# My "honorary Maltese" Molly is in heart failure-UPDATE @ 22



## mss (Mar 1, 2006)

PLEASE SEE UPDATE ABOUT A YEAR LATER, AT #22. REST IN PEACE, MOLLY AND HER PAL SPUNKY. :bysmilie: 

Molly toppled over in a faint on Monday while chasing a squirrel. :shocked: She has had a heart murmur since I got her from the city animal control shelter about five years ago. But it had stayed about the same. Although she is only very active in spurts, I had never noticed any problems. 

I got her to the vet right away. Xrays this week show her heart greatly enlarged compared to last year. It is so large it is pushing her trachea way up! The vet said she was surprised there had not been any coughing. She didn't see fluid in the lungs, so prescribed only Pimobendan aka Vetmedin. The next day she called and said the expert radiologist actually did see fluid in her lungs! So I had to go back and get furosemide aka Lasix, the diuretic. 

So far she seems to be doing okay - I was worried about the diuretic since she has occasionally used a scatter rug as a puppy pad. So I picked most of the scatter rugs and put down another set of puppy pads. She used them! Good girl! :wub: 

If anyone has any experience with Pimobendan, I'd really like to hear about it. My dog Possum got it when it had not yet been fully approved in the U.S. He seemed very sensitive to it - I was late giving it to him a couple of times, and I thought the delay really affected him. In fact, the night before he died, I was detained at work and was a couple hours late giving it to him. He perked up after he got the medicine and was even jumping around on and off furniture. But he passed away the next morning. 

If Molly is going to be as sensitive to it as Possum seemed to be, maybe I should stick to the drugs that have been in longer use, such as ACE inhibitors and digoxin. I had another dog who lived with Cushings for 3 years plus congestive heart failure for 2 on those traditional drugs.

Anyway, any sharing of experiences or information about Pimobendan and other current drug therapies would be appreciated!


----------



## Hunter's Mom (Dec 8, 2008)

I don't have advice or experience with this but I wanted to tell you how sorry I am to hear that Molly is ill. Hunter has a heart murmor and I dread the day when he starts to be greatly effected by it. I wish you all the best and I hope that someone has information that can help you.


----------



## bbry (Feb 17, 2007)

Sorry Molly is having such a hard time.


----------



## Maidto2Maltese (Oct 19, 2004)

My Missy had enlarged heart and eventually had congestive heart failure. She was on Enapril, theophyline, and lasix, so I'm not familiar with this drug but did find this in my vet drug link :

http://www.veterinarypartner.com/Content.p...;C=0&A=2715
Will be praying that it helps Molly!


----------



## jmm (Nov 23, 2004)

Quite familiar with using Pimo...that is a really odd choice, especially without an echo with a cardiologist. Pimo is usually added in along with other medications a dog is on. I would ask for a referral to a cardiologist.


----------



## KAG (Jun 1, 2006)

Prayers and lots of luck to you and beautiful Molly.
xoxoxoo


----------



## mss (Mar 1, 2006)

Thanks for your responses.

JMM, I was kind of surprised, too, about the choice. I had something of the same idea about it being something of an additional drug. With her heart that enlarged, you'd think that she ought to get the full arsenal.  

Molly did have an echo of her heart years ago, which showed mitral valve problem. But as I mentioned, she seemed about the same for years. 

The vet who was available at the hospital is not the one I usually see, who has been there the longest and helped with my other heart patient dogs. Molly collapsed on one of his days off.  Maybe I should check or ask about a cardiologist, or at least find a way to get her under the care of the vet I see most.


----------



## SicilianRose (Jun 8, 2008)

I am so sorry to hear about Molly. :bysmilie: I will keep her in my prayers.


----------



## Gracie's Mommy (Feb 14, 2008)

:grouphug: :grouphug: :grouphug: 

Praying for Molly ...


----------



## 3malteseboyz (Feb 6, 2008)

I was given this drug (Vetmedin) for my little one but it was too late he was taking it for only a week before I had to make a decision (He was in the final stage of CHF.) The specialist told me at that time this drug was not used here. It was a promising drug. It had received good results in England.

