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Cardio blog: Dilated Cardiomyopathy

Welcome to cardio blog! In this blog I plan to describe some of the interesting cases of heart disease that we see here at MK Vet Group. My thanks go out to all the owners who have allowed their companions to feature in these blogs. I would like to also thank all owners who show such dedication to allow their pets to lead happy and fulfilled lives whilst suffering from heart disease.

In this first blog I am going to be talking about dilated cardiomyopathy, or DCM for short. This is a disease of the heart muscle which occurs in many large breed dogs. The heart muscle becomes weak, and unfortunately the heart is unable to pump properly. This leads to dilation of the heart and eventually heart failure. DCM is usually seen in large purebred dogs such as Dobermans, Boxers, Great Danes and Irish Wolfhounds. Dogs often present at the vets once heart failure is beginning to develop and may have signs such as fatigue, reduced appetite, weight loss, breathing problems and an irregular heartbeat. Cats can also get DCM, but it is much rarer. It was historically associated with a nutritional deficiency in cats, but cat food is now supplemented to prevent DCM from developing.

A recent study in Dobermans has shown that early treatment with a drug called pimobendan before the onset of symptoms can extend the survival time for dogs with DCM. For this reason we are currently offering a free of charge blood test for a heart blood marker called proBNP. High levels of this marker raise suspicion for heart disease and allow us to pick up early cases before they develop symptoms. We have written to all owners of Dobermans, Boxers, Great Danes and Irish Wolfhounds, who have animals aged over 3 years old to invite them to come in for the blood test.

G’s Story

Here is a lovely photo of G. He is a beautiful 7 year old Great Dane. He was blood tested for proBNP and was found to have very high levels. He was admitted to our hospital for an echocardiogram (a heart ultrasound) and an ECG.

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G is a very worried dog at the vets so to minimise his stress we performed his ECG in a quiet room away from any noise. He was perfectly behaved for both his diagnostic procedures, he truly is a gentle giant! The ECG is a simple but very useful test of the heart’s electrical activity. It involves attaching a lead to each of the dog or cat’s legs and recording the electrical activity of heart on a special machine. The worst bit is the squirting of a little spirit at the lead attachment sites, which can be quite cold. A tasty treat at this stage usually helps as a distraction. Here is a photo of G’s ECG trace as seen on the ECG machine. Although it is very fast due to him being worried, it is nice and regular. It is not uncommon for us to detect an irregular rhythm called ‘atrial fibrillation’, which may require some additional medications to slow the heart rate.

Here is a photo of G’s ECG trace as it appeared on the ECG machine:

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The next stage was to perform a heart ultrasound or echocardiography. We are able to use an ultrasound probe to image the heart in real time. The moving heart can be paused at certain points to allow measurements of the heart to be made. From these measurements as well as a general overall impression of the heart we are able to make a diagnosis of the underlying heart disease and make a treatment plan. We lie the animal down very gently on a specially padded table which allows the ultrasound probe to examine the heart from the underside. This gives a better picture and we find that most animals relax quite nicely during the scan (they have been known to nod off!). If they do become agitated, we use treats or a squeaky toy to distract them.

This is the examination table and ultrasound machine.

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This is the echo probe. It’s quite small to allow it to be able to fit between the animal’s ribs without causing any discomfort.

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G’s heart showed enlargement of both the left atrium and ventricle. The atrium is the top chamber of the heart which receives blood before pumping it into the ventricle. The ventricle pumps the blood around the body. The heart is measured in both the long and short axis. Measurements made of G’s heart showed its ability to contract was reduced.

This is a short axis (cross section) frozen picture of the left ventricle with a measurement being made. You can see that the inside of the ventricle makes a mushroom shape due to the papillary muscles poking into it. The papillary muscles anchor the valve that sits between the atrium and the ventricle.

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Here is a video showing G’s enlarged left ventricle which is not contracting properly (opens in new window):

After I had discussed G’s condition with his owner, he was prescribed a medicine which helps to increase the force of contraction of the heart. This medicine is called pimobendan, which is given twice daily on an empty stomach. As his condition progresses, G will probably need to take more medicines to help reduce the accumulation of fluid in his body.

It is a sad fact that the long term prognosis for dogs suffering with DCM is not good and many dogs pass away within a year of starting treatment. However we try to make their quality of life as good as possible after diagnosis and they enjoy every day that is given to them. You can’t meet better patients than dogs and cats. For dogs that are caught earlier in the disease process, like G, starting treatment early can help to extend their life span.

Many thanks for reading this blog and I hope you have found it interesting.

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Babesia infection in dogs

What is Babesiosis?

Babesiosis is a malaria-like disease caused by a microscopic parasite (Babesia Canis). The parasite is carried and transmitted by ticks.

