Congestive Heart Failure in Dogs – What We’re Doing Pt.4-Sophie’s Story

Previous Post Recap:

• My 13 year old Portuguese Podengo Pequeno, Sophie, was diagnosed out of the blue with Congestive Heart Failure.
• I put her on traditional medication and sought out a homeopathic vet and a holistic vet to support.
• Between us, a protocol of conventional meets complementary was created and Sophie began it.
• During this process, Dr. Adriana Sagrera, the homeopathic vet I’m working with, had a hunch and suggested Sophie have a Bile Acids test to see if she was processing proteins properly
• The test revealed that Sophie had Hepatic Microvascular Dysplasia, a condition where the liver can’t process protein properly. Sophie was probably born with it, and we never knew.
• Sophie was about to have her first acupuncture appointment to help her heart, her tremors and more…

The waiting room was small but bright and cheerful. Dr. Amy Birdwell, the acupuncturist at North Austin Animal Hospital, was about to give Sophie her first treatment. We settled into an exam room with blankets on the floor and Sophie started shaking. She’s always been nervous at the vet and she’d been seen by several in the last couple of weeks. She probably had no idea what was coming next.

Dr. Birdwell is a soft-spoken, kind, gentle person who is extremely patient. Even though the needles are tiny, at least for a small dog like Sophie, she still flinched once or twice and then, boom!, proceeded to give a shake before any of us could stop her, and out they all came. Very patient, indeed. So, Dr. Birdwell put more needles back in and we guarded Sophie to stay put with lots of treats.

The Results

 

I guess the first thing I noticed when we got home was Sophie’s head/body tremors were about 90% gone. I was so relieved, I  cried (not in front of Sophie. They take in everything we’re feeling!). She was also a bit peppier. I thought, this is great! We’ll go for acupuncture every week and this will be a wonderful support for everything else we’re doing.

I still feel that way, although the effects lasted for about two days and then Sophie was shaking her head, side to side, again.

The next few days were about ups and downs. Sophie started coughing more and not only when she was excited. Yet, the day after her acupuncture appointment, she brought me her toy when I got home, for the first time since this all began. There were signs in the positive and negative about her condition.

Then, things began to change.

What Can Happen When You Wean Off of Medication Too Soon

 

On May 3rd, I started noticing Sophie would want to poop more often and when she went, she had to try several times before she finished. Straining and loose stools. It didn’t seem to matter what I fed, as I tried several things; adding basmati rice to her meals to bind her. Sophie also started being more picky about what she would eat.

Sometimes, medications can alter a dog’s tastes. Sophie used to love raw beef; I get this beautiful rump roast from a local ranch here in Texas, where they don’t spray with chemicals and they don’t give their animals antibiotics and hormones. She would stand in the kitchen as I cut it up, waiting expectantly.

Now, she started turning her nose up at it.

On May 5, we stopped the dandelion/parsley tea at the suggestion of Dr. Sagrera, to see if that would restore her gut balance. Something was obviously upsetting her tum. Now, we were losing two diuretic herbs which were supposed to be supporting her body so fluid didn’t build up in her lungs or abdomen, especially with being on only two doses a day of Lasix, the pharmaceutical diuretic.

Each day was a desperate attempt to get her to eat. Oftentimes, she wouldn’t touch her breakfast and many of her complementary supplements were in there, so that was a big deal. I would sprinkle my cat, Suki’s, freeze-dried food in her bowl,  anything I could think of that I know she liked. I tried lightly cooking the beef. That worked for a day.

On May 7, Sophie awakened with a low vital force. I thought she had plateaued but I was now seeing a decline. She didn’t even want to get out of bed; I had to carry her to the living room and then out in the yard to do her business, which she was able to do. It was hard not to think, oh no, is this the beginning of the end?

I spoke with Dr. Sagrera that morning, and we discussed Sophie’s case. She thought giving her another dose of Sepia 12C might help. After all, it had helped nicely the first time we gave it. If I got no response this time, then we would do it again as a dilution, which means in a half glass of filtered water.  I would dose her every 15 mins for 10 doses. For the first dose, I would stir the liquid with the remedy pellet in it 100 times, this was to release more energy from the remedy into the water. I would give her a partially filled syringe of the medicine. Each subsequent dose would get 10 stirs in the glass before dosing.

In homeopathy, it is energy medicine and the remedy is coated on the outside of those little white sucrose pellets with the actual medicine. When you tap a pellet into a glass of filtered water, the energy of the medicine goes into the water. When you rapidly stir the liquid, the medicine is activated further and further, with each additional stir. So, the more you vigorously stir, the stronger, more powerful the medicine in the liquid becomes. Choosing how much to stir, how often to dose and what potency to dose with are all parts of the intricate dance that is homeopathy. You are always trying to choose a potency and frequency that is enough to overpower the energy of the sickness in the body, but not so strong that you trigger an aggravation, which can be uncomfortable and unpleasant.

