Monday, April 11, 2016

20. A 12-year-old Shih Tzu coughs and pants a lot - congestive heart failure

April 11, 2016

The 12-year-old Shih Tzu was coughing for some weeks but now the coughing and panting becomes too frequent.
"It could be the smoke from the praying to the dead," the husband said. "But my dog did not go to the graveyard." This is the period where graves are cleaned and food offerings are given at the graveyard.
 
The dog was heaving and the abdomen appeared swollen. The right heart had a loud systolic murmur.  X rays confirm congestive heart failure. Heart enlarged considerably and the lungs are filled with fluid (pulmonary edema).

Heart medication is given for 2 weeks and will be reviewed. Each vet has his or her own idea of treatment. I usually prescribe 3 types of heart disease drugs but my other vet prescribe Vetmedin only. I gave the dog an IV glucose, antibiotic and lasix to ease his pain and clear the lungs.  

The tongue was so cyanotic and the dog was panting so badly that I gave oxygen therapy. However, the owners had to go home as the therapy took more than 30 minutes.

I advised the Prescription Diet H/D but the owner does not want it.

Right sided heart enlarged and lots of fluid inside the lungs - difficulty in breathing for the dog. 

Nowadays, the Singaporean pet owner is better educated. He wants to know the prognosis. X-rays will show the severity of the heart disease, the shape, size and surrounding lung fluid. The vet must produce the X-ray or ultrasound evidence rather than prescribing medication trying to lower medical costs. 

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