Soli's Holter Test

Wednesday and yesterday, me and Soli went on a little trip back to the university vet teaching hospital at Leahurst in Wirral. I have duly documented the fitting process for the monitor she had to wear, which was kept on for 24 hours.

Soli was diagnosed with DCM - dilated cardiomyopathy - last friday and was confirmed eligible for inclusion in a study into the disease in dobes that's running at the moment. The study is looking into the effectiveness of pimobendan (Vetmedin) on treating occult DCM (that is, early stage, non-symptomatic as yet) in dobes. Vetmedin is used a lot for treating symptomatic DCM but not much is known about how well it works at Soli's stage of it, simply because DCM isn't generally detected until it's quite advanced. The scan last week was to pick up any signs of it.

To get her into the study, she had to undergo the holter test to get a 24-hour ECG of her heart. We'll be back again in a month to repeat that, then 6-monthly after that.

First step was to shave three little patches for the sensors, which were then stuck on:
    

These were stuck in place with strips of elastoplast (which later become one whole strip around her body, as everything slipped and we had to go back for re-bandaging), the wires were organised and taped together and then bandaged over:
     

A walking harness was put on during the bandaging, this was used to secure the monitor itself.

Starting the test:


And securing the monitor:


Ready to go!



Thus followed 24 hours of diary-keeping, exploring and general holiday-type stuff.  We had chips on the beach (no pics, forgot my camera. Miffed!), got lost in a nature reserve (the last time I allow Soli to choose the route), frightened a poodle (sigh), got many weird looks and had cake on the bench outside the vet for lunch the next day before everything was taken off again.

We now wait for the results and for the first lot of drugs (or placebo) to come through and everything to begin properly.

DCM is an evil disease - it will kill her - which is why I am willing to include her in the study: her being in it may help another dobe and his/her family someday to beat back DCM for longer than they might be able to at the moment and that, for me, is the most important thing. Soli's time is limited anyway - her joints are progressing at a terrible speed so it may actually be them that calls it a day for her before her heart does - so I would like to help others if I can. She won't know the difference and once she starts to show symptoms, her role in the study will be over anyway so then she can go on the vetmedin for sure.

We are back in one month to have the ultrasound echo, blood tests and holter all done again, then all done yet again every 6 months after that.

Soli's Heart

Greetings from the Wirral!

Following the unexpected (and very unwelcome) news that Soli is suffering from occult DCM, we are once again in Merseyside for her Holter test.

Pictures will follow - in all my infinite wisdom, I remembered to check my camera for the SD card, and then fetch it from my card reader when I wasn't there. What I did not do was pick up the card reader itself so although I have been documenting the fitting process and will take more photos tomorrow, I cannot remove them from said camera. Sigh.

The girl herself is sound asleep next to me. She's knackered, bless her; she's had more exercise today than in the last week! It's been bittersweet - I've been wanting a little trip away from everyone with her for a while, whilst she still can; but I can see that she is getting older now, and her joints are getting worse by the day.

She's now on trocoxil - a very potent painkiller (to the tune of one tablet once a month) and one of the best - and tramadol on top of that. Okay, the tramadol is mainly to cover whatever is wrong with one foot (she seems to be reacting to something, it is VERY sore), but even with all that in the arsenal, she was still getting stiff after an hour's exploration.

This from the dog who would easily walk 3 or 4 hours plus just last year. As I said in my last post - it doesn't matter what we do to combat her heart disease, or whether she gets the drug or the placebo and so on... those joints will be the death of her.

Back from Liverpool

We went to Liverpool for the PROTECT scans on Friday - the result are a bit of a mixed bag, unfortunately.

Remy - the main concern and one both me and the cardio vet thought would have heart problems - has a perfect heart. He also, however, has pulmonary hypertension: for those who aren't geeks like me, that's increased blood pressure in the lungs. Casue unknown at this stage; cardio suggests gettnig a chest x-ray to look for lung disease. Googling has not made me happy...

Paige has an ever-so-slightly rounded heart, and low contractility (contractions of the heart are slower than expected); so no problems at present but one to watch in the future as that may develop into DCM (Dilated Cardiomyopathy - enlarged heart).

Soli - the bad news :( Soli has occult DCM. In english - she is at the very early stages of DCM; preclinical so no symptoms at all at this stage. Exactly what the PROTECT study is looking at.


So next week, me and Her Grumpness are off back to Liverpool. We go in on one day; Soli gets fitted with a holter vest - basically like a body-warmer with sensors - which she will wear for 24 hours to get a complete picture of her heart condition, rhythms, any misbeats and so on. On day 2 we go back to have it removed then come home, and the results will be in a day or two later.

At this stage it looks likely that she'll be entered into the study - I have already given consent - in which case, she'll receive either pimobendan (retail name Vetmedin, a very good treatment for late-stage DCM but the study is looking at its effectiveness on occult DCM) or a placebo.

I've been asked if I would just go elsewhere to guarantee she'd get the drug - i.e. duck out of the study - but a friend; but as much as I am tempted, I will not. I know Soli is on borrowed time anyway; her joints are progressing that fast. But I have to do the whole 'greater good' thing: the more information the vets have about treating occult DCM, the greater the chances of helping other dobes like Soli. And with her pedigree as well, the greater the chances of identifying the genetic cause which could one day lead to genetic screening, gene therapy - or even eradication of this horribly disease.

Is all that worth risking my girl, my baby, my heart dog, getting a placebo?

Yes.

Pictures

Pictures will be added and updated soon; with Paige now in the mix, my picture up top is a smidge out of date!

Watch this space...

The Dogs: Paige

Paige is another little foster who won't be leaving again. Honestly, me and dobes are a doomed combination!

I got an email a few weeks back about a small dobe bitch, chocolate and tan, needing a home due to terminal illness - could I foster? Silly question. Paige - then Xena - landed here on Friday June 18th, after a nice long trip to Chatteris in Cambridgeshire.

Small is right - Paige stands 22.5" to the shoulder (dobe bitches start at 25/26" generally), small in stature and a dinky frame too. She's around 4-6 years old - the owner reckoned 5/6 but her teeth etc suggest a bit younger. When I get the microchip and vet information through I'll be able to work it out with more accuracy.

Paige is an odd little thing: size aside, it's very unusual to see a dobe older than 3 years still with tail intact - the docking ban came into effect in April 2007 and undocked dobes prior to then were very rare.

She also has charming little forward-flopping ears - she resembles a giant Manchester Terrier (see here - http://dogbreedswiki.com/images/dogst/ManchesterTerrier2.jpg)! She's also rather plump at the moment, and needs spaying, but this is all being addressed. SHe's also now tattooed as all my dogs are - she didn't half scream, I do hate having it done but it's all over quickly and is an effective, permanent ID.

She's fitted in beautifully, and is soft as butter - with luck from Monday I'll be starting agility training with her. Just the basics for now; working her on the sidelines to develop her self control around other dogs (at present she has precisely zilch), but later on she'll join the beginner's class, once River has worked through it.

I was also able to pop her onto Remy and Soli's heart scan appointment for this Friday as she's within the age range they are recruiting. Many thanks to the staff at Liverpool Small Animal Teaching Hospital for allowing me to add her on!