# Merlin is in for his EKG



## Porkchop (Sep 2, 2019)

That’s concerning that the receptionist seemed not to take your warning seriously. Good thing you were there to correct that. Maybe “show teeth” is their code for “bite” (kidding).

I didn’t know that Merlin was having issues, sorry if I missed a post. I hope the testing goes smoothly and your results are normal. ❤


----------



## Dechi (Aug 22, 2015)

Porkchop said:


> I didn’t know that Merlin was having issues, sorry if I missed a post. I hope the testing goes smoothly and your results are normal. ❤


Thank you. His symptoms are very mild for now. This is more to establish a baseline to use later on, if he starts having problems. Or maybe it will show that we should start medications now, to delay complications.


----------



## Porkchop (Sep 2, 2019)

I’m glad to hear that he’s not in too rough shape symptoms wise. You’re a good dog mom to check it out and be prepared.


----------



## Porkchop (Sep 2, 2019)

Also want to add that you’re a great dog mom with all that you’ve done for both Merlin’s anxiety and Beckie’s allergy issues.


----------



## lily cd re (Jul 23, 2012)

Why do people insist on useless euphemisms? If I had a dog that would bite under stressful circumstances I would feel much better about things if I knew that everyone was clear about what the likely outcomes could be.

Anyway I think it is wise to get senior baseline information when there are concerns based on signs so that great management can be put in place asap when needed. I hope you get a good report with clear findings.


----------



## Streetcar (Apr 13, 2014)

I hope Merlin's test results come out with happy results, Dechi.

Also agree with your corrections at the front desk. Good on you. The tech deserved accurate information so she could handle Merlin in the way he needed.


----------



## PeggyTheParti (Sep 5, 2019)

Hoping for good news!


----------



## Dianaleez (Dec 14, 2019)

Please let us know how things went. We're all hoping that you and Merlin have reasons to smile.


----------



## Dechi (Aug 22, 2015)

Thanks everyone. The cardiologist will send the results to the clinic, and the senior vet will call me on wednesday.

They said that Merlin was very good, he didn’t need to be muzzled. They have a lot of experience doing EKG and dealing with many difficult dogs, I’m sure, so Merlin wasn’t a challenge for them. I was very happy to hear that.

Poor Beckie was completely distressed by Merlin’s absence. When I came back from dropping Merlin, she was crying very loud, like the sounds a human in severe pain would make. I had never heard anything like it coming from a dog; I was completely taken aback by it and it made me cry too. So I brought her with me when I went to get Merlin. I made her wait in the car. Good thing because there was a huge pitbull going completely nuts and howling to get to a small shi tzu type dog. 

Everyone is resting now. I’ll keep you posted. Have a good evening !


----------



## Skylar (Jul 29, 2016)

Hope the MRI is normal but good to have that baseline especially if he’s possibly experiencing symptoms.

Sounds like a busy stressful day for all of you.


----------



## PeggyTheParti (Sep 5, 2019)

Good boy, Merlin!


----------



## 94Magna_Tom (Feb 23, 2021)

Hope your results are normal. 🤞


----------



## Rose n Poos (Sep 22, 2017)

Hoping you hear good news and keeping you three in my thoughts.


----------



## Mfmst (Jun 18, 2014)

Good thoughts your way for clear results. Sorry that Beckie was distressed. Hugs to you and the crew!


----------



## PeggyTheParti (Sep 5, 2019)

Fingers crossed for tomorrow!


----------



## Dechi (Aug 22, 2015)

The vet called. The news aren’t too bad. Merlin has stage B2 chronic degenerescence of the mitral and tricuspid valves (it basically means the illness has started progressing but is still at a mild stage). He has heart murmur grade III/VI (still waiting for explanation about that but I guess one side of the heart is III and the other is VI).

At this stage medication is not in order yet. The cardiologist recommends another EKG in 10 months and he thinks in 10 months medication would be needed. The meds they give are Vetmedin; it will give on average two more years of life. This is expensive so I’ll budget for one in about a year and we’ll go from there (they caught the heart murmur a few days before I got him insured so it’s not covered).

No exercise restrictions needed. A special anesthesia protocol has been provided in the report. Low sodium diet is recommended so I will start giving him canned z/d which I already have and respects that criteria. Beckie’s food is a little too elevated in sodium but by feeding him canned, he won’t be too tempted to steal hers. 3-4 kibbles once in a while won’t be a big deal. He is not a big eater.

I haven’t had the chance to do too much research yet. I suppose when I do I’ll start freaking out. The vet says they can have a very good life expectancy as long as the heart doesn’t decompensate. But who knows when it will happen ? I can’t even think about losing him.

