This disease is rarely diagnosed in cats or small-breed dogs; however, it is a common cause of heart disease in large and giant breed dogs, and usually occurs more in those that are middle- to older-aged. Dogs with DCM may also receive an electrocardiogram (ECG), which measures electrical activity within the heart. Chronic medical therapy includes diuretic therapy (furosemide) at a dose of 1-4 mg/kg q8-24h. However, more commonly, these early indications are overlooked and the diagnosis of DCM is not established until congestive heart failure (CHF) develops and the patient is presented for coughing, dyspnea, tachypnea, wasting, arrhythmia and sometimes ascites. The goal of treatment is to delay the development or progression of congestive heart failure. In dogs that are already showing signs of heart failure, enalapril is given to dilate blood vessels. This encouraging outcome suggests that diet-associated DCM is largely reversible in dogs when the underlying cause is addressed. There are a number of potential causes of DCM, including both genetic and environmental influences. Indeed, DCM contributes to a large proportion of the overall mortality in certain large breed dogs <10 years of age. Tidholm A, Svensson H & Sylven C (1997) A retrospective study of 189 dogs with dilated cardiomyopathy. Antiarrhythmic medications: In rare cases, dogs with DCM may develop significant arrhythmias that require treatment. Diet Recommendations for Dogs A diet change is recommended for any dog diagnosed with DCM and that is eating a BEG, vegetarian, vegan, or home-prepared diet. Although DCM is currently believed to be a genetic disease, there are currently no genetic tests available for establishing early diagnosis and the diagnosis is, therefore based on phenotype characterization. Win a LIFETIME SUPPLY of Interceptor® Plus(milbemycin oxime/praziquantel) Initial stabilization usually depends on the first two. DCM (Dilated Cardiomyopathy) is a disease that affects the heart muscle, causing it to become thin and weak. A soft heart murmur may be heard with a stethoscope, indicating turbulent blood flow within the heart. This disease is rarely diagnosed in cats or small-breed dogs; however, it is a common cause of heart disease in large and giant breed dogs, and usually occurs more in those that are middle- to older-aged. Am J Vet Res 2007;68:42-47. Subcutaneous Fluids Can Be Given at Home for Dogs and Cats. Her primary medical interests are preventive medicine and client education. This offers the duel benefits of feeding your dog a product which does not contain problematic and potentially unhealthy ingredients such as potato starch, but also allows you to introduce important substances such as taurine. Taurine assay: Taurine deficiency may play a role in some cases of DCM. DCM Reversal Possible with Early Intervention. The above mentioned drugs are often added stepwise as the severity of clinical signs progress. Asymptomatic dogs with ventricular dilation/dysfunction (occult) Two types of therapy have been under investigation for treatment of occult DCM, ACE inhibitors and beta-blockers. : In rare cases, dogs with DCM may develop significant arrhythmias that require treatment. Mildly symptomatic dogs or those with stabilized CHF may be managed at home. As the disease progresses the heart chambers become enlarged, one or more valves may leak, and signs of congestive heart failure develop. If arrhythmias are not controlled with the above medications, antiarrhythmic drugs may be added in cautiously. Your dog loves you with their whole heart, but what happens when their heart isn’t working as it should? Treatment of DCM is directed at improving systolic (pump) function of the heart, dilating the peripheral blood vessels to decrease ventricular workload, eliminating pulmonary congestion if present, and controlling heart rate and cardiac arrhythmias if present. Taenia Species Tapeworms in Dogs and Cats. The cause of DCM is unclear in most cases, but certain breeds appear to have an inherited predisposition. Taurine deficiency may contribute to the development of DCM in some dogs, particularly Golden Retrievers who may have a genetic predisposition to deficiency. Borgarelli M, Tarducci A, Tidholm A, et al. The suggested criteria for diagnosing DCM are likely to be changed in the future as new findings and new techniques become available to a broader veterinary community. It’s very common in dogs and causes congestive heart failure. © 2020 Great Pet Media. Neutraceuticals such as taurine/L-carnitine and omega-3 fatty acid supplementation may be considered. In a proportion of boxers and Dobermans (not all), ventricular tachyarrhythmias may cause fainting and weakness, whereas the cardiac dilatation and systolic dysfunction is