[music plays] [no dialogue] >>Kelly Runyon: Veterinarians say heart disease is the number four cause of death in dogs.

They say the causes, symptoms, diagnosis and treatment can vary widely.

We'll talk about of all those issues on this episode of the Paw Report with Dr. Marci Kirk.

So stay with us.

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>>Kelly Runyon: Dr. Marci Kirk joins us for this episode of the Paw Report, and she's brought along her pal Charlie to talk about pet heart disease.

So thank you so much for joining us.

>>Dr.

Marci Kirk: Oh, thanks for having us!

>>Kelly Runyon: And Charlie is just a little dreamboat.

He is so precious.

And you said he's 4-years-old.

>>Dr.

Marci Kirk: Yep.

>>Kelly Runyon: And he is a golden doodle.

>>Dr.

Marci Kirk: Mmhmm, yep.

>>Kelly Runyon: He is beautiful.

>>Dr.

Marci Kirk: Oh, thank you.

>>Kelly Runyon: Well thank you so much for joining us.

As I mentioned, we're talking about pet heart disease.

And before we actually get into the heart disease topic, we need to kind of understand a mammal's heart.

And it's made up of four different chambers?

>>Dr.

Marci Kirk: Mmhmm, that's correct.

Yeah, it's in a way very similar to human hearts.

You know, there's four chambers that, you know, basically the blood comes in, pump it to the lungs to get oxygenated, and then pump it to the rest of the body.

So those chambers kind of work a little bit in a circle.

You go to the lungs, come back, and then take it to the rest of the body once the oxygen's there so you can get oxygen through everything else.

>>Kelly Runyon: So, what is heart disease?

I mean specifically in animals, but what is it?

>>Dr.

Marci Kirk: So, I think heart disease is a lot of things all in one.

It's just basically saying there's something wrong with the heart.

It's not working at its optimum level, so that you can get oxygen everywhere, which is necessary for all life.

And it just, it can be a lot of different conditions, that just mean we're not functioning properly.

>>Kelly Runyon: Mmhmm.

Well, how common is heart disease in dogs?

Do you see a lot of animals come into your office with problems?

Is it prevalent?

>>Dr.

Marci Kirk: So, I was just reading something, it's a little different in people.

You know, I think they say that heard disease is one of the number one, you know, things that kills people.

It's not quite that common in animals, but it's something that we definitely look for, because our animals are living longer and longer lives.

So, that means that things are going to start happening, where things aren't working so well.

And the heart is one of them that can start to kind of, over time, not be as efficient.

And we need to step in and intervene.

So, it's not the number one disease, but it's something we definitely want to search for.

>>Kelly Runyon: It may sound like a strange question, but do dogs actually have heart attacks?

>>Dr.

Marci Kirk: You know, they can, but it's not something that we see frequently.

It's not, because they can't say oh, you know, I've got chest pain, or anything like that.

We don't tend to see it too often.

They can go into like an acute crisis, where they're either having a really strong arrhythmia, and you know, you can tell they're in distress.

But it's definitely not as common as you see in people.

>>Kelly Runyon: Mmhmm.

Is heart disease the same as heart failure?

Are they...?

>>Dr.

Marci Kirk: I would say they're not exactly the same.

So, you know, as I said before, heart disease I think, we've got a problem with the heart, you know.

But heart failure means that we're really not functioning well.

There can be other forms of heart disease that don't mean the heart is failing.

So, there can be a case where you maybe have a tumor, you know, on the heart, and it's not causing heart failure yet, but it could lead to it.

So, there are things that cause heart disease that could lead to failure, but failure means we're not pumping blood.

We're not, you know, we need to intervene, because otherwise we're not going to make it.

>>Kelly Runyon: Sure.

What are the different signs?

You know, if I have a pet, how would I know, what are some of the warning signs, what are the things that I should look for to see if maybe my dog is experiencing a problem?

>>Dr.

Marci Kirk: Sure, that's a great question.

And there are, it's different for cats and dogs.

Cats are just a whole different scenario.

And a lot of times, they won't snow us any signs at all.

