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  #1  
Old 07-17-2017, 07:21 PM
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Default Lulu has Congestive Heart Failure--Long Post

I'm sorry it's been a while since I've been here--life. I knew Lulu had a cough for quite a while like she was coughing up a fur ball. I also knew that a cough was an indication of possible heart issues. I mentioned it to the vet, but he didn't seem too worried about it. He only mentioned hearing a heart murmur on her last annual vet visit, but still wasn't worried about her. I didn't know enough to put 2 and 2 together to link the murmur with the cough. We recently moved, and for a couple of weeks before the move I was packing and "cleaning" out. One week before the actual move I was taking boxes myself daily to our new home. Funny thing, every morning I could hear a crazy fast heartbeat while I was laying on my pillow, but I never thought in a million years it was Lulu's! We moved on a Saturday for 6 hours, and spent our first night at our new place. On Sunday morning I ended up at the ER vet with my mom and Gidget, our Maltese, with bloody diarrhea from nerves. While I was there, Lulu got out at our new place--looking for me I'm sure--that was probably the thing that put her over the edge. Sunday night I noticed she seemed to be breathing funny, but not enough that even I took her to the ER (HUGE GUILT). I took her Monday morning to my vet, and she was diagnosed with CHF. She had fluid on her lungs and heart, both sides of her heart were enlarged. She almost didn't make it. She spent all day at my vet and I took her straight to the ER to spend all night for observation until they felt she was able to go home. She is now on Lasix and Enalapril. She was on Pimobendan for several days, but the diarrhea and no eating was so bad I decided to take her off of it. I have really mixed feelings about that, but she was so bad off on it I didn't see a choice. Her breathing now is great 36-40. Her heart rate stays between 104-120. She still coughs--sometimes she goes long periods of time with no coughing, sometimes she coughs several times in a row.

My most urgent issue (because my overall problem is knowing this is a death sentence for her) is her absolute lack of appetite. She wants to eat, but can't seem to. She sniffs the food and walks away. She stand there and looks at me and shivers. I give her Pepto to settle her stomach-as ordered by the doctor, but it doesn't help with the appetite. When she finally eats, it's not nearly the amount she's used to. I have tried EVERYTHING! She's at the point her backbone is starting to show and you can pinch up her skin and it doesn't go back down.

I am FREAKING! Any advice is most appreciated!
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Old 07-18-2017, 01:09 AM
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I am lucky. Zarita has been in heart failure for 3+ years. The meds don't seem to bother her. I have the same three medications for her. I have the first two compounded into a liquid. The lasix is 1/2 a pill. Usually one half, unless she is coughing more then I give a second lasix (1/2). I find that the liquid is easier to give (the vet gives me a few syringes) as she really dislikes pills. Zarita never had diarrhea from the meds. The pharmacy that compounds the meds is: Diamondback pharmacy in Scottsdale Arizona. Phone # is 1-866-646-2223 Your vet will have to give them the dosage or you can read it off the label. They will OK it with your vet.

As for the appetite, I'd feed her anything she wanted. Chicken, other meats, cottage cheese, regular shredded cheese, soft food. People food is not horrid at this stage. You just want her to eat. Are her teeth OK?
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Old 07-18-2017, 01:15 AM
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As I sat here thinking about the above post, I thought that maybe you could mince the meat up? Sometimes eating actually makes the dog have symptoms. Heart has to work harder to digest food. Several tiny/small meals though out the day? Zarita likes the small soft treats---training ones the size of your pinky fingernail.
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Old 07-18-2017, 02:01 AM
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If her skin stays up when you pull it up over her neck/shoulders/back, she is VERY DEHYDRATED! Get her to the vet for some fluids!
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Old 07-18-2017, 01:07 PM
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Took her back to the vet yesterday because of her lack of appetite. Thank you, Reta, for your response. I know that normally that does indicate dehydration--which is a concern for me with her on Lasix, but I was more concerned with it's meaning in connection with her extreme weight loss. She's lost 7 oz in 3 weeks. She weighs 5 lbs 4 oz now which is the lowest she's ever weighed. The vet didn't like her weight loss, but said it was far from dangerous at this point. Just wanted to check and make sure there wasn't an underlying cause other than the meds. Thus the bloodwork--which I very much wanted any way. We never did blood work when all this happened because it was all we could do to keep her alive, then get meds sorted now fighting weight loss. Susan, thank you so much for responding!! So glad to hear Zarita is doing OK!!! Lulu has no problem taking the pills--as far as me giving and her taking. The problem came with the Pimobendan giving her HORRIBLE diarrhea and absolutely no eating. She just couldn't take it. My doctor prescribed 1/2 Lasix pill (12.5 mg) and 1/2 enaparil (2.5 mg) every 12 hours. I probably should have left well enough alone, because within a few days her breaths have come down to consistently be 36-40. Never over 40. Her resting heartrate is consistently 104-120. Never over 120. My vet says that's very acceptable, but every time she did that cough like she was hacking up a furball more that 3 times I would give her a 1/2 Lasix. I could just picture her full of fluid and drowning! When it would get within 2 hours of time for her meds she would cough more on the 1/2 Lasix and actually come get me for her meds (it could be because she liked the bit of peanut butter I hid them in). For the past week I started giving her 1 Lasix every 12 hours. My vet knows I increased her Lasix, and said it was OK if she needed it, but now I'm wondering if I'm over-reacting. He has continually told me if her breaths are good and her heartrate is good she's OK, but the coughs scare me. My husband said she's been coughing like that months--I shouldn't over-react. What do you think?

