Pet Owner FAQ

In many animals, heart disease in the early stages will be silent and may not cause any overt clinical signs.  As heart disease progresses and becomes more severe, animals may exhibit the following signs:  exercise intolerance, increasing lethargy, trouble breathing (particularly at rest), a new cough, fainting, abdominal distension, a disinterest in food or acting withdrawn (cats may go off and hide in unusual locations).  If acute paralysis of the pelvic limbs are noted in a cat and the limbs feel cold, this is strongly suggestive of serious underlying heart disease in a cat.

An annual to bi-annual examinations with your family veterinarian are important for the early detection of physical evidence of underlying heart disease – this may include the presence of a heart murmur, arrhythmia, abnormal heart sound (gallop, split heart sound) or abnormal lung sounds.

A heart murmur is an abnormal heart sound that is created from turbulent blood flow through the heart.  Some young animals can be born with heart murmurs that resolve with maturity – these are referred to as innocent heart murmurs.  If a heart murmur in a young animal persists beyond maturity and/or continues to get louder in intensity, this is strongly suggestive of underlying congenital (born with) heart disease.

Heart murmurs often appear with age – this is because many forms of heart disease in animals are acquired.  

Causes of heart murmurs can include leaky heart valves, narrowed valves that are not opening completely, holes in the heart that allow communication between the heart chambers and any factors that may lead to increased blood flow velocity through the heart.

An arrhythmia is an irregular heart rhythm.  Some normal dogs can have an arrhythmia that is very pronounced when they are calm and resting that is phasic with respiration.  However, some arrhythmias are pathologic and are a marker for underlying heart disease and should be evaluated.  Certain arrhythmias can be life-threatening.  

If an arrhythmia is detected on examination, an electrocardiogram (ECG) is indicated to define the arrhythmia and help determine next steps (diagnostics, treatments).

Any breed can be born with heart disease or acquire heart disease with age.  However, there are certain breeds who do commonly have heart disease.  This list is not exhaustive but gives you a general idea of the breeds who are more commonly affected by heart disease:

•  Doberman Pinschers – Dobermans commonly develop an acquired heart muscle disease called dilated cardiomyopathy (DCM).  It is estimated that upwards of 60% of Dobermans in North America will develop DCM.  The average age of onset is typically 5-6 years of age, but some Dobermans can be affected at a much younger age.
• Cavalier King Charles Spaniels – Cavaliers commonly develop an acquired heart valve condition called degenerative mitral valve disease.  It is estimated that upwards of 90% of Cavaliers over the age of 10 will acquire this valve disease!
• Maine Coons & Ragdoll cats – These two breeds can commonly develop an acquired heart muscle disease called hypertrophic cardiomyopathy (HCM).  A genetic test has been developed specifically for these two breeds to detect the mutations which cause HCM.
• Golden Retrievers – Goldens have been reported to have a higher prevalence of a congenital cardiac condition called subaortic stenosis (SAS) – SAS is a condition where a ridge of tissue obstructs the blood flowing from the left ventricle to the body. 
• Labrador Retrievers – Labs have been reported to have a higher prevalence of a congenital cardiac condition called tricuspid valve dysplasia (TVD) – TVD is a condition where there is malformation of the tricuspid valve (a right sided valve) typically causing a leak to develop on this valve.
• Small breed dogs such as Chihuahuas, Poodles, Shih Tzu’s will commonly develop mitral valve disease with age.  It is estimated that over 1/3 of smaller breed, geriatric dogs will acquire mitral valve disease after the age of 10.

Appointments with Dr. Orr are directly scheduled through your primary care veterinarian.  Your family veterinarian will contact Dr. Orr to schedule a mobile cardiac evaluation for your pet.  Generally pets will be dropped off the day of the appointment for several hours for the cardiac evaluation.  If an owner wishes to be present during the evaluation, an approximate window of arrival (1-2 hours) will be provided.  Due to the nature of mobile practice, precise arrival times can be difficult to predict!

No.  East Coast Veterinary Cardiology is a mobile cardiology consulting service for family veterinarians.  Only veterinarians directly may request our services and schedule appointments for their patients.  This allows continuity of care as your family veterinarian will remain the primary caregiver of your pet.  

No – your pet can eat and drink as normal.  If they are taking any medications, they can receive them as normal the day of their evaluation.

Fortunately the cardiac tests commonly performed are non-invasive.  For the tests, pets are gently positioned on their side on a soft, padded table.

Sedation is typically not required.  If your family veterinarian feels that your pet would benefit from a mild sedative (if your pet historically has become anxious or stressed easily for other diagnostic procedures) they may have you give an oral medication prior to coming to the hospital the day of the evaluation or a mild sedative will be administered in hospital.  You will be informed prior to any sedatives given for a cardiac evaluation.

Generally, shaving is not required for echocardiograms or electrocardiograms (resting).  Some very furry dogs or cats may need a small amount of shaving in their armpit area for the echocardiogram.  For animals having a Holter monitor performed (ambulatory electrocardiogram that is worn at home) some shaving will be required.  

