Expert: Dr. Louis N. Gotthelf - 2/8/2006

Question
I emailed you this past weekend about my 6 y.o. Dalmatian, Marley. I have since taken him for a 2nd opinion. He has been taken off of the Throxine, new urinalysis revealed normal specific gravity. He has a Grade 3 heart murmur, a full neuro exam revealed normal. The vet said we would do testing for cardiomyopathy and to see if the murmur was atropine responsive or not. He had an ECG/Ultrasound today. The vet sent the results to a cardiologist to read, however, she said from her observation, the mitral valve was slightly thickened with a slight enlargement on the left side of the heart (not the right as the previous vet stated). Oh...and she said she was 99% sure there was no brain tumor! ;~}  So, now, I wait until tomorrow to find out the cardiologist interpretation of the results. But she said if he was not atropine responsive, which he was NOT, then a pacemaker may be in order. My husband is leaning toward not spending so much money on a dog (about $1600 for pacemaker in Gainesville, FL). I am curious if you know of any studies or outcomes on pacemaker placements, quality/longevity of life, or any other useful information. Or any other options that you may know of (medication management?). I do not want to prolong the dog's life for my own pleasure, but also don't want to not give him a fair chance at life. Please help.

Answer
I am glad that you got another opinion.   Many of the facts that you wrote about did not stack up! I do not have that much sophistication in cardiac disease to know when or how to put in pacemakers, so I really can't tell you much. They must think that the heart is having a problem maintaining rhythm and that is the function of the pacemeker.