So, we'll focus on the dog.

And some of the things that you want to look at is, you know if, so like Charlie, he goes on runs with me.

You know, we can run three, four miles, and he's great, doesn't have any problems.

And if they used to do that, but now they're getting worn out a little more quickly, maybe they're only making it a mile or two miles, and they used to go four or five.

So an exercise intolerance.

Even if you're dog isn't that athletic, but they used to walk around the block, and now they make it down the driveway and they're like, I just can't make it any further.

That's one of the, you know, first things we'll see.

You might also notice, you know, well he's really worked up and panting, and excited.

But like, when they're relaxed or sleeping, you know, they breathe very easily, very slowly.

If you start noticing there's an increased effort with that, where they're really kind of, oh it looks like I'm noticing that he's breathing more.

You know, he's taking bigger breaths, and he's really relaxed; he's not panting, and he's not excited.

That is another thing that we'll see, is a change in their breathing pattern or their rate.

They actually make an app on your phone that's free, that you can like, track your dog's breathing, their respiration rate when they're sleeping.

And that's kind of nice to have so you have a baseline, and then you can kind of work from there.

And so, you can track, if they do have heart disease, you know, that's really valuable for the veterinarian to know what their resting respiratory rate is so that we can tell if they're struggling more than we thought.

>>Kelly Runyon: What about, elaborating a bit more on the signs, what about a change in diet, or maybe any signs of weight gain or weight loss?

Would that have anything...?

>>Dr.

Marci Kirk: In cats, yes.

We will see cats lose weight with some heart disease, and maybe not have any other signs.

And obviously, if you have a pet that has extra weight, similar to people, that is going to put more of a strain on their heart.

It has to work harder to get, you know, the blood circulating to make sure everything goes.

It can also raise their blood pressure, which means the heart has to work even harder to go through those vessels.

So that means it's working harder, it can tire more quickly.

Plus, if there's fat around the heart, you know, it's not working as well.

>>Kelly Runyon: Are there different types of heart disease?

>>Dr.

Marci Kirk: Mmhmm, yeah.

So, I think what we probably see the most common is as pets age, the valves in the heart that keep the blood from going back and forth, and moving it in a forward direction, it starts either thickening or just not being as efficient at pumping.

So, that's the most common one we see, it's called mitral valve disease.

But there are some genetic diseases that some are prone to.

So, some of the larger breed dogs are prone to like a, basically it's called dilated cardiomyopathy, where the heart is very, the muscle is very big and loose, and it's just kind of not, you know, your heart pumps like that.

And it just kind of doesn't pump, so it's not efficient.

And those big dogs, you know, they need that heart to be efficient.

They've got a lot of body space to work with and cover that they need they need blood to flow through.

And that's something they can be born with, so it's something you want to watch for.

Definitely screen those large breed dogs.

The tricky thing with them is sometimes they won't have any symptoms, you know.

We can listen, every time we take them to the vet, you know the vet puts the stethoscope on there, you listen to the heart, and you may not hear any signs of an issue.

So that's when we start to screen other ways, which would be like X-rays or an ultrasound of the heart, to see how it's functioning.

>>Kelly Runyon: What are some of the leading causes of heart disease, particularly in dogs?

>>Dr.

Marci Kirk: Yeah, this is another thing that would be different in people.

You know, they say you need to get out there and exercise and eat right, and everything.

That doesn't tend to be the case, where as yes, we want them to stay fit, we don't want them to get overweight, but it doesn't seem to minimize their risk for heart disease as they get older.

So, a lot of times, I would say old age is a risk for them.

Or their genetics, you know, some of those larger breeds we talked about.

And it used to be in cats, before, you know, we really started regulating the cat food industry, they would be short on taurine, which would cause them to have heart problems.

And now it's not really an issue.

So, that's probably why we don't see it as often in cats anymore.

>>Kelly Runyon: Mmhmm, we've talked, or you've mentioned different breeds.

Let's talk about the breeds that might have problems more so on heart disease than maybe some other breeds.

Large dogs vs. smaller dogs.

>>Dr.

