: Mid June 2015.
25.6.15 Boarded 15 days. Inappetant, cough and night panting.
Night panting. Coughing and sits on backside with front legs straight, head tilting upwards
Vet 1. Diet changes from eating boarding operator's food. Elevated liver enzymes and low White Cell count. (viral infection during boarding affecting heart muscles?)
14.7.15. Still has nocturnal cough. Vet 2. X-ray heart. Heart disease. Invoril tab 5 mg.
15.7.15. Vet 3. Abdominal ultrasound. Heart murmur stage 1. Arranged French heart specialist to do ECG. ECG normal.
17.7.15 Vet 4. Toa Payoh Vets. Cyanotic tongue. Painful throat. Nocturnal panting. Usual fursoemide, vetmedin and fortekor drugs for one month. Follow up. Less coughing.
17.8.15 Vet 4. Toa Payoh Vets. Unproductive Coughing 4-5X/day for one week. Owner and dog has ringworm. Treatment for ringworm. Dog does not want to eat H/D and so none was given.
1.4.16 Follow up since no news. Dog coughs around 5X/month. On Vetmedin 1/2 tab per day. Overweight. Fed commercial fish-based diet.
CONCLUSION. The lady owner loved the dog very much by seeking so many opinions. She found it hard to believe that such a young Chihuahua could have heart disease. It is very rare. Most likely the dog could have suffered an attack of viral myocarditis at the boarding kennel and the heart muscles had been damaged. Circumstantial evidence was based on the low white cell count in the first visit to Vet 1 in mid Jun 2015. The dog has not fully recovered. My follow up today Apr 1, 2016 shows that the heart disease was not well controlled as evident by some occasions of coughing.
Chihuahua, F, S, Sable/White, 11 years
An interesting case of posture believed to be due to heart disease. So I review the records today as there is close follow up by the couple who treated this pet as a family member wanting her to live the longest life possible.
Vet 1 - loyal to a family vet until the vet vaccinated the dog SC right hand side and cartophen for stiffness on the neck skin area on Dec 2, 2014. The dog screamed. Vet 1 x-rayed spines and did blood test for liver and kidney function on Dec 5 and 14 but nothing abnormal was discovered.
The dog was lethargic on Dec 19, 2014, 7 days after vaccination. She lay on the right hand side but had good appetite. So the owner switched vet to Toa Payoh Vets in Dec 19 2014. Palpation showed to the owner a very painful right paralumbar area, probably a cellulitis due to vaccination injection reaction.
Abnormally high urea, haemoglobin and platelets. Low creatinine but no high total white cell count and so no sytemic bacterial infection.
pH 7 (5-8). SG 1.016 (1.005-1.030). Trace of protein, blood and 1+ bacteria.
Chest heart and lungs normal. Abdomen right hind back area - possible cellulitis. The dog was had a painful right back area after vaccination.
20.7.15 The dog ate, stopped eating and ate. The couple in their 50s diagnosed tooth ache. Came to Toa Payoh Vets, probably by surfing the internet or by reason of close proximity as in many Singaporean pet owners. Extracted 7 teeth.
Abnormally high red blood cells, haemoglobin, platelets and urea. Low creatinine. I advised review of blood one month later. Cut down on supplements including glucosamine and check quality.
Follow up on 24.7.15, the dog was more active, eating well. No painful mouth.
The dog always sleeps curled up on her right side. Why?
Some pain in the back of the rib page around the liver and spleen area.
Supplements given were flaxseed oil and glucosamine.
Abnormally high platelets. Low urea and creatinine.
Abdomen. Liver slightly enlarged. Spleen is normal.
Given hepatavite 30 days and painkillers 4 days. Follow up tel on 18.8.16, dog is normal, not curled up on right hand side but now "sleeps on chest" as in normal sternal recumbency.
Unusual head flexed downwards position and pants.. Pulse pressure higher than normal. Few nocturnal coughs.
Left heart systolic murmurs
Heart medication (vetmedin, fortekor and furosemide) and change to H/D diet.
The dog had no problem eating the H/D diet unlike the chihuahua in Case 1.
Follow up on 31.3.16. Dog is energetic and full of life. No more coughing or head downwards.