I would like to mention if at all possible try to keep Molly from running or over exercising. Hope Molly will be ok for along time.


----------



## Starsmom (Jan 31, 2009)

I'm really sorry Molly is so ill. :flowers: 

I have no idea what the other drugs are, but I do know about Lasix. Because she's going to be peeing a lot you *must* keep her potassium, and electrolyte levels up. Do you have any pedilyte/nutrical?

I'll be thinking of you both. rayer: rayer: rayer:


----------



## Kutsmail1 (Dec 26, 2007)

Yes, the little male I lost last year was on this protocol: Pimobendan, Enalapril, Lasix, and Aldactazide. Prior to this protocol, he has been on digoxin and lasix which were ineffective and have unwanted side effects which do not lend to any real quality of life.

Once on the Vetmedin (Pimobendan) protocol, the fluid started to resolve making breathing so much easier. On either protocol, there is no promise of "extra time", but the quality of that time was so much better for my little guy. He became his stubborn little self again. 

NO untoward side effects...just the positive effects on the heart which assists in better circulation, providing better oxygenation. The fluid went down dramatically over a period of time.

We had to play with dosages in the protocol until we found the "magic" amount of aldactazide and enalapril.

If it were Zippy, I would do it again. the only thing is that I felt very limited when I wanted to do something because the protocol was pretty strict. I wouldn't leave him anywhere EXCEPT at the vet's office, and even then, my vet or his specific tech had to be there...or I wouldn't leave him.

If I can help in any way...if there are more specific questions, please feel free to PM me or email me.
Barbara


----------



## mimi2 (Mar 29, 2005)

I have no advice, but wanted to say I'm adding Molly to my prayer list. :grouphug: :grouphug: :grouphug:


----------



## MalteseJane (Nov 21, 2004)

When Alex was diagnosed with the heart murmur we started with furosemide and enalapril. Everything was ok until last year in August. We almost lost him. After that episode his dosage of furosemide and enalapril was upped and they added vetmedin. He gets 1/2 pill of lasix and enalapril in the morning and at night and 1 pill of vetmedin at noon. We make it a point that he gets the medicine on a regular basis. They don't like to give the vetmedin if not absolutely necessary. So I am wondering too why they started out with that before giving the lasix and enalapril. Alex had x-rays, ultra-sound and blood work done. Alex is also taking potassium.


----------



## dr.jaimie (Mar 23, 2004)

there is one side that says use pimo as soon as signs of CHF are present and another side says wait til lasix and enalapril/benazepril not controling the prob. i am one for the first b/c usually the latter is too late. ive seen pimo do some wonderful things. ..if a dog has a murmur with no symptoms then no meds are needed


----------



## mss (Mar 1, 2006)

Thanks for the response.  I guess there are a number of choices. I am at least going to be sure to watch how she does and follow up if I see any difficulty. They are going to send me a reminder to come in for blood work after a few weeks to make sure her kidneys don't get harmed by the medicine. 

She has used the puppy pads :biggrin: and seems as active as ever now. She's doing some moderate squirrel-chasing and chihuahua chasing without any problem. No coughing.  

But I did notice that in a journal/blog I kept back in October, when I was taking a lot of time off and thinking about retiring, that none of my dogs were active during the day so I didn't have a suitable walking companion. She must have been going downhill back then but I couldn't see it.


----------



## dwerten (Oct 6, 2007)

I agree i go to specialists when it gets to something serious as they study specific things and have further education than a regular dvm 



QUOTE (JMM @ Feb 5 2009, 09:39 PM) index.php?act=findpost&pid=720291


> Quite familiar with using Pimo...that is a really odd choice, especially without an echo with a cardiologist. Pimo is usually added in along with other medications a dog is on. I would ask for a referral to a cardiologist.[/B]


----------



## mss (Mar 1, 2006)

If you know of one ... 

I hesitated to say anything about this, but I had bad experiences a few years ago trying to find one who would take a real interest in another, sweet old dog. ... The vet school clinic was a little more helpful, although they handed me off to someone who wasn't particularly interested in cardiology anyway and some 2nd year students. After a year or more of frustration, I ended up taking my poor old dog to yet another vet to have her euthanized.  