Marci Kirk: And it is, we do tend to see the genetic link in the larger breed dogs.

That's not saying smaller breeds couldn't have it.

But one breed in particular that has something very unique to them is the boxer.

They are a large breed, but they can also have a life threatening arrhythmia that they can have, and it can be controlled.

But you definitely, boxers in general should be screened very regularly for any signs of heart disease.

And make sure, if you're getting a puppy from a breeder, make sure that the adult, you know, the parents of them were screened for heart disease.

Because, it can, it's a pretty serious problem in the boxer realm.

The other breeds, you know, dobermans and great Danes, you know, you think of those giant breeds, yeah.

Newfoundlands, some of those really big breeds are other ones you just want to be extra careful of.

They can have that dilated, you know, heart where it's just a little too big, and doesn't work as well.

>>Kelly Runyon: Mmhmm.

If I'm bringing, let's say Charlie is my pet, and I'm bringing Charlie into your office just for the routine, you know, vet check-ups, what sort of things do you do for a pet owner?

They're maybe not seeing any signs, but you know, just the routine check.

So what, take me through that process.

>>Dr.

Marci Kirk: Sure, well anytime you go to the vet, you know, they're going to check nose to tail.

And that includes putting a stethoscope on the heart and lungs.

And they can have some signs.

Now, not every dog or cat that has heart failure is going to have a sign that we'll talk about, but they could.

And that's how we're going to catch it early.

So, we can listen to the different chambers of the heart, and we're going to listen to those.

And what we're going to listen for is a heart murmur or any sounds in the lungs that might be something different, you know, where fluid could be accumulating.

So, we'll listen, and if we hear a heart murmur, and it's new, that's going to be something we want to, you know, investigate.

We want to make sure the owner's not noticing any exercise intolerance, you know, any coughing, any, you know, just breathing heavy or anything like that.

And if they're not, you know, we're still going to talk about, well maybe we need to get some baseline X-rays, see the size and shape of the heart, make sure it all looks okay.

Because, there are such a thing as innocent murmurs.

I had a beagle growing up.

She had a heart murmur diagnosed at the age of 9, and we just checked it regularly.

And it never caused her a problem.

She never had any issues with it, but she had that heart murmur that we just wanted to make sure it didn't develop into...

So, she had heart disease, but didn't have heart failure in that case, so.

>>Kelly Runyon: So, I bring Charlie in, you do some checks, and you do notice that there's probably or maybe an issue.

There's some chest X-rays that are done, and he's been diagnosed with heart disease.

What are some of the treatment options?

I'm sure there's a lot out there.

And if there are, let's go through some of the list.

>>Dr.

Marci Kirk: So, it depends on, you know, the type of heart disease.

And one thing we could do to try and narrow it down a little bit is set up a time with a cardiologist, and have an ultrasound of the heart done, an echocardiogram.

We don't always have to do that, and not everybody can afford that.

So, if that's not an option to really pinpoint it, then we'er going to start trying to ease the burden of the heart.

So, if we, let's say on the X-ray we say fluid on the lungs, because it's backing up because the heart's not pumping the blood like it should, so fluid's starting to accumulate.

That's a lot of times where we start seeing the cough come.

Adn even if they're not coughing anything up, it feels like there's something on their lungs they need to get out, and so they're trying to.

So, a lot of times we'll start with things like Lasix, you know, a diuretic that will pull fluid off the lungs and make them a lot more comfortable.

And that's very common in people, it's used too.

So, people are usually familiar with Lasix, you know, as a treatment.

One of the other treatments that we'll use is something that kind of helps lower the blood pressure a little bit, so that those vessels can loosen up and make it easier for the heart to pump blood through there.

We want to make the burden of the heart's job a little easier.

And so, that's one thing that we will use commonly, and that's kind of our first line most of the time.

There is a new drug that's out that helps the muscle of the heart contract, so it can be more efficient.

And we'll a lot of times grab that.

Now, that won't work for every heart condition.

And if there is something else going on, we'll use a different.

But if it's just the typical mitral valve disease that we talked about, those are kind of the first drugs that we go to.