For a standard new patient evaluation & consultation with Dr. Orr, a complete cardiac physical examination will be performed.  Dr. Orr will listen to your pet’s heart and lungs, assess mucous membrane colour and pulse strength and assess your pet’s heart rhythm.  All consultations also include a Doppler blood pressure and a single lead electrocardiogram (ECG).  An echocardiogram will generally be performed.  This is an ultrasound of the heart.  It allows for evaluation of heart size and function, evaluation of the heart valves, measuring the speed of blood flow through the heart and estimation of the pressures within the heart.  This is the best test to evaluate animals for underlying structural heart disease such as valve disease or cardiomyopathy.

If indicated, a more complete ECG will be performed called a 9-lead ECG.  This is useful if an irregular heart rhythm (arrhythmia) is detected.  If there is concern for an intermittent arrhythmia or your pet is having episodic episodes of collapse/fainting, a 24 hour ECG called a Holter monitor may be performed.

After an echocardiogram is performed, Dr. Orr may recommend that thoracic radiographs (x-rays) be performed.  These are useful if your pet is exhibiting any respiratory signs such as coughing or trouble breathing.

For more information on cardiac testing, please visit information page.

We ask that all pet owners who have a scheduled appointment with Dr. Orr complete our online history questionnaire – this will help Dr. Orr’s evaluation of your pet by allowing him to understand the signs that you may be noting at home (including duration), knowing which medications your pet may be taking and knowing any other previous health issues your pet has had in the past.

As your family veterinarian remains the primary doctor for your pet after a mobile cardiac consultation, we ask that you call your family veterinarian directly with any questions or concerns.  This helps to maintain continuity of care as you have an existing relationship with them.  Dr. Orr will continue to work with your family veterinarian even after the initial evaluation with any changes in your pet’s condition or questions/concerns that may arise to ensure the best quality care possible for your pet.

Costs will vary depending on the indicated diagnostics.  Please speak with your family veterinarian directly regarding the costs associated with a mobile cardiac evaluation.

A complete report will be sent to your family veterinarian following the evaluation.  The report can be provided to each owner upon request.  All of ultrasound studies are stored in the cloud and can be easily shared to your veterinarian if needed.

There are many forms of heart disease diagnosed in animals.  Please visit our disease information page to explore the diseases encountered in more detail.

The most common form of acquired heart disease in the dog is mitral valve disease & dilated cardiomyopathy.  In cats, hypertrophic cardiomyopathy is common.  There are a variety of congenital cardiac conditions noted in animals, with subaortic stenosis, pulmonic stenosis and patent ductus arteriosus (PDA) most commonly noted.

Most of the medications prescribed for the treatment of heart disease are human medications.  Common examples include diuretics such as furosemide, blood pressure medication such as amlodipine and benazepril/enalapril as well as platelet inhibitors such as clopidogrel (Plavix).  There are few veterinary specific heart medications – the most commonly prescribed is Vetmedin (pimobendan) which is indicated for the treatment of some forms of heart disease in dogs.  Please visit our cardiac medication information page for more!

Many of the prescribed medications will be available directly through your family veterinarian’s in-hospital pharmacy.  However, some medications may need to be called into a human pharmacy for dispensing.  Your family veterinarian can help direct you to the best options for obtaining any prescribed heart medications for your pet.

Following each cardiac consultation, Dr. Orr will prepare a complete report including signs to monitor specific to your pet.  Each form of heart disease may have unique signs to monitor for.  Generally, we recommend that pet owners monitor the resting/sleeping respiratory rate (see our information sheet on how to count your pet’s breathing here), monitor for cough frequency, monitor or any episodes of weakness or fainting and monitor your pet’s activity levels.  Other signs that may suggest that a cardiac re-evaluation is needed include abdominal distension, a reduced appetite or vomiting/diarrhea.  In cats, we have owners monitor for any sudden limping in any limb (especially if that limb becomes cold or painful to touch). 

Most forms of heart disease in animals are managed medically so generally surgery is not recommended.  

There are some congenital (born with) conditions that surgery can significantly improve the quality and length of life of affected pets.  This includes surgery for patent ductus arteriosus (PDA) and valvular pulmonic stenosis.  If surgery is indicated, a referral to the Atlantic Veterinary College (AVC) at UPEI can be facilitated.

In coming years, surgery for dogs with degenerative mitral valve disease may become more common.  Although there are several institutions worldwide which offer this surgery, it is cost prohibitive for most unfortunately.

If your dog is wearing a Holter monitor, we are using this test to detect an intermittent arrhythmia (that may suggest underlying heart disease) or evaluating your pet’s response to anti-arrhythmic therapy.  We have compiled extra information here for you while your pet is wearing this 24 hour monitor.

No problem!  The Holter diary is very helpful for us when we review the Holter findings.  We have provided a copy here that you may download and print at home to complete while your pet is wearing the Holter.  Don’t forget to bring the diary with you when the Holter is removed by your family veterinarian!