I think this is the "down side" of being near a major veterinary school. Many of the young vets haven't mentally transitioned to caring for people's pets. They want "interesting cases." Not another little old dog with a bad mitral valve. 

I edited this before posting so that I don't cut my own throat with the vet community around here, in case they are reading. 

Edited to add: By "around here," I mean in my geographical area, where I have had these experiences. I don't mean on this board, where people have been so helpful.


----------



## dr.jaimie (Mar 23, 2004)

QUOTE (mss @ Feb 8 2009, 01:40 PM) index.php?act=findpost&pid=721977


> If you know of one ...
> 
> I hesitated to say anything about this, but I had bad experiences a few years ago trying to find one who would take a real interest in another, sweet old dog. ... The vet school clinic was a little more helpful, although they handed me off to someone who wasn't particularly interested in cardiology anyway and some 2nd year students. After a year or more of frustration, I ended up taking my poor old dog to yet another vet to have her euthanized.
> 
> ...


i dissagree with you..i prefer the long standing client who has been through it all with the pet and will do whatever needed for that pet. this allows me to offer the best advice possible for that animal. the interesting cases are fun every now and then but can be stressfull and i crave the normal cases more often. there is no mystery, u know how to fix it or at least make it better...coming out a hero more often or a kind soul compared to the case u cant figure out what the heck is going on and it ending bad or owners running out of money.


----------



## mss (Mar 1, 2006)

Well you are the kind of vet I love and I wish you were closer to me! :wub: 

And thank you so much for all the help you give us here on spoiledmaltese!


----------



## lovesophie (Jan 28, 2008)

I'm so sorry to hear of Molly's heart condition. I'm happy to hear she seems to be to her old self, though. I hope you continue to see improvement with her!!


----------



## mss (Mar 1, 2006)

As a sad double-update -- 

Molly was seen by a cardiologist who just recommended greatly increasing the Lasix and continuing the Pimobendan. Molly lost her appetite and got horribly thin in just a few months, even though she remained fairly perky and alert. I tried syringe feeding her and we gave her a medicine that was supposed to stimulate her appetite. it didn't help much, so we doubled that medicine. I thought it knocked her out for a day or so--but then I found out she had sudden, severe problems with her liver. The vet and I decided not to try any extraordinary measures, and put her gently to sleep last summer.

A few months ago we put Spunky, my 13 year old Maltese, on Pimobendan plus lasix. (We tried enalapril, too, but he lost his appetite for a few days.) I didn't think he was in such bad shape--as I recall, he was doing well enough last fall to have a full dental. But he lost his appetite and got very thin. It was confusing because he wasn't fond of the prescription diet he got for bladder stones. He was eating maybe every other day, it seemed. Two days ago he had some trouble breathing and then collapsed in my arms and was gone by the time we arrived at the vet hospital.

I just wonder if Pimobendan was "over-sold" to my vets, who are not specialists in heart disease. I had a small terrier that lived for 2 years after diagnosis with congestive heart failure, passing away in 2001, and did pretty well on the older digitalis-type heart medicines, enalapril and lasix. My Maltese mix, Possum, got Pimobendan before it was fully approved and had to be bought from abroad and compounded into little capsules. He lived another 9 months or so, pretty happy, eating well and doing okay--between fainting episodes. :bysmilie: 

My remaining dogs are pretty young still (or so I think--they are all rescues) but if they develop heart problems, I may have to try some other medicines.


----------



## gibbert (Jan 13, 2005)

I'm so sorry to hear of your loss of sweet Molly. Sending great big hugs your way.


----------



## theboyz (Jan 10, 2007)

Ohhhh, I am so sorry.
Sending hugs for comfort.


----------



## maltlovereileen (Jan 19, 2009)

Keeping Molly and you in my most positive thoughts and prayers...


----------



## MaryH (Mar 7, 2006)

My thoughts and prayers are with you on the loss of Molly and Spunky. They are never with us long enough, are they?