Now, if it's the boxer arrhythmia, we're going to do a different medication that will help kind of regulate the heart's rhythm.

>>Kelly Runyon: You know, it may sound like a silly question, and you know, when we think of heart problems in humans, open heart surgery is sometimes an option.

Is there open heart surgery performed on dogs?

>>Dr.

Marci Kirk: They can, and they can put in, I mean, pace makers, stints, things like that.

Absolutely.

Or if there's like a tumor on the heart, sometimes they will go in and remove that.

Typically, that's done by a cardiologist and, like a Board certified cardiologist and surgeon.

It's not something most practitioners will do, but that doesn't mean that they couldn't try it.

But a lot of times you need special, you know, breathing, ventilation, things like that.

There's also a condition in dogs, there's a sac around our heart, and sometimes it can fill with fluid.

And that's called pericardial effusion.

And that, obviously your heart can't expand then and pump like it needs to because this fluid's blocking it.

And in some of those cases, they can go in there and make a window into that sac, and then that, you know, the fluid just kind of drains, and the body takes over absorbing that and flushing it out.

So, they can definitely do open heart surgery.

And let's say a puppy's born with a heart defect.

I've seen it twice done in general practice where there was an extra, kind of, it should have gone away, an extra valve on the heart basically, that should have gone away as normal, but it was kind of restricting the esophagus, and then it's not working as well.

And you can go in there and clip that out.

It sounds, it sounded much easier than it actually is, but you're going into the heart.

>>Kelly Runyon: Can you do that in your office?

>>Dr.

Marci Kirk: Yeah, I mean it can be.

It's very risky.

You know, you're getting into lungs and things like that, and it's a whole intricate system.

But it can be done, and both those dogs lived and are doing very well.

So, it's something that not every general practitioner will want to do, and if you have the option for referral, that's great.

But yeah, they can definitely do surgery on the heart.

>>Kelly Runyon: Well, speaking of that, and I know it's the million dollar question, and all pet owners want to know, what are the survival rates for, you know, dogs that are diagnosed?

Every heart is different, every dog is different, and every body's different, just like humans.

>>Dr.

Marci Kirk: That's perfect.

>>Kelly Runyon: That's probably the first question that you're asked when somebody's expecting... >>Dr.

Marci Kirk: And that's exactly our answer, too.

You know, we don't know.

But we do know things we can do to help them.

There's not, because it's not the number one disease in animals, you know, that causes death or anything.

So, there are some studies, but I don't have any, you know, survival rates.

But I can tell you, you know, if we're very proactive about it, and we do regular checks, you know, they can live a long time with it.

Now, with the arrhythmias, that's a little bit harder.

They, you know, might need, they'll probably have a shortened life expectancy compared to another dog that doesn't have any heart disease.

But some of these pets, you know, like I said, they're a lot older when they get heart disease.

And if we get them on proper medication, sometimes changing their diet to a lower sodium, you know, diet, can help.

They can live a long time.

>>Kelly Runyon: And you know, that's what a pet owner wants to hear, you know, because they're part of their family.

And they don't want to lose them.

How do you know if the medicine regime that you're talking about is working?

So, we'll use Charlie again.

I bring in Charlie, he's been diagnosed.

There is a very strict regimen of medicine that he needs to be on, diet.

How do we know if it's working?

>>Dr.

Marci Kirk: So, that's going to come back to the things that we were noticing.

So, if you noticed a problem, you know, the exercise intolerance, the coughing, or the just kind of feeling blah, you should see that stop.

You should see an improvement in that.

And that's another place where that app will come in handy, or monitoring their respiratory rates.

Because, we want to know what they're doing at resting.

If they're back to a normal, what we would consider, there's kind of some thresholds that we, you know, let's say 15 respirations a minute whenever they're sleeping is normal.

You know, if they have heart disease, maybe we're going to accept 15 to 20.

If we're seeing over that per minute, then we're going to start maybe tweaking the medication a little bit more precisely to what they need.

And in some cases, maybe they're feeling better, we can wean them down to a lower dose, and then just bump them up if they start having problems.

