Many dogs , especially small breed dogs , as they age will develop degenerative changes to their mitral valve . The mitral valve is composed of three leaflets which open and close to control the blood flow between the left ventricle and left atrium .
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Ask the Vet
What is the Best Therapy for Congestive Heart Failure Related to Mitral Valve Disease ?
This additional med is called spironolactone . Spironolactone is an old drug but has come back into popularity . Spironolactone helps to block aldosterone , a hormone made in the adrenal gland , which can cause increase sodium levels and heart fibrosis .
With the aging process these valve leaflets deteriorate and then begin to leak , which allows for the back flow of blood from the left ventricle to the left atrium . As this progresses the backflow of blood eventually builds and leads to fluid buildup in the lungs . Once fluid begins to accumulate in the lungs , the patient becomes symptomatic , and the condition is called congestive heart failure ( CHF ).
The first indication of CHF noted at home would be an increased Resting Respiratory Rate ( RRR ). This can be measured by counting the number of breathes per minute when the patient is at rest . A normal RRR should be 20 breathes or less per minute . If the RRR gets to 30 or more this is a clear sign of lung congestion and warrants a visit to the veterinarian . This is usually the time at which heart medications are discussed and started .
It turns out this combination of all four drugs provides better outcomes for heart patients and is the newest recommendation by specialists in the veterinary field . Cardalis is a new FDA approved heart medication that combines spironolactone and the ACE inhibitor , benazepril , in one tablet . This is a once per day medication and will make the administration of these four medication easier for the pet owner .
In general patients with CHF secondary to mitral valve disease can improve on medication , and some will live nicely for several years .
The veterinary visit will likely include physical exam , chest radiographs , and possibly blood work and ultrasound of the heart and lungs . Once the appropriate data base is collected then traditionally three heart medications would be started .
These heart meds include a diuretic , an ACE inhibitor , and a drug called Pimobendan . The diuretic helps to pull fluid away from the lung , angiotensin converting enzyme inhibitor relaxes the veins and arteries and lowers blood pressure , and the Pimobendan helps the heart be a stronger pump .
These meds have worked very well together over the past 10 years , and now the “ The American College of Internal Medicine ” is recommending a fourth medication .
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