My Skipper lost the battle with mitral valve disease four years ago. I had known about his heart murmur from the time I got him at 8 yrs. old but my vet when I got him, the cardiologist, and the vet that I go to now all said there was no need for medication. I did have periodic xrays done through the years to monitor his heart and, yes, it did get progressively more enlarged but never to the point where medication was recommended. Then one day Skipper keeled over in the yard while outside for a potty break. I brought him immediately to the vet, he was put on Lasix right away, had an echocardiogram three days later, and was put on Enalapril along with the Lasix. I had never heard of Pimobendan and neither my vet nor the cardiologist mentioned it. Skipper lived for another 8 months. Just a week before Skipper lost the battle my good friend Cathy's Maltese was diagnosed with mitral valve disease and the recommendation was the same, Lasix and Enalapril. She, however, joined a Yahoo list for people dealing with dogs with CHF and mitral valve disease. They were almost all treating their dogs with Pimobendan which, at that time, was not even available in the US; they were all getting it from England I think. She talked to her vet, he spoke with a vet in England, they determined the appropriate dosage, and her dog is still alive. He also gets Lasix but I don't know if he's getting Enalapril. He's 16 but he is failing now. I've often wondered if Skipper would have lived longer had I known at the time about Pimobendan.

MaryH


----------



## mss (Mar 1, 2006)

Thanks for your response. I'm so sorry about Skipper--we never met but I'm sure I read about him here and elsewhere. 

I'm glad to hear some people have good results with the Pimobendan. I just thought it was so strange that two of my dogs became so anorexic while on it. Spunky topped out at 11 pounds and was plump but not obese at that, and was about 8.3 pounds the week before he died. I even wondered if there was something about the way the tablets were being manufactured now -- flavored tablets vs. the loose powder in the capsules. Maybe it is just conincidence, or maybe I was lucky in the way my other dogs' illness progressed.

It sure is hard losing them, isn't it. :bysmilie: 

Thanks again. Hugs. {{{{}}}}


----------



## Moxie'smom (Dec 16, 2007)

I hope your baby feel better real soon. My Moguls had a heart murmur and lived a very happy life. See a cardiologist.


----------



## maggieh (Dec 16, 2007)

I'm so sorry about Molly and Spunky. Hugs to you.


----------



## EmmasMommy (Jun 2, 2008)

You know , I had to look back at the time/date stamp after your update post and realized a whole year has passed. That was a year of barking , and tail wagging and doggie kisses ............a year of love that you gave both of them.

May the many memories of the good times bring you some pace in this difficult time. I am so sorry you have so much hurt.

It is never easy to say goodbye. May they be forever etched into your heart.

Cat


----------



## mpappie (Jun 28, 2005)

QUOTE (mss @ Feb 5 2009, 08:15 PM) index.php?act=findpost&pid=720209


> Molly toppled over in a faint on Monday while chasing a squirrel. :shocked: She has had a heart murmur since I got her from the city animal control shelter about five years ago. But it had stayed about the same. Although she is only very active in spurts, I had never noticed any problems.
> 
> I got her to the vet right away. Xrays this week show her heart greatly enlarged compared to last year. It is so large it is pushing her trachea way up! The vet said she was surprised there had not been any coughing. She didn't see fluid in the lungs, so prescribed only Pimobendan aka Vetmedin. The next day she called and said the expert radiologist actually did see fluid in her lungs! So I had to go back and get furosemide aka Lasix, the diuretic.
> 
> ...


Mr. Pup takes both the Pimobendan and Lasix as well as enapril (sp) he seems to be doing well on these meds. He still seems like himself. Don't worry I think it will be fine.


----------



## MalteseJane (Nov 21, 2004)

Alex is on lasix, enalapril and pimobendan. I don't think it was the pimobendan that caused your problem, I rather think it was the lasix or enalapril. The last time we were at the vet (in fall), he told us that the only medicine safe to raise the dosage would be the pimobendan. The lasix is a diuretic and is hard on the kidneys and can account for the weight loss. I know they don't like to give too much enalapril. My vet in Houston added the pimobendan in 2008 when we almost lost him. It could well be that he is still alive because of it.