So, I think it really comes down to the symptoms you're noticing at home.

And if they weren't noticing any symptoms, they may notice all of a sudden, maybe they were so gradual in onset, now we're on medication, wow he's really feeling better, you know.

So, if they start noticing that slip back to, maybe he was sleeping a little bit more, things like that.

And I know that's hard because older dogs tend to sleep more.

But you should notice that their sleep is more restful.

You know, they're not having trouble breathing or anything like that.

And maybe you didn't notice it before, but now that it's not there, it's, you know, you notice it would come back.

>>Kelly Runyon: But you shouldn't rush.

You know, all pet owners, I've been there.

I had a dog, I had a yellow lab that had an enlarged heart, and you just so desperately want them to get better and to feel better.

And I think probably the one thing that I did, that I shouldn't have done, is really rush back, her name was Winnie, getting Winnie back out in the yard running and playing, and going for those long walks.

Because, that's what, we just want them to do that.

>>Dr.

Marci Kirk: You want them to be back to themselves.

>>Kelly Runyon: But that's not a good idea.

>>Dr.

Marci Kirk: Right, so you know, you've got to remember the heart's a muscle.

So, think about if you injured any other muscle or strained a tendon or ligament, or something like that, you're going to have to rest.

And what they're going to prescribe to you then is to go slowly back into your exercise.

So, a mile.

Let's say they used to go a mile, you know.

And when they got diagnosed, they could only go a half mile.

Well, you're going to start doing maybe a quarter of a mile, maybe a time or two a day, and then slowly work up to what you used to be.

But you've got to make sure that muscle is taken care of.

And it's just like anything else, you know, you strain anything else, and that's going to be really important to rest and work your way back up to where you were.

>>Kelly Runyon: Let it heal.

You mentioned when you were a little girl that you had a beagle that had a heart murmur.

What is a heart murmur, and you mentioned in your case that it was an okay thing to have, but what is it, and how serious is it?

>>Dr.

Marci Kirk: And that's a really good question, because it can be serious and it can, like in the case of my beagle, it can be just something we need to watch that could eventually cause a problem.

So, a heart murmur again, we talked about the blood and the heart, you know, has certain areas it's going to go, you know we always want to move forward.

It's either going to move to the lungs or move to the rest of the body.

Whenever their valves don't close tightly, for whatever reason, maybe the valve isn't working well, maybe it became thickened and can't close as well, blood starts to swirl back and forth, back and forth.

And so, when we listen with a stethoscope, we start to kind of hear this [makes blowing sound], kind of washing machine that kind of, you know, hear it.

And we should normally just hear that ba-bum, ba-bum.

You know, if you hear that extra thing in there, we're starting to notice that there's something not right.

And again, if they're not having symptoms at home, we take X-rays, it measures right, we might just watch it.

But at least we have a baseline.

But if we start noticing they're having symptoms, maybe on the X-rays the heart looks a little enlarged or rounded, or anything like that, then we might start medication.

One other thing that we kind of didn't touch on, and that we should talk about, heart disease can also be caused by heart worm disease.

So, that's something that, you know, yearly they might do a heart worm check, but it's very important especially in this area to keep them on heart worm preventatives.

Because, the heart, the worms live in the heart and lungs, and obviously they can cause damage.

So, even if you cure, let's say they go through the treatment, they're cured, they could have already caused damage that could lead to heart failure later in life.

So, that's something that you can prevent, too.

>>Kelly Runyon: Well, and that leads me to my next question, is can you prevent heart disease, and what can pet owners do to make sure they're pets stay healthy?

>>Dr.

Marci Kirk: Sure.

Well, I don't think there's any one thing that can prevent it.

Like in people, they tell you to go exercise and, you know, eat right.

And it doesn't seem to be the case in our dogs yet.

Now, in 10 years we may be having a different conversation.

Maybe our pets our living even longer.

But definitely keeping them, you know, at a lean body where they are not overweight makes it so their heart doesn't have to work as hard.

But it seems like genetics and age are the biggest factors, and we can't really do anything about that.