What has changed?

Babesiosis has been diagnosed in UK dogs before but in all those cases the dogs contracted the infection abroad. For the first time there is an outbreak of Babesiosis in the UK. Four dogs in Harlow, Essex, with no history of foreign travel have contracted the disease. Unfortunately, one of these dogs has died.

How is it transmitted?

Babesia Canis is predominately transmitted by the Dermacentor reticularis tick (Ornate Cow tick). In warmer climates (Southern Europe) it is also transmitted by the Rhipicephalus sanguineus tick (Brown Dog Tick).
It is the D. Reticularis tick that was implicated in the recent outbreak in Essex. Importantly, D. Reticularis is not widespread in the UK, with only very limited confirmed populations in isolated areas in the UK.
The Brown Dog Tick (Rhipicehalus Sanguineus) is not currently established in the UK but there are reports of dogs returning from abroad carrying it and subsequently establishing in households.

What are the symptoms of Babesiosis?

The infection results in anaemia following destruction of the patient’s red blood cells. Signs of infection include pale gums, high fever, weakness, red urine and collapse in severe cases.

How is it diagnosed?

Vets can in most cases diagnose the infection by looking at a blood smear. There is also a PCR blood test available if the blood smear results are inconclusive.

How is the disease treated?

There is effective treatment for the infection. It normally consists of two injections given two weeks apart. More severe affected cases might need supportive care, which can include blood transfusions.

How can I protect my dog?

Regular control of ticks by using an effective product is the best way to protect your dog. It takes at least two days for the tick to transmit the parasite to a dog, so we advise you examine your dog carefully after walks, particularly in woods or fields. Any ticks found should be removed with a tick remover to ensure all parts are removed successfully.

Can the disease be transmitted to humans?

The is no risk to humans from Babesia Canis.

What is the prognosis?

Early diagnosis is the key. With appropriate treatment 85 to 90% of patients should recover from the infection.

Should I be worried?

It is very important to point out that the tick implicated in the outbreak is at the moment only found in very limited areas in the UK. You can find an up to date distribution map here.

What will we do?

We will monitor the situation closely and keep you up to date on any new developments in the outbreak. Milton Keynes Veterinary Group has recently taken part in the ‘Big Tick Project’, run by Bristol University. In total vets across the country have collected 6, 372 ticks for analysis for tick borne diseases, including Babesiosis and Lyme disease. The results of this study will be available later this year and we will update our clients on the results.

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Spring Surprises!

As the winter draws to a close and the days become warmer pets start to spend more time outside enjoying the Spring sunshine (hopefully!) and longer daylight hours.

However Spring brings some unexpected problems for our pets:-

  • Chocolate – keep all those Easter eggs well away from dogs as the theobromine in chocolate can be toxic at relatively small amounts especially dark chocolate or those with a high cocoa solids content

  • Chocolate

  • Lilies – many people decorate their house with lilies at Easter time. However the leaves, flowers and pollen can cause kidney failure in cats and is often fatal. Please avoid bringing these into your house if you have cats.

  • Lillies

  • Hot Cross buns – raisins and grapes can cause acute renal failure in dogs. It does not affect every dog but it is impossible to know which dogs are susceptible and in those dogs that are affected even a small amount can be fatal.

  • Buns

  • Gardening – bulbs can be poisonous in dogs and cats so if digging up a flowerbed make sure you dispose of any carefully! Also take extreme care if using ANY pesticides.
  • Slugs and snails – they love the wet, warm weather Spring brings and in this area they can carry Lungworm. This parasite infects dogs causing blood clotting problems as well as coughing and other symptoms and can be fatal. Dogs are infected by eating the slugs or snails. Regular treatment with an anti-lungworm insecticide such as Advocate can prevent it.

  • Lungworm

  • Grasses and pollens – as the garden springs into life skin allergies can be more common. Watch out for itchy skin, rashes and sore eyes. Ears can also be affected.
  • Lamb bones – we enjoy a lovely roasted leg of lamb at Easter, but dogs should not have cooked lamb bones as they splinter, and any fatty left-over meat could cause an upset tummy.

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Doggie Donor Day success

We had a fantastic turn out for our first doggie blood donor session on Valentine’s Day. We are so grateful to everyone involved, especially the doggie lifesavers! The Pet Blood Bank team were very impressed with how well behaved the donors all were.


Donor

This amazing bunch of beauties collected 15 units of blood between them which can help up to 60 sick dogs. And with such an amazing effort, we are planning another donor session in June.

Please email us at info@mkvetgroup.co.uk to register.