not apparent. As such, treatment for DCM is based around improving the heart function to slow the disease. The prevalence of DCM in male dogs (0.66 percent) is nearly twice that of female dogs (0.34 percent) according to the VMDB. An … These changes interfere with the heart’s ability to pump normally, limiting efficient blood flow throughout the body. Although reasonable, there is very little evidence that these drugs are beneficial at this stage. Secondary DCM can be caused by exposure to a toxin, deficiencies in certain nutrients (especially taurine), muscle diseases (such as muscular dystrophy), and certain infections. Sign up for our newsletter to stay in-the-know. Pimobendan has been shown to improve quality of life variables and survival in a population of different breeds and in Dobermans when compared to placebo. Histopathological characterization of dogs with DCM has shown that there are two histopathological phenotypes that presumably precipitates different clinical presentations. Occasionally, DCM-like heart muscle dysfunction develops secondary to an identifiable cause such as a toxin or an infection. Canine dilated cardiomyopathy (DCM) is one of the most common heart diseases observed in medium and large-breed dogs. Dilated Cardiomyopathy (DCM) is one of the most common acquired heart diseases in dogs. Treatment of dilated cardiomyopathy in dogs Treatment is based on the administration of diuretics to help eliminate the retained fluids, that is, pulmonary edema and ascites; vasodilators to facilitate blood circulation; and various medications to regulate and stabilize the contraction of the heart so that it works properly. Additional medications might be used to help control heart rate and arrhythmias (if present). Researchers are exploring whether some of these cases are linked to a taurine deficiency, which could be corrected through a diet change and supplementation (2). Your veterinarian will guide you through the diagnostic and treatment process to ensure that your pet receives the highest standard of care. At this time, however, we cannot say that taurine deficiency is the cause of all diet-associated DCM. In the absence of genetic tests, dogs are currently screened for DCM in affected breeds using echocardiography and/or 24h-Holter ECG recordings. New techniques that appear particularly promising are the Tissue-Doppler Imaging (TDI) and Tissue Tracking Imaging (TTI) techniques. However, a number of common factors including nutritional, infectious, and genetic predisposition are known to occur. Ideally, clients should choose a diet that is manufactured by a well-established company following the World Small Animal Veterinary Association (WSAVA) Global Nutrition Committee Guidelines. Caution should be used when introducing an antiarrhythmic drug with negative inotropic actions (such as beta-blockers) in a dog with a hypocontractile heart or in a dog with fluid retention (heart failure). The most common acquired heart disease of dogs, this is a progressive disease of the heart ventricles: early diagnosis and treatment is key. Diuretics such as lasix are used to help control and prevent accumulation of fluid Veterinary cardiologists began observing an increase in cases of dilated cardiomyopathy in dogs, often occurring in breeds that are not typically predisposed to the disease. Canine dilated cardiomyopathy (DCM) is a cardiac disease that results in a decreased ability of the heart to generate pressure to pump blood through a dog’s vascular system. Vet Rec 2006;158:742-743. Drugs such as pimobendan are used to help the heart contract more strongly. You should speak to your veterinarian about whether your dog can benefit from a change of diet. Chest radiographs are primarily used to look for evidence of congestive heart failure, although they can also suggest the presence of DCM if significant heart enlargement is seen. Dukes-McEwan J, Borgarelli M, Tidholm A, et al. Dogs with documented taurine deficiency will often return to normal with taurine supplementation. Dilated cardiomyopathy (DCM) is a disease of the heart muscle that is characterized by an enlarged heart that does not function properly. This allows blood to flow more easily, decreasing the heart’s workload. Doberman; Great Dane; Irish Wolfhound; Newfoundland; Portuguese Water Dogs; Onset and natural progression. Dilated Cardiomyopathy (DCM) has made it on everyone’s radar lately. Kramer G K, Kittleson M D, Fox P R et al (1995) Plasma taurine concentrations in normal dogs and dogs with heart disease. DCM is most common in large bred dogs, but not all large breeds are affected. ACE inhibitors also help improve general blood flow, which is another benefit for a dog suffering from DCM. In 2018-2019, many pet owners developed a