This is apparently very common in small dogs.


----------



## PeggyTheParti (Sep 5, 2019)

I’m starting to wonder if Gracie may have had this condition. I’m so impressed you caught it so early! And it sounds like you have a good, manageable plan in place.


----------



## Skylar (Jul 29, 2016)

(((Hugs))) Merlin is lucky to have you as his mom planning for the best care.


----------



## fjm (Jun 4, 2010)

A helpful vet, good information and a solid plan - it sounds as if you have all the bases covered. Won't stop you worrying, of course, so (((hugs))) from us, too.


----------



## Liz (Oct 2, 2010)

So it hasn't progressed since the spring? That's good news. It sounds like he is in good hands, and I hope you're feeling supported, too.


----------



## Rose n Poos (Sep 22, 2017)

All in all, this is not bad news at all. 

I'm going to kick off your research with a link at the end but some of my experience with Noel first.

At the time her murmur was found, I don't remember exactly when but around 2012-2013, wait and see was the standard course and still is but with a difference as I understand current best practice. Possibly because of some other symptoms, Lasix was her first rx. Vetmedin wasn't started until clinical signs, stage C, were evident. 

More recent studies are showing that starting Vetmedin in the pre-clinical stage is even more beneficial. 

It's possible that there are even more current studies but look this over and ask your vet/cardiologist if this is worth considering.
Pimobendan Delays Onset of Congestive Heart Failure in Dogs with Mitral Valve Disease and Cardiomegaly (dvm360.com) 

Pimobendan and Heart Disease - Today's Veterinary Practice (todaysveterinarypractice.com)


----------



## Dechi (Aug 22, 2015)

PeggyTheParti said:


> I’m starting to wonder if Gracie may have had this condition. I’m so impressed you caught it so early! And it sounds like you have a good, manageable plan in place.


My vets offered to do the EKG as soon as they noticed the heart murmur, last year. At first I said no because I ddn’t think it was needed. But then it clicked that his coughing/retching after running 1-2 minutes with Beckie was probably related to that. I started doing research and saw that weak hind legs might also be a sign, and this summer I noticed his rear end shaking a bit while he was eating. So I got worried and decided to do it.

But overall, I think with veterinary medicine advancements, vets are more proactive and readily offer advanced testing to their clients. This is not something we saw just 10 years ago. I think it’s good and bad at the same time. We do worry a lot more and I wonder if it always makes a difference.


----------



## Dechi (Aug 22, 2015)

Liz said:


> So it hasn't progressed since the spring? That's good news. It sounds like he is in good hands, and I hope you're feeling supported, too.


We can’t really know because this is his first EKG. But the heart murmur is rated the same, so I suppose it hasn’t progressed much in the past months.


----------



## Dechi (Aug 22, 2015)

Rose n Poos said:


> All in all, this is not bad news at all.
> 
> I'm going to kick off your research with a link at the end but some of my experience with Noel first.
> 
> ...


Great info, thank you !

From the report, the cardiologist believes Merlin should be ready to start medication in 10 months or so, thus the need to do another EKG to verify. Meanwhile, I was told to count Merlin’s breathing once a week and report back if there is an increase above 32 beats per minute.

The paper you linked has tons of good infos and also links to a study done in 2008 that shows that starting Pimobendan early has adverse cardiac effects. 








Comparative Adverse Cardiac Effects of Pimobendan and Benazepril Monotherapy in Dogs with Mild Degenerative Mitral Valve Disease: A Prospective, Controlled, Blinded, and Randomized Study


Background: Pimobendan (PIMO) is an inodilator that may have some beneficial effects in canine degenerative mitral valve disease (MVD). However, little information is available about its cardiac eff...




onlinelibrary.wiley.com





I’ll have to clear my head and think about it for a while.


----------



## Liz (Oct 2, 2010)

Sending hugs, Dechi.


----------



## Rose n Poos (Sep 22, 2017)

Dechi said:


> I’ll have to clear my head and think about it for a while.


It can't hurt to ask the cardiologist. The 2008 study gives specific conditions or combination of conditions, as do the later ones. 
Your cardiologist will surely know if starting earlier will be beneficial with Merlin's situation.

In the meantime, just breathe .


----------



## DogtorDoctor (Mar 20, 2020)

Dechi said:


> The vet called. The news aren’t too bad. Merlin has stage B2 chronic degenerescence of the mitral and tricuspid valves (it basically means the illness has started progressing but is still at a mild stage). He has heart murmur grade III/VI (still waiting for explanation about that but I guess one side of the heart is III and the other is VI).


