A popular song from the ’60’s says that hearts are made to be broken, but the amazing thing is how well and how long the heart can keep on ticking. In this York County Magazine article on animal health, Dr. Platt shares the basics on heart health and heart disease in pets, reporting on the symptoms of and the latest diagnostic tests for heart problems in dogs and cats. Simple preventive care from your veterinarian can help keep your pet’s heart beating strong and long. When heart disease occurs, however, the results can be serious and tragic for our pets. Relating a personal story that hit close to home, Dr. Platt reminds us how dear to our hearts our pets really are. Broken pets’ hearts break their families’ hearts. By celebrating the relationships we have with our pets, and by holding each other close, we can hang on while our broken hearts heal.
This month’s Animal Health column was intended to be a discussion of heart diseases in pets: how their hearts are similar to ours and how the problems, diagnostic tests, and treatments for those diseases are also similar. As any regular reader of these columns probably knows, I do enjoy weaving a tale or a story or sometimes a clever (or not so clever…my wife continues to lovingly remind me that I’m not as funny as I sometimes think that I am) anecdote into my “fabric of verse,” and I had intended to look for some interesting or unique segue into the subject of cardiac problems in pets.
This month’s effort, however, took an unexpected and personal turn when a pet belonging to a family member became affected by severe heart disease, and I was reminded once again how a broken heart (or a broken liver or kidney for that matter) can truly break a heart. More serious than an injured paw or hand or itchy skin, and more important than any article on vaccinations or flea control, the manner in which we as pet owners and friends of pet owners respond to broken pet relationships has very properly hijacked my thoughts and subsequently this month’s column.
Blue has been a member of our extended family for many years. A mature, slightly-overweight Chihuahua, Blue successfully multi-tasked the roles of comic relief, walking buddy, ferocious alarm dog, Queen of the couch, and beloved little girl.
She would always raise hell (can I write that?) when I would come to visit, but a soothing reminder from her “mom” that I was family and a french fry from me would usually suffice as the password to enter her home. Until this summer, the most serious illnesses she had ever experienced was an infection that occurred after I gave her annual vaccinations ( Note: a corollary to Murphy’s Law says that if anything is going to ever go wrong with a pet, it will happen to the pet of a relative or neighbor!), and a frantic emergency trip to our veterinary office in Rock Hill office up from Columbia to examine the “tumor” that turned out to be a tick!
But a combination family lunch and annual exam for Blue this summer – I am Blue’s “uncle” as well as her veterinarian in Rock Hill – revealed a heart murmur which had not been previously noted. Her annual senior bloodwork was completely normal, but the X-rays we took did show an enlarged heart. The type of murmur, Blue’s breed, and her past health history strongly pointed to “Mitral Valve Endocardiosis” as the cause of her problems. This is the most common type of age-related heart disease.
Let me briefly digress to provide some basic information on heart disease in animals to try to keep this article seasoned with at least a little medical flavor. The hearts of cats and dogs are essentially identical to ours. The heart is a special muscle; its four chambers pump blood through a system of arteries and veins to supply the body with oxygen and nutrition and to carry away waste products of metabolism such as carbon dioxide. It is a remarkable organ, pumping worry-free literally billions of times during a person or a pet’s lifetime, but when something goes wrong, it can go terribly wrong.
Diseases of the heart can be placed in one of several categories:
Congenital heart problems are those which develop even before birth, and include many different types of valve problems. Some are minor (many pets and people live a healthy lifetime with mild heart murmurs, for instance), but serious congenital problems may be untreatable and may be fatal. We carefully evaluate the heart function during initial pet exams, listening for murmurs and performing electrocardiograms as we look for signs of of congenital heart disease.
Acquired heart disease includes several types of problems which begin during a pet’s lifetime. Heartworm disease in both dogs and cats is one all-too-common example. Carried by the bite of infected mosquitoes, immature heartworms are injected into the skin and grow up into adults which move to the heart and blood vessels in the lungs, damaging the heart muscle and valves and obstructing blood flow. Dangerous and expensive to treat, fortunately heartworm disease is easily prevented with monthly medications.
Heart rhythm diseases are a group of acquired diseases which interfere with the proper conduction of the electrical activity which controls the heart function. Just as with humans, changes in heart rhythm such as Atrial Fibrilation or Flutter, Ventricular Premature Contractions, or Heart Block can result in sudden decrease in blood flow and even collapse and death. Periodic exams and electrocardiograms help us to monitor for this type of problem.