new awareness of DCM. General Cost to Treat DCM in Dogs DCM is one of the most common heart diseases observed in medium and large-breed dogs. The echocardiographic diagnosis of DCM is based on the identification of myocardial (predominantly but not solely systolic) dysfunction with the active exclusion of other acquired or congenital cardiac disease. Dogs, however, are able to synthesize it from other nutrients. This allows blood to flow more easily, decreasing the heart’s workload. However, introduction of a beta-receptor blocker should be done with care to avoid adverse side reactions and the dose should preferably be titred upwards slowly. Guidelines for diagnosing DCM were suggested in 2003 by the European Society of Veterinary Cardiology (ESVC) Taskforce Group. Hypothesis: Carvedilol improves echocardiographic and neurohormonal variables in dogs with DCM over a 4-month treatment period. Spironolactone at a dose of 2 mg/kg q 12-24h and/or hydrochlorothiazide at a dose of 2-4 mg/kg q12h may be added in cases where the fluid retention is refractory to furosemide alone. Cardiomyopathy is a common heart disease among dogs, and by paying attention to any of your dog's symptoms and bringing them to the veterinarian for regular heart screenings, you can help detect these heart issues and more quickly begin treatment when possible. January 20th, 2015 | Posted in Medical Articles. She currently splits her time between part-time clinical practice and freelance writing, as well as serving on her county Board of Health. This leads to a decreased ability to effectively pump blood to the lungs, accumulation of fluid on the lungs, and ultimate death by heart failure. The clinical presentation may be subtle and include the gradual development of exercise intolerance and weight loss. But what about the possible diet-related causes? J Vet Intern Med 2006;20:894-903. Once started, these medications are typically continued for the remainder of your dog’s life. Echocardiography is the most sensitive test for diagnosing DCM. DCM is a disease of the heart muscle that results in weakened contractions and poor pumping ability. disease within 6 months. It is important that the owner is educated on the following issues: how to monitor heart rate and respiratory rate at home; importance of regular habits and medication; the possibility to modify diuretic dose within a fixed range; avoid strenuous exercise; diet; possible complications; and importance of rechecks. Furosemide dosing may require adjustments, because treatment requires carefully balancing the need to remove excess fluid with the need to prevent dehydration. Dog breeds that are predisposed to DCM include: Other cases are idiopathic, meaning that they occur spontaneously with no identifiable underlying cause. Egenvall A, Bonnett B, Häggström J. Other types of antiarrhythmic drugs used long term can include procainamide, mexiletine, and amiodarone. For the asymptomatic patient, the challenge lies in differentiating normal variation and cardiac or non-cardiac pathologies from DCM. In dogs with cardiac dilatation, ACE-inhibitors (0.5 mg/kg q12-24h is the usual dose for most of the ACE-inhibitors) and/or the inodilator pimobendan (0.25 mg/kg q12h) are often introduced. Vet J 2001;162(3):182-195. While there are likely multiple factors that combine to produce clinical DCM, the fact that the disorder occurs at a higher incidence in specific breeds has always suggested that there is a heritable genetic component to this disease, says Cornell University College of Veterinary Medicine . DCM is a disease of a dog’s heart muscle and results in an enlarged heart. DCM Reversal Possible with Early Intervention. If DCM is caused by a dietary deficiency, it can usually be corrected by addressing that deficiency. The dose should be slowly titrated upwards starting with approximately ¼ to ½ of the recommended dose. Dilated cardiomyopathy (DCM) is prevalent in certain breeds of dog and is rare in cross breeds. DCM is a disease of a dog’s heart muscle and results in an enlarged heart. Interceptor is a trademark of Elanco or its affiliates. Most breeds are screened using echocardiography, whereas Dobermans and boxers are also screened with 24-h (Holter) recordings because a single ECG trace is not useful, since it corresponds to a small fraction of the dog's rhythm over a 24 hour period, and identification of abnormalities may be entirely fortuitous. Therapy should be started once a tentative diagnosis has been established. Heart disease is as scary in dogs as it is in humans. In the case of atrial fibrillation, therapy is usually aimed at reducing ventricular rate by introducing digoxin (0.22mg/m2 q12h or lower), or a beta-blocker (carvedilol (maximum dose 0.5 mg/kg q12h), metoprolol (maximum dose 1 mg/kg q8h), atenolol (maximum dose 1 mg/kg q12h), or propranolol (maximum dose 1 mg/kg q8h)). 