As far as food--I do mince her chicken because I found she would chew on it and not swallow if I tore it even in tiny bites. I have been putting down boiled chicken, brown rice in chicken broth, cooked hamburger meat, her Primal she usually loves, I bought Ziwi Peak again because it can be left down longer without going bad--she ate it 2 times really good, then sniffs and walks away, I even gave her some roast beef I cooked in the crock pot--the center where I was hoping salt didn't work it's way to. She ate a couple of bites and left. She did eat every bit on canteloupe I gave her but that's no nutritional value. She loves cheese and begs for it but won't eat it.
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Old 07-18-2017, 03:16 PM
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I think (and I'm not a vet) that giving Lulu 2 full lasix is too much, in 24 hours. If she coughs really often; like 3-4 times in a period of a hour then I would give 1/4 of a lasix. I use a 20 mg lasix, so Zarita USUALLY gets 10mg in the am. About once a week or so I'll give her another 10mg at night if she has been coughing. She always coughs after a nap, or in the am when she wakes up. She also has a really big abdomen, which the vet says is ascites. That means her heart is not able to clear the fluid and it collects in the abdominal area. Lasix also helps that.If you have a scale that does ounces, then you might weigh her in the am. If her breathing and heart rate are OK, then I'd say RELAX! As your hubby says--! Have you tried some cream cheese, or whipped cream cheese? Zarita loves it! Good luck, and keep up the good attitude! Dogs know!
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Old 07-19-2017, 01:38 AM
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The vet called this evening with Lulu's bloodwork. Thankfully nothing that can't be overcome. Her potassium is low. He said not dangerously low, but low at all is dangerous. I have had that worry/fear in the back of my mind as well. The vet said that comes from her not eating and can make her not want to eat only making things worse. He gave several options to get her potassium up and said overdoing wasn't possible at this point. I went straight to his office and picked up some Tumil-K to give her 1/2 tablet twice a day. He said of course feed her bananas if she will eat them. Unfortunately that's one of the only things she doesn't like when she's doing well. He also said I could sprinkle a little of something called No Salt on her food. She should not have sodium chloride, but she needs potassium chloride (or maybe it's something else I can't think of at the moment). I'm just so grateful this seems to be medication issues, and at this point I feel like we can get it worked out.

Susan, part of me really thinks I should go back to 1/2 Lasix pill every 12 hours, but the coughing has all but stopped even with the 1/2 Lasix every 8 hours. My vet said I could do whichever I felt comfortable with because he says that cough can also be collapsed trachea etc., but he also said if she's doing well on 3x a day consider leaving that for a bit. I don't want her on any more Lasix than she absolutely needs, but I'm convinced the cough is fluid or why else would it get so much better with the increased Lasix. If her breaths and heart rate are great would you back up to 2 times a day and see if the cough comes back? Thanks so much for helping me!!
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Old 07-19-2017, 04:08 PM
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Tina, yes I would go back to giving Lulu 1/2 a tablet every 12 hours. She probably will never stop coughing completely. Just so you know not to judge too much from the coughing. Of course if the coughing becomes more pronounced, then you can increase the lasix to every 8 hours. Zarita does well with 1/2 of a 20mg lasix a day. Yes lasix can cause some electrolyte problems, so that is why I think maybe a lesser dose might help. It can be a real 'trick' to see how much medication to give sometimes! Lula will probably cough after a nights sleep, after a nap, and sometimes just to get attention! Yes, Zarita has learned that too. When I tell her, 'its time to take your medicine', she will sometimes cough! Doesn't work! If you have any other questions just ask away, and I will try to give you an answer.
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