Echocardiogram
| 2022-03-19 Results: equivocal/symptomatic |
| 2022-04-15 Results: equivocal/symptomatic |
| 2022-07-22 Results: equivocal/symptomatic treated by medication |
| 2022-12-16 Results: equivocal/asymptomatic |
| 2023-08-25 Results: equivocal/asymptomatic |
| 2024-03-08 Results: normal |
| 2024-04-05 Results: normal |
DNA Gene Mutation Tests
| DCM 1 (formerly PDK4): |
Negative |
| DCM 2: |
Homo-positive |
Holter Monitor
| 24 hour holter monitor 2022-03-25 Results: >50 PVCs Singles Couplets Triplets /symptomatic |
| 48 hour holter monitor 2022-04-03 Results: >50 PVCs Singles Couplets Triplets /symptomatic |
| 24 hour holter monitor 2022-05-03 Results: 0 PVCs/asymptomatic treated by medication |
| 24 hour holter monitor 2022-06-06 Results: >50 PVCs Singles Couplets Triplets Runs /symptomatic treated by medication |
| 48 hour holter monitor 2022-06-17 Results: >50 PVCs Singles Triplets /symptomatic treated by medication |
| 48 hour holter monitor 2022-07-14 Results: >50 PVCs Singles Couplets Triplets Runs /symptomatic treated by medication |
| 48 hour holter monitor 2022-07-25 Results: >50 PVCs Singles Couplets /symptomatic treated by medication |
| 24 hour holter monitor 2022-09-07 Results: 0 PVCs/asymptomatic |
| 48 hour holter monitor 2022-10-03 Results: <10 PVCs Singles /asymptomatic |
| 48 hour holter monitor 2022-11-01 Results: 0 PVCs/asymptomatic |
| 48 hour holter monitor 2022-11-13 Results: 0 PVCs/asymptomatic |
| 48 hour holter monitor 2023-06-12 Results: <10 PVCs Singles /asymptomatic |
| 48 hour holter monitor 2023-08-17 Results: <10 PVCs Singles /asymptomatic |
| 48 hour holter monitor 2024-01-05 Results: <10 PVCs/asymptomatic |
| 24 hour holter monitor 2024-04-03 Results: 0 PVCs |
Laboratory
| N-terminal pro-brain natriuretic peptide (NT-proBNP): |
Normal |
| Troponin I (cTn1 ): |
Normal |
Other Cardiac Related Diseases
Comments
|
The information in this section only makes sense in context. Please see the general Breeder/Owner Notes section for background and related information.
Echocardiograms:
2022-03-19: Echo parameters normal, PVCs noted.
2022-04-15: Reduced fractional shortening, structural parameters within normal range, PVCs noted.
2022-07-22: Further reduced fractional shortening, structural parameters still within normal range.
2022-12-16: Per cardiologist: “His heart strength has improved significantly, [fractional shortening] ranging from 28-34%. No PVCs noted. Heart medications are not needed.”
Holters:
All holters marked as being 48 hours were actually between three and six days long, averaging about four days.
>1,000 PVCs noted in each of first two holters, dog symptomatic. Recheck after Sotalol started showed apparent excellent response to medication. June 6 holter done when symptoms suddenly returned and showed far higher number of PVCs. Sotalol increased with no improvement, Mexiletine added with no improvement.
In July 2022 a variety of medications not used in canine cardiology trialed over 6-day period while being holtered to determine which could safely be used for non-arrhythmia purposes. One, whose mechanism of action is as a centrally acting α-2A agonist, inexplicably stopped the arrhythmia during the time it was trialed at doses normally considered to be subclinical for the dog’s size. The α-2A agonist medication was added to the Sotalol and Mexiletine regimen and the following holter showed a 55% reduction in PVCs. Clonidine is not used in canine cardiology and has a couple of different uses in human medicine, the most common of which is as an antihypertensive. A couple of human studies have shown that it can paradoxically increase and stabilize the blood pressure of people with autonomic dysfunction.
The owner worried that anti-arrhythmia medications may have become pro-arrhythmic over time and, under the guidance of the cardiologist, gradually tapered the dog off Sotalol first, and then off Mexiletine as well. As of March 2023, the dog has been holtered a combined 12 days since the discontinuation of the Sotalol on August 1, 2022, with only 1 PVC.
The α-2A agonist was also discontinued November 1, 2022 for non-cardiac reasons. It was resumed in an abundance of caution in late January 2023, and discontinued again in August of 2023. See Breeder/Owner Notes for more information.
Cardiologist commentary regarding holters: They felt it was notable that the triplets and runs were never tachycardic. They also noted that no holters ever had any abnormalities that would account for the pale mucosal membranes observed by the owner and felt that this symptom may instead be due to some kind of inappropriate vasoconstriction.
August 2023: Echo parameters remain within normal bounds.
Dec 2023 Update: NT-proBNP and Troponin blood tests repeated and found to be normal, as before.
Jan 2024: Holter is 4 days long with 4 singles
March 2024: Echo shows evidence that the heart is actively healing the prior damage that it sustained. FS 32% While some damage remains, Echo marked normal instead of equivocal because all parameters are well within normal, the cardiologist noted that his heart is the best she had ever seen it, and all indications point to continued healing.
April 2024: Additional echo repeated as part of stress test. Results remain normal. 24 hr holter also completed with 0 PVCs. |
This dog has been tested for Chagas Disease