5. The combined alpha- and beta-receptor blocker carvedilol was recently studied in DCM, but the authors could not detect any clinical or laboratory effect of the drug. AND a $500 SHOPPING SPREE at Muttropolis! The prevalence of DCM increases with age (VMDB). Initial diagnostics (exam, radiographs, echocardiogram) = $500-$1,000, Ongoing maintenance therapy (medications and monitoring) = $50-$200/month. Your veterinarian will select the appropriate medication(s) for your dog, based on your dog’s clinical signs and other health factors. Dilated Cardiomyopathy, DCM2 What is DCM2? Enalapril: In dogs that are already showing signs of heart failure, enalapril is given to dilate blood vessels. In dogs, the disorder is uncommonly diagnosed and is rare in cats. In DCM, the ventricles gradually lose muscle mass, leading to ventricular dilation, loss of heart contractility and an inability to pump oxygenated blood to the body. In dogs, DCM occurs at a higher incidence in specific breeds including the Doberman pinscher. When the ventricle, or lower chamber, becomes enlarged, its ability to pump blood out into the lungs and body deteriorates. Once the disease is present, it will most likely continue to progress. Furosemide: In dogs with heart failure, furosemide (a diuretic) is given to remove fluid that has pooled in the lungs and elsewhere in a dog’s body. Dilated cardiomyopathy: an update. Dilated cardiomyopathy is a disease of the heart muscles. If your dog is on medication to treat DCM, you will likely return to the vet every 10-14 days for a blood test to check the kidney and liver function, gauge your dog’s blood pressure and/or re-evaluate his heart beat. There are still many questions and unknowns about how food and nutrition impact the development of this condition. Additional medications might be used to help control heart rate and arrhythmias (if present). Put simply, DCM occurs when a dog’s heart becomes enlarged, and can no longer function properly. J Vet Cardiol 2003;5:7-19. 2. Therapy of symptomatic dogs varies in composition and intensity depending on severity of clinical signs and presence of arrhythmia, but chronic therapy should preferably include furosemide and pimobendan ± ACE-inhibitor. The treatment your dog needs will depend on what stage of DCM they have. Pimobendan helps the heart beat more strongly and dilates blood vessels (allowing blood to flow through the body more easily). J Vet Intern Med 2007;21:719-730. However, because of the lower number of aged dogs examined, the majority of dogs presented for evaluation and treatment of DCM and heart failure are between 4 and 10 years old. Veterinary cardiologists began observing an increase in cases of dilated cardiomyopathy in dogs, often occurring in breeds that are not typically predisposed to the disease. DCM is a disease that generally affects large and giant dog breeds like Doberman pinschers, Irish wolfhounds, boxers, Afghan hounds, Great Danes, Dalmatians and Saint Bernards. The nutrient scientists are looking into now is taurine. Veterinary Treatment for Enlarged Heart in Dogs Unfortunately, a diagnosis of DCM is never good news. Dogs with DCM develop a big, floppy heart that struggles to pump blood around the body and usually an irregular heart beat. 9. Let our authors & experts know what you think. If you have a dog breed that is predisposed to DCM, discuss any concerns you have with your veterinarian. Many dogs with diet-associated DCM return to normal with a dietary change. Summary: Dilated cardiomyopathy is a disease of predominantly large and giant breed dogs that results in progressive heart muscle dysfunction, chamber dilation, and eventual congestive heart failure or death of affected patients. A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy. Prospective screening for occult cardiomyopathy in dogs by measurement of plasma atrial natriuretic peptide, B-type natriuretic peptide, and cardiac troponin-I concentrations. There are a number of factors associated with the development of DCM in dogs. 1. The diet is changed to reduce sodium intake. Follow up echocardiograms ($500-$800) or cardiology consults ($100-$200) will also add to costs. Treatment of DCM is aimed at both improving the heart’s function and controlling the signs of congestive heart failure. Veterinarians are not yet certain whether the disease is caused by a nutrient deficiency, nutrient excess, or an interplay of ingredients that interfere with nutrient absorption. JAAHA 33 (6), 544-550 PubMed. Successful CHF therapy is always based on a good collaboration between pet owner and veterinarian. 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