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Question
I have an 8 year old Chesapeake Bay Retriever, he had a vet visit yesterday, we were concerned at his increasing lack of energy and a strange almost gagging noise he has been making occasionally. We have regular blood work done on him and his thyroid has been a little low. Blood work revealed thyroid level too low, but other levels within range. Xray of his chest showed a slightly enlarged heart and some fluid on his lungs also a slight collapse of an area in his trachea. The vet has given him Thyroxine, Furosemide for the fluid and Theophylline bronchodilator, with follow up xray in 6 weeks. In your opinion is this the best we can do for him at this time. His heart hasn't enlarged enough to cause coughing or appetite loss. Should he have heart medication also. I didn't ask but I am guessing it is the left ventricle that is the problem. We saw the xray, our vet is very good at explaining and she said it isn't life threatening at this time but I am still very worried about our Ben.

Answer
Hi Wendy,
Treatment for DCM is mainly focused on improving the  function of heart, and on treating the symptoms of congestive heart failure. Drugs may be administered to enhance heart contraction and to slow down rapid beating, and diuretics may be used to control the accumulation of fluid in the lungs. Vasodilators, drugs that induce dilation of the blood vessels, and help the heart pump blood more effectively, are also usually part of the therapy for DCM.

There  are  many  potential causes of the disease but the vast majority of clinical cases  are  “idiopathic” meaning that  the cause is unknown.  
There are  some  rare,  but  partially  reversible  causes  of  DCM.
Taurine  Deficiency:  Taurine is an amino acid (building block of Protein)that is  metabolized abnormally  in some  dogs.  It is rare  but  when  taurine  deficiency  is  identified,  is  partially  treatable.
Hypothyroidism:  Thyroid  is  a hormone that helps maintain  metabolism,  and  is  also  essential  for  heart  function.  In  rare  cases dogs  with  severely  decreased  thyroid  levels  (hypothyroidism),  can  develop  reversible  DCM.
L-Carnitine  Deficiency:L-Carnitine is an important molecule that is essential for  myocardial metabolism.In very rare and unique cases,supplementation with  L-Carnitine has  been shown to improve systolic function in specific breeds of dogs (Boxers)with  DCM.

Most cases of DCM are idiopathic or genetic and slowly progress to  congestive heart failure despite treatment. There is a wide range of disease, ranging from “occult” disease (meaning that the dog has no overt signs of disease but has  changes that can be detected by your cardiologist) to overt disease with clinical  signs  of  heart failure.

In your pet's case probably your vet is suspecting hypothyroidism as a reason for DCM and may be she is expecting results with the present treatment protocol.I think a review during the next X ray will be crucial for further treatment approach.

Wish you all the best  

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Dr S Bindu Anand

Expertise

Large and Small Animal Medicine and Surgery, Farm Management,Preventive medicine http://binduanand.webs.com/

Experience

A Senior Veterinary Surgeon with more than 25 years’ experience in the field of Veterinary Science and Animal Husbandry. Mixed animal Practice that will utilize my skills in medicine and surgery, public health, client relations, and developing relationships within the community, such as humane society

Organizations
Veterinary Consultant with Department of Animal Resources,Ministry of Environment,State of Qatar (Present). Animal Husbandry Department, Government of Kerala, India. Oakland's Park, Gloucestershire, United Kingdom. Severnside Veterinary Center, Gloucestershire, United Kingdom. Saud Bahwan Group, Sultanate of Oman. Trivandrum Regional Co-operative Milk Producers Union,Kerala,India.

Education/Credentials
BVSc & AH (Bachelor of Veterinary Science and Animal Husbandry) 1990. College of Veterinary & Animal Sciences, Mannuthy, Thrissur, Kerala, India under Kerala Agricultural University. Certificates Of Accomplishments- Equine Nutrition- University of Edinburgh Principles of Public Health-University of California, Irvine. AIDS- Emory University, Atlanta, Georgia. General Environmental Health – EPHOC-Tulane University School of Public Health and Tropical Medicine and the University of Alabama at Birmingham School of Public Health. Food Protection-EPHOC-Tulane University School of Public Health and Tropical Medicine and the University of Alabama at Birmingham School of Public Health. Zoonoses:University of Minnesota-School of Public Health online. Food Safety:University of Minnesota-School of Public Health online. Occupational Safety and Health-EPHOC-Tulane University School of Public Health and Tropical Medicine and the University of Alabama at Birmingham School of Public Health. Rabies Educator Certified -Global Alliance for Rabies Control. Animal Handler & Vaccinator Educator Certified -Global Alliance for Rabies Control. Wildlife Conservation-United for Wildlife

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