Alex's prescription :
Salix 12.5 mg : ½ tablet in the morning and ½ tablet in the evening
Enalapril 2.5 mg : ½ tablet in the morning and ½ tablet in the evening
Vetmedin (Pimobendan) : ½ tablet in the morning and 1 tablet in the evening.

We raised the Vetmedin to 1-½ tablet a day because he started coughing so much more. Before he was on 1 tablet a day that we gave at lunch time.

His trachea is collapsing because of the enlarged heart. We know that we can loose him anytime. We have to stay realistic, they don't live for ever. :crying 2: It is heart breaking when you hear that kind of cough. It sounds like they are whining.


----------



## casa verde maltese (Apr 7, 2007)

I am so sorry for your losses. I cannot image loosing 2 in less than a year. Many hugs to you and your family.
thinking of you.


----------



## Maglily (Feb 3, 2009)

I'm so sorry that you lost 2 of your little ones this year...it's so sad to see them go. :grouphug: 

I have a cat on medication for kidney problems, it is hard to know if I can do more to help her.


----------



## MalteseJane (Nov 21, 2004)

QUOTE (mss @ Feb 1 2010, 04:10 PM) index.php?act=findpost&pid=880336


> As a sad double-update --
> 
> Molly was seen by a cardiologist who just recommended greatly increasing the Lasix and continuing the Pimobendan. Molly lost her appetite and got horribly thin in just a few months, even though she remained fairly perky and alert. I tried syringe feeding her and we gave her a medicine that was supposed to stimulate her appetite. it didn't help much, so we doubled that medicine. I thought it knocked her out for a day or so--but then I found out she had sudden, severe problems with her liver. The vet and I decided not to try any extraordinary measures, and put her gently to sleep last summer.
> 
> ...


I re-read a few times your post especially about the appetite loss. When we had that episode in August 2008, afterward I blamed myself. Alex started coughing more and since it was kind of an emergency I saw a different vet at the clinic. He raised the dosage of the lasix and enalapril. Mind you Alex was not on vetmedin yet. He lost his appetite too, and us thinking this is because of all the medicine, we stopped the lasix for a day and went back to the old dosage. Then the coughing got worse, he coughed from 4 am til we went to the vet at 10 am without stopping. When they tried to do the x-rays he collapsed and they had to revive him and put him under oxygen. They manage to do the x-ray and he had also an ultra sound. After that my usual vet added the vetmedin.

So sorry for your loss. :grouphug: :grouphug: :grouphug: My vet said with the medicine they can keep them alive for about between 2 and 4 years. I suppose the older the dog, the less survival time. I know the clock is ticking for us.


----------



## jodublin (Sep 27, 2006)

QUOTE (Casa Verde Maltese @ Feb 2 2010, 10:35 PM) index.php?act=findpost&pid=880836


> I am so sorry for your losses. I cannot image loosing 2 in less than a year. Many hugs to you and your family.
> thinking of you.[/B]


 :grouphug: :grouphug: wish you lived nearer so i could give you a hug ..


----------



## Maidto2Maltese (Oct 19, 2004)

I'm so very sorry to learn you lost Molly and then Spunky as well... So difficult to lose one but two in a relatively short time is beyond my thinking. Please know my heart goes out to you... and so do prayers to help comfort you.


----------



## mss (Mar 1, 2006)

Thanks for all your kind thoughts and words. 

Now if Pimobendan was not the culprit but really helped, I can't help wondering if there was something we could have done differently--maybe given 1/2 Pimobendan twice a day instead of one tablet once a day so the level might not drop so far. I guess there's no knowing, at least not now. 

Spunky was almost 13-1/2, which is a pretty good lifespan, I guess, but I wish he had had more time. I'm sure we all feel that way about our pups.


----------



## remy (Jul 9, 2009)

i'm so sorry for your losses :grouphug:


----------



## donnad (Aug 22, 2006)

I am so sorry for your losses.


----------



## moshi melo (Jul 2, 2009)

So sorry for your losses. They were blessed to have someone who loved them so much. :grouphug:


----------