So, it's mostly just kind of knowing what's normal for your pet really helps the veterinarian, you know, a lot.

And if you start noticing any changes, that's going to be really beneficial to tell them so they can really pinpoint on their quality of life and what works for them.

>>Kelly Runyon: And we mentioned food and diet.

You know, that is something.

When you go to a store to, you know, try to decide what to feed your animal, you're just overwhelmed with all the different types and kinds, and lamb and rice, and you know, all the different... Is that, should you keep an eye out for that, I mean as far as...?

>>Dr.

Marci Kirk: Well, I don't think there's anything in the diet.

I mean, when they're diagnosed with heart disease, we are going to recommend a lower sodium, but I don't think there's any food that's going to cause.

>>Kelly Runyon: There's not a magic food out there that, you take this and you're not going to have heart disease.

>>Dr.

Marci Kirk: Yeah, I don't think there, as long as you're sticking with a good name-brand food, most of the time, and feeding, you know appropriate amounts, you're doing about everything you can to minimize their risk.

Because, most of the time, like I said, it's going to be as they age or if they had a genetic predisposition, you know, some of the larger breeds or things like that.

>>Kelly Runyon: Let's talk just a little bit, as we wrap up our discussion, about cats.

Because, is the treatment the same for cats?

>>Dr.

Marci Kirk: Cats, I mean I feel like you could fill a whole show with how different cats are from dogs, and that makes sense.

But the heart disease that cats get is really tricky.

The most common one they get is where the heart gets so, so thick, it can't get blood or pump efficiently at all.

And that's called hypertrophic cardiomyopathy.

So, it's kind of the different, complete opposite of dilated cardiomyopathy.

So, with them, a lot of times you might notice that they breathe differently, you might notice some weight loss.

We might get lucky and hear a murmur.

But a lot of times, it's kind of, if we start seeing any of those symptoms, we definitely want to take X-rays, we definitely want to think about, you know, an echocardiogram, which is the ultrasound of the heart.

They can be on some of the same medications.

I had a cat that I treated very, very well.

It was a young cat that had the hypertrophic cardiomyopathy, where the wall was just so thickened.

And it did great on one of those medications that kind of dilated the vessels, so it was easier for the heart to work.

And so, they can, they have the same medications available.

It just is kind of up to the cat, I think, sometimes if it's going to work or not because they are very, it's very difficult.

And sometimes with cats, they're trained, they just want to instinctively hide things from us, so a lot of times we may not catch it until it's too late.

>>Kelly Runyon: And the important thing is, just as we take our dogs to the vet for routine yearly check-ups, it's very important to take your cat, even though you don't see any signs of problems.

>>Dr.

Marci Kirk: That's exactly right.

And what makes them tricky, too is they seem to be more likely to have innocent murmurs.

So, we might hear that, and it might be nothing, but it's something we'll want to watch for sure.

And checking them yearly, every six months, things like that, is very important.

Even if they stay inside only, there's a lot of things we can screen for and bring them in.

>>Kelly Runyon: Alright.

Well, Dr. Kirk and Charlie, you've been well-behaved today, probably because you've got a little pocket full of treats.

>>Dr.

Marci Kirk: Got to bribe them.

>>Kelly Runyon: That's right.

Well, thank you so much.

This was fun and very interesting, and I actually learned a few things.

So, thank you for joining us.

>>Dr.

Marci Kirk: Well, thank you.

>>Kelly Runyon: Alright, and thank you for joining us for this episode of the Paw Report.

Did you know full episodes of the Paw Report are on YouTube?

They can be accessed at youtube.com/weiutv, then just go to the Paw Report playlist and select the episode you want to see.

More information about the show is also available 24/7 on our website, at weiu.net under the television tab.

Production of the Paw Report is brought to you by... >>Rameen Karbassioon: Okaw Vet Clinic in Tuscola and Dr. Sally Foote remind you to properly take care of your pets, and are happy to help support the Paw Report on WEIU.

Okaw Vet Clinic, located at 140 West Sale Street in Downtown Tuscola.

More information available at okawvetclinic.com.

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