I'm glad the results came back with (fairly) good news! I can help explain a little bit about grading murmurs. Merlin's grade is a 3 out of 6. Some vets have personal ways they grade, but in general this means that his murmur can be heard everywhere on that side of the chest, but it does not cross to the other side. The louder the murmur, the farther aways from its origin you can hear it. A 4 can be heard on both sides, a 5 can be felt, and a 6 can be heard without a stethoscope/off the chest wall.

I stole this explanation of the stages of heart disease from a cardiologists website:


> Stage A – Predisposed breeds (see below) currently without any sign of disease
> 
> Stage B1 – Disease is present without signs of heart enlargement nor heart failure
> 
> ...


My roommate's rat terrier has lived with B2 disease for years. She is on pimobendan and no other medications or restrictions. She also gets yearly echos performed and has safely had dentals cleanings during that time.

All of this to try to help you not panic when you do more research of your own!  I'm sure your vet will also answer any other questions you have, but I'm also here if you think of anything.


----------



## Dechi (Aug 22, 2015)

DogtorDoctor said:


> My roommate's rat terrier has lived with B2 disease for years. She is on pimobendan and no other medications or restrictions. She also gets yearly echos performed and has safely had dentals cleanings during that time.
> 
> All of this to try to help you not panic when you do more research of your own!  I'm sure your vet will also answer any other questions you have, but I'm also here if you think of anything.


Thank you for the infos and reassurance, it really helps ! I won’t hesitate to ask if I need more.

This is all new so it’s hard thinking about it. I get emotional just looking at him and thinking he might go sooner than he should. I’m sure with time it will get better and I won’t be thinking about it so much.

I’ve started counting his breathing and his baseline will be 18-20 breaths per minute while relaxing and 12 while sleeping.

I started the canned z/d with a little z/d kibble last night and he was quite pleased !


----------



## Porkchop (Sep 2, 2019)

Aww, I’m sorry they found abnormal results in the ekg. I would be feeling pretty emotional too if I was in that situation. Doesn’t matter how mild or severe, it would be hard to learn your dog has a chronic health problem.

I know what you mean about the advances in vet medicine are both a good and bad thing in some ways. 

Hugs to you. I’m glad Merlin is liking his new kibble.


----------



## Streetcar (Apr 13, 2014)

I really appreciate @DogtorDoctor's post explaining more. And I am very sorry Merlin has the conditions, but confident he is in his best possible home. Dechi, you give Merlin the best care and love, and his happy face and manner reflect that 🥰💗.


----------



## Dechi (Aug 22, 2015)

Merlin had his second EKG today. He will probably have to start medication; we will know more when we get the report in about a week.

I also brought Beckie as she gets distressed when alone at home. Both were stressed but I still took a picture, lol ! I’ll let you know when I have news.


----------



## Rose n Poos (Sep 22, 2017)

Having been down this road with Noel, I'm sending hugs and hope to you all .


----------



## Streetcar (Apr 13, 2014)

Sending protective loves to Merlin, Oliver's virtual bro, whom he so resembles. We love all three of you so much 💓 ❤ 💗 💖 .


----------



## Dechi (Aug 22, 2015)

Update : Merlin had his second EKG 2 weeks ago and I got the results back yesterday and a call from the vet today. He is still at the B2 stage (can’t remember what it means but it’s in my notes) but it has progressed a little. His condition is not severe nor worrying, although he is choking/coughing more and more, and without much effort. There is no decompensation so he can be put under anesthesia (potential biopsy to come to determine the cause of his chronic inflammatory gastric illness).

He will be put on Pimobendan once a day to start, then twice if he tolerates it. If the cough is caused by his heart condition, it should stop. If not, we’ll have to investigate more to find the cause.

I’m pretty happy with those results.


----------



## Skylar (Jul 29, 2016)

It’s excellent news that there has been only a little progression. Hopefully the medication will be effective for dear Merlin.


----------



## Streetcar (Apr 13, 2014)

Much love to you and Merlin in this trial ❤.


----------



## fjm (Jun 4, 2010)

That is very good news. I hope you now get some answers on the digestive issues.


----------



## Rose n Poos (Sep 22, 2017)

That is wonderful news!!! I'm so glad .


----------



## Liz (Oct 2, 2010)

Really happy for you and Merlin, Dechi!


----------



## Looniesense (Jul 10, 2021)

Very happy with your news. I will need to book an EKG for Luka since his first one was done in May.


----------