Donor

Pet Blood Bank UK (PBBuk) was set up as the first UK charity to collect, process, store and distribute pet blood products in the UK. A change in legislation in October 2005 made it possible for vets to store pet blood. Recognising this as an opportunity to develop a blood bank, Vets Now raised the funds to set up and support the PBBuk charity, which supplies dogs all over the UK with vital, lifesaving blood. PBBuk was launched in 2007 and has provided over 10,000 units of blood products to help save thousands of dogs lives.


Donor

PBBuk collects canine blood which is then processed into various blood products and stored on the premises. The blood products are then sold to veterinary practices across the UK. Any profits will be re-employed into educational programmes such as developing veterinary transfusion medicine within the UK.


Donor

We at Milton Keynes Veterinary Group are so proud to support the work of the Pet Blood Bank UK, but of course, we couldn’t have done it without our doggie donors! Thank you so much and see you again soon!


Donor

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Vaccine improvements encourage policy change

New emerging strains of one of the most common and potentially deadly dog diseases –Leptospirosis – have prompted Milton Keynes Veterinary Group to launch a new vaccination policy in a bid to protect the local dog population from this and other fatal diseases.

Leptospirosis is a widespread disease which is carried by rodents such as the rat and other animals. It is a serious disease that infects dogs, and even people, potentially fatal to both. It is passed via an infected animal’s urine or from contaminated water, so almost any dog that goes outside is at risk. This risk is currently heightened due to the recent widespread wet weather and flooding, and extra precautions are being advised. Early diagnosis can be complicated due to symptoms being vague, but as the disease progresses, symptoms include stiffness, muscle pain, vomiting and diarrhoea and lethargy. Following infection some dogs become long-term carriers that whilst appearing healthy, can put others at risk of disease. However, the good news is that like Parvovirus the disease can be prevented by vaccination. In recent years, more strains of Leptospirosis have appeared so we are now using new vaccines that are available, providing higher levels of protection against four strains of leptospirosis, rather than just two strains covered by traditional vaccines. These vaccines also helps to protect the local dog population and environment by preventing the spread of this disease via dogs’ urine.

As well as dog owners benefiting from this up-to-date vaccine, there is also good news for puppy owners as this vaccine can be used in puppies as young as six weeks of age, if needed. This means puppies can be protected from deadly viral disease as early as nine weeks of age.


leptospirosis

What is leptospirosis?

Leptospirosis is a bacterial disease that affects blood, liver or kidneys. There are several different types of leptospira that can be responsible for the disease. New strains have been identified in recent years, and they can affect dogs and also humans. It is carried by rodents, such as rats, and other animals, including cattle, sheep and dogs.

How common is leptospirosis?

The disease does occur in the UK, affecting stray or unvaccinated dogs. In urban areas, it is mainly spread by the urine of infected dogs, whereas in rural areas, another type of leptospira is more common and is spread by the urine of rats. Due to routine vaccination, the disease in Britain is now less than it was but it does still occur. New strains have been identified in recent years and vaccinations have been developed to include 4 strains instead of the two years covered by traditional vaccines.

How is it transmitted?

It is passed via an infected animal’s urine or from contaminated water. Ingestion is the most important means of transmission, but some forms can penetrate damaged or very thin skin. The incubation period is usually 4-12 days.
Extra precautions are advised following the recent wet weather and flooding that we have been experiencing.


leptospirosis

What are the signs of leptospirosis?

Some infections are undetected and show no symptoms, but the dog can still act as a carrier. Acute cases can be life-threatening. There are three main forms of the disease: haemorrhagic (bleeding), icteric or jaundiced form (involving the liver), and also the renal type. In the acute disease there is a high fever with lethargy and loss of appetite. Bloody diarrhoea and vomiting are common. This form can rapidly be fatal. If the liver is mainly affected, although the early signs are similar to the haemorrhagic form, jaundice a yellow colour can occur and affect the mouth or the whites of the eyes. Sometimes even the skin is yellow. In the renal form, kidney failure can occur. The dog is very lethargic, off food and vomits. Often the breath is offensive and there are ulcers on the tongue and inside the lips. If the dog recovers, chronic kidney disease often follows.

What is the treatment?

Since leptospirosis is caused by a bacteria, appropriate antibiotic treatment is effective if the condition is diagnosed early enough. Dogs are often so ill when presented that hospitalisation and intensive nursing care, including intravenous fluids, are usually necessary.

How can it be prevented?

Leptospirosis has been included in vaccination regimes for many years as part of the routine vaccination programme. Protection against the new strains of leptospirosis have been improved with the introduction of the L4 part of the vaccine. Previously, Leptospira icterohaemorrhagiae and Leptospira canocola were the two strains covered. The L4 vaccine has both of these in addition to protection against L.bratislava and L.grippotyphosa. The vaccines give a minimum of 12 months protection.

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