Keep the Beat
You’re aware of the prevalence of heart disease in
humans, and are probably doing what you can
to keep your own ardiovascular system healthy. But
did you know it’s also a common affliction in dogs and
cats? Unlike people, who often develop coronary artery
disease because of artherosclerotic plaques, dogs and cats
typically develop other types of heart disease.
In dogs, cardiomyopathy and mitral valve disease are
common. Cardiomyopathy is a condition in which the
heart muscle fails. It typically occurs in larger breeds such
as Doberman pinschers and boxers. Mitral valve disease,
in which leaky heart valves develop, most often occurs in
middle-aged to older small breeds. Cavalier King Charles
spaniels are especially prone to this disease, even at
an early age; in fact, most Cavaliers will develop heart
disease at some point in their lives.
In cats, cardiomyopathy is the typical heart condition.
One form of the disease, dilated cardiomyopathy, is
caused by taurine deficiency and was once very common.
Now, thanks to added taurine in cat foods, the condition
is rarely seen. Now, hypertrophic cardiomyopathy is the
most common form of heart disease found in cats.
Making a diagnosis
Diagnosing heart disease is relatively simple. Your
veterinarian will listen to your dog or cat’s heart with a
stethoscope, and if he hears a heart murmur or irregular
heartbeat, then the animal has heart disease. At this point,
however, one of two mistakes are often made.
Mistake #1: The veterinarian takes a “wait and
watch” approach. With very few exceptions, a heart
murmur always indicates heart disease. To simply “wait and watch” makes no sense. What are we waiting
and watching for – the animal to go into heart failure?
Whenever a heart murmur is detected, it indicates the
need for more testing to determine the severity of the
disease.
Mistake #2: The vet puts the animal on medication.
There is no need to prescribe medication to a dog or cat
simply because a heart murmur is detected. Without
further diagnostic testing, there’s no way to know if
the animal has a need for medication at this stage. The
good news is that for most asymptomatic animals with
heart murmurs, a natural approach can be taken and no
medications are needed.
Further testing
Once a heart murmur is detected, radiographs (x-rays),
an EKG and echocardiogram of the heart will be
necessary. These tests allow us to determine the stage
of heart disease and will guide the treatment. In my
experience, most asymptomatic animals have very early
heart disease and do not require medication. Follow-up
testing, usually with further echocardiograms and EKGs,
are done every six months. Medication is prescribed only
when the disease has progressed or when heart failure
occurs.
Conventional treatments
Three different types of medication can be used for the
animal with heart disease. With rare exceptions, these
are only necessary with severe heart disease or failure.
They have no place in the treatment of dogs or cats with
mild heart disease.
Diuretics – Furosemide (Lasix) is most commonly
prescribed whenever a diuretic is needed. Diuretics work
by removing excess water from the animal. This class
of medication is only needed when fluid accumulation,
most often in the lungs (pulmonary edema), is present.
Because edema is not present until advanced heart failure
occurs, diuretics should not be used for most animals
with heart disease.
ACE Inhibitors – This class of drugs, which includes
enalapril (Enacard) and benazepril, is used to help the
heart pump more efficiently and reduce resistance to
bloodflow by dilating blood vessels. ACE inhibitors
may reduce coughing in animals with an enlargement
of the left atrium. While generally safe, these are potent
medications that can cause side effects such as kidney
damage. Animals taking ACE inhibitors should have
frequent examinations and blood and urine testing. Once
again, these medications are not needed for most animals
with early heart disease but may be considered for those
with advancing heart disease or failure.
This new medication offers several positive benefits for
dogs with heart failure. It opens the blood vessels, reducing
the amount of work the heart has to do to circulate blood
through the dog’s body. It also helps the heart pump more
efficiently. Pimobendan is often prescribed for animals
with heart disease rather than heart failure, but there is no
reason to do so as the drug is not beneficial unless heart
failure is present.
Natural alternatives
A number of natural remedies can be used for the dog
or cat with heart disease. In my practice, animals with
early heart disease (based on a heart murmur and normal
cardiac testing) are placed on one or more of the following
natural therapies.
• Coenzyme Q10 is an antioxidant synthesized in most
tissues of the body and found in all cells. The highest
concentration is found in the heart, kidneys, liver and
pancreas. It is one of several coenzymes and is required
for the conversion of energy from carbohydrates and
fats in the synthesis of ATP. CoQ10 also protects cell
membranes and DNA from oxidative damage.
Studies in people with high blood pressure showed
a reduction in systolic blood pressure when they were
treated with CoQ10. In humans with heart failure,
CoQ10 therapy also increases cardiac output, improves
contraction of the heart, and dilates the blood vessels
necessary to allow normal bloodflow through the body.
In general, 1 mg of CoQ10 per pound of body weight one
to two times daily is used for most animals with heart
disease. It’s recommended that it be taken with a meal or a
small amount of oil, since it is a fat soluble supplement.
• Hawthorn is an herb well known for its use in the
treatment of heart disease thanks to its flavonoids
and oligomeric proanthocyanidins (OPCs). Hawthorn
exhibits several clinically beneficial effects, including antiarrhythmic
properties, increased coronary bloodflow,
decreased energy utilization by the damaged heart, and
decreased cardiac excitability.
• Omega-3 fatty acids derived from cold water fish rich
in EPA and DHA – especially wild salmon, mackerel,
sardines and herring – are among the most commonly
prescribed supplements for people and animals with a
variety of problems, including heart disease.
Fish oil has been shown to be superior to statin therapy for
lowering mortality in human patients with cardiovascular
disease. Fish oil may lower lipids (especially triglycerides)
but may cause minor elevations in LDL concentrations.
It may decrease blood clotting and can also reduce
atherosclerosis, coronary heart disease, arrhythmias,
heart failure, sudden cardiac death and stroke. To
minimize oxidation, most fish oil products should be kept
refrigerated after opening.
• Homeopathic remedies can be used for animals with
heart disease. I typically use homotoxicology remedies
(made by the Heel Corporation) which are combination
remedies that contain several different homeopathics.
Cralonin is a commonly used toxicology remedy for
patients with heart disease, especially those with heart
damage and older animals with heart disease. It contains
several homeopathics including crataegus, spigelia and
kali carbonicum.
Cactus compositum is another remedy useful for animals
with circulatory disorders as well as heart weakness.
It also contains several homeopathics including kali
carbonicum, spigelia, prunus and glonoinum.
In clinical practice, I will typically combine homotoxicology
remedies with nutritional supplements and/or herbs
to get the best response.
Unfortunately, heart disease cannot be prevented. The
good news is that natural treatments may be able to
delay or prevent mild heart disease from progressing to
heart failure. |
