I am continuing the series highlighting the most common pet insurance claim by month by Petplan pet insurance company and giving my perspective as a veterinarian. This month's focus is on heart disease.
Source: Press Release
The most common heart disease in cats is hypertrophic cardiomyopathy. It is usually seen in middle-aged cats, but can also occur in very young or older cats. Some cats with cardiomyopathy have a heart murmur or an arrhythmia. Cardiomyopathy in cats is usually diagnosed with an echocardiogram (ultrasound of the heart). Anytime I hear a new murmur in a cat, I recommend an echocardiogram to determine the cause. Some of these cats will eventually develop congestive heart failure (CHF) or other complications like thromboembolism. Cats can be treated medically for cardiomyopathy/heart failure. A few cats may die suddenly without showing any evidence of disease previously.
The most common heart disease in small breed dogs is degenerative mitral valve disease. Usually, a heart murmur is present. This is diagnosed primarily in middle-aged to older dogs. Not all dogs (maybe 25 - 50%) with a heart murmur will progress to congestive heart failure and require treatment for the disease.
Symptoms of CHF are decreased activity, coughing, rapid respirations or difficulty breathing, restlessness, and fainting (uncommon). These symptoms are caused by an enlarged heart, arrhythmias, and fluid accumulation usually in the lungs and sometimes the abdomen.
A cough is the reason most people present their dog for an examination. Respiratory disease, especially chronic bronchitis, is also a common cause of coughing in small breed dogs. Therefore, the cause of a cough in a dog with chronic respiratory disease that also has a heart murmur isn't always easy to determine. Dogs with symptoms due to primarily respiratory disease usually have a normal heart rate, normal respiratory rate, and can usually lay down, relax and go to sleep. A chest x-ray will usually help the veterinarian differentiate between heart disease or a respiratory disease as the cause of a cough.
Mitral valve disease is very common in Cavelier King Charles Spaniels and likely is inherited. See this article about a surgical procedure now available to repair a dog's mitral valve. The procedure involves flying to Japan or France for the procedure and will cost $40,000 plus travel expenses. About 700 or so dogs have had this procedure done. I contacted 3 pet insurance companies in the United States who said they would cover the procedure if the condition wasn't pre-existing and it was done in the United States. So far, nobody has developed the expertise to perform the surgery in the United States.
The most common heart disease in larger breed dogs is dilative cardiomyopathy. Breeds most often affected are Doberman Pinchers, Boxers, Dalmatians, Great Danes, and Irish Wolfhounds, but any large or giant breed dog can be affected. The one exception is Cocker Spaniels who can also develop dilative cardiomyopathy. Most cases of cardiomyopathy in dogs are thought to be hereditary.
Symptoms of dilative cardiomyopathy are not that much different from those of mitral valve disease except that arrhythmias are more common. Unfortunately, the initial symptom noticed by owners in about 25% of large breed dogs with dilatative cardiomyopathy is sudden, unexpected death caused by a severe arrhythmia. Therefore, seemingly healthy dogs may have cardiomyopathy for a time before symptoms appear.
Many cardiologists now recommend that those breeds that are commonly affected be screened early in life and at least annually for "occult" (hidden) cardiomyopathy by wearing a Holter monitor for 24 hours to detect arrhythmias.
One of the best things you can do when you are told your dog has a heart murmur is to monitor his or her sleeping respiratory rate at home. This costs you nothing but a little time and can save you money by helping you become aware of the early signs of congestive heart failure so that treatment can be started early before a crisis situation develops that threatens your dog's life. You simply count the number of breaths your dog takes while asleep. Normal is less than 30 breaths/minute.
There is an App, Your Dog's Heart, that has been developed for both ios and android phones that helps you count the sleeping respiratory rate and also keeps a log of the results that you can show your veterinarian when you take your dog in for a checkup. There is also an instructional guide on how to use the app available on the website.
Besides the surgery to repair mitral valve disease, CHF can be treated with medication. Some dogs and cats will live months to years with a reasonable quality of life with proper treatment. The main treatment is a diuretic to get rid of excess fluid which isn't expensive. Another medication, Pimobendan, helps strengthen the heart and dilates blood vessels which allow the heart to work more efficiently. Pimobendan can be relatively expensive depending on the size of the dog. Other medications may also be indicated.
If your dog develops a crisis situation where breathing is very difficult, he or she will need to be hospitalized for a few hours/days for more intensive treatment, oxygen therapy, frequent monitoring, etc. which can be $1,000 plus.
There will be periodic medical progress examinations perhaps with x-rays and lab tests. So, pet insurance can come in handy to help pay for the diagnosis and treatment of these chronic and progressive heart conditions.
Do you have a story to tell about one or more of your pets who has been diagnosed and treated for heart disease? If so, please share it with us by commenting below.