Interestingly enough, pets do not develop coronary artery disease and do not typically have “ heart attacks” as we do. Diet, lifestyle, and most importantly, species genetics prevent those issues in dogs and cats.
By far the most common diseases of the heart are age-related. Over time, the valves and moving parts of the heart can simply wear out. Smaller dogs and those with weight problems have more stress on the heart valves due to blood pressure differences, and therefore more heart disease. Signs of this type of heart problem at home include panting, coughing (especially at night or while resting), and weakness and reluctance to exercise. Diagnosis of this heart disease involves physical examination of murmurs, X-rays to evaluate the size of the heart (when heart valves leak, the extra pressure can cause the heart muscle itself to stretch and the heart to appear enlarged), and cardiac ultrasound to see the thickness of the heart muscle walls and the valves as they actually open and close.
Treatment for valvular heart disease involves medications to lower the blood pressure and open the blood vessels so the heart doesn’t have to work as hard, and drugs to strengthen the heart contractions themselves. Diuretic drugs can eliminate the fluid that builds up in the lungs or abdomen. Low-sodium diets can also help improve heart efficiency, and maintaining proper weight and muscle tone can be very important.
This is where Blue’s story intersects with this month’s article. She was diagnosed with mitral valve endocardiosis, which means that her mitral valve, chronically thickened because of age and blood pressure, began to leak and interfere with proper blood flow. Congestion developed in her lungs, interfering with oxygen availability. Her heart enlarged, putting pressure on her windpipe and interfering with breathing. When we started Blue on medicines for her heart disease she initially improved but still had episodes of stubborn cough and shortness of breath.
Late one evening, Blue’s breathing stress worsened dramatically and I received a call from my sister in Columbia. After hearing the symptoms described over the phone, I knew she needed to get to the after-hours veterinary emergency clinic in Columbia right away. Unfortunately and unexpectedly, her condition rapidly deteriorated, and despite aggressive and intensive therapy Blue passed away.
Even though I am well aware of the potential seriousness of any case of heart disease, I was shocked that she had worsened so quickly, as were the emergency vets who had treated her. But our sad surprise paled in comparison to the sense of shock, grief, and loss which was experienced by my sister. Because it was so severe, so sudden, and so unexpected, but mostly because they had a deep, close bond, losing her pet Blue also broke her heart.
I have spoken before about pet loss, in general terms when our veterinary practice in Rock Hill began partnering with Hospice and Community Care in providing a pet grief support group, and more personally when we lost our own wonderful dog Cokie two years ago. It is undeniably true that our pet relationships impact our lives in many ways, but never so profoundly and deeply as when we lose them.
Just as when we lose a human relationship, we experience different stages of grief when we lose a pet: shock, denial, anger, depression, acceptance, and peace. Professional grief counselors and psychologists tell us all of the things we need to hear: we are not “crazy” when we are so sad, we are not alone in our feelings, and we need to keep the lines of communication with family and friends open as we grieve. Sometimes we also hear things that would be better left unsaid: “it was “just” a dog”, “at least she didn’t suffer”, or my least favorite: “ just get another dog to replace her!”
Certainly many of our family and friends mean well, though some of their comments seem just plain mean. I am reminded of the Book of Job in the Old Testament, in which several of Job’s friend try to help explain why such terrible things had happened to him and to his family. They meant well, but their explanations were shortsighted and incomplete.
The reality is that sad experiences make us profoundly sad, and that is what happened to Blue’s mom. Her heart was indeed broken, and time and lots of love will be needed to help it heal. Time provides new experiences which help give us perspective; love of and from family and friends gives us the support system we need as we move through grief.
And that is the bottom line…we get through these experiences, not over them. In a way, being sad honors the ones for whom we grieve, but being sad forever is not good for our heart, either. If someone you know is grieving keep on loving them. If your’s is the heart that’s broken, know that your feelings are honest, valid, and shared by others. For me, as I contemplate broken hearts, whether it’s my sister, our friend who just lost his wife, or my new acqaintances who had lost their father in a tragic accident, knowing there is a Healer who has Himself been broken
allows us to grieve with hope for our own healing.
If you’re indeed grieving over the loss of a pet, we’ve got some resources at our office that you might find helpful. Just call me at our office number, 366-8188, and we can help get you connected with a pet loss support group, share some websites and printed resources which have helped others, and even be a sounding board if you have some questions.
“ A merry heart doeth good like a medicine: but a broken spirit drieth the bones.”
– Proverbs 17:22