After the dry dose of Sepia, that afternoon, she wanted to go out for a walk, which she hadn’t done in a couple of days. I was excited. She did something really weird on that walk. Sophie sometimes likes to take me into a strange looking townhouse complex in our neighborhood. I call it the Stepford Wives complex; all the town homes look the same and they are constructed cheaply; it almost looks like a set. After exploring each house, she chose to go into a gravel side area where the HVAC machines and the electrical meters are and lie down right up against a meter. Even though I could tell she was uncomfortable lying there on the gravel, she didn’t want to get up. What was it about being next to that electrical meter that drew her? I don’t know.

Later that day, Sophie declined a bit. Her cough had gotten worse, and Dr. Sagrera suggested I try one dose of Bryonia 30C as a bridge remedy before trying wet dosing of Sepia. I did. She stopped coughing that evening, all night and the next day. It was almost like magic, if you didn’t know the power of homeopathy. But, she still woke up with very low vitality the next morning, refusing to eat.

That night, the night of May 8 – 9, was a turning point. Sophie woke me up at 4:45am coughing intensely. It lasted until 5:15 and then just stopped. She went back to sleep and slept for a few more hours and didn’t cough at all until 9:30 in the morning. She didn’t want to eat her breakfast again.

Dr. Sagrera suggested we put her back on Lasix three times a day. It was apparent the fluid in her lungs was building and not only was she coughing more, but it could also be affecting her appetite. So that day, May 9, I did.

I also commenced the Sepia 15 minute apart for 10 doses protocol the morning of the 9th. She brightened up after and then possibly had an aggravation with more coughing. We would not give any more doses for now and let the Sepia, which had given her some goodness each of the other times administered, do its work.

What I Learned In My Follow Up With Dr. Ruskin

 

The next day I had a follow up consult with Dr. Ruskin, the holistic vet mentored by Dr. Marty Goldstein. She felt we’d tried to wean Sophie off of Lasix 3 times a day too soon. “These drugs are like crutches,” she said. “We use them until we see goodness for a good while before weaning off one by one.”

When I told her Sophie wasn’t eating regularly and having loose stools, she suggested feeding her the meat she loved. She reasoned that her Hepatic Microvascular Dysplasia wasn’t life threatening right now but her heart condition was. That eating protein was important for her heart. She also told me about the outward signs of Hepatic Microvascular Dysplasia:

• vomiting
• diarrhea
• pica (eating non-food objects)
• increased thirst
• straining to urine
• blood in the urine

If it progresses into Hepatic Encephalopathy, they show behavioral signs like:

• head pressing
• abnormal vocalization
• ataxia (acting wobbly)

With the exception of loose stools which could be from her diet change, Sophie exhibited none of those symptoms.

That night, Sophie ate her entire dinner of beef, chicken hearts, chicken livers and boiled chicken in about 2 minutes flat.

The lesson I learned here is don’t be too quick to pull back on medications when they are necessary for a particular condition, like congestive heart failure. Make sure your animal is not only stable, but stable for a long enough period of time.  And, we had to make a decision of what was the most pressing illness right now. That is her heart and if protein is good for it, that’s what we need to do right now. We can revisit a more appropriate diet for her hepatic condition once she’s truly stable.

How I’m Getting Her Meds & Supplements Into Her Each Day

 

Maybe this can work for you, if you have an animal that you have to give medicine to every day.

• meds are given with a little bowl of water and 2 filled syringes by my side. After putting the pills down her throat, I immediately slowly and steadily put water into her mouth with one syringe after the other so she has an easier time swallowing them. Each pill is followed by the water and then a treat, so she is motivated by the treat and has ample swallows to get the pills down.
• her one capsule, Systemic Enzymes, which must be given on an empty stomach and away from food by 30-45 minutes before eating or two hours after, is given with a tiny bit of ghee butter on it to make it go down easier, followed by the water. Ghee is very healthy clarified butter. It’s got great nutritional properties for people and pets like having healthy fats, strengthening the immune system, it’s anti-inflammatory and anti-cancer, it’s a source of essential vitamins and promotes healthy skin. We use organic ghee all the time in my house.
• all complementary supplements for her heart and seaweed calcium to tighten up her stools and replace any calcium she was losing go into a wad of my favorite raw green tripe from Raw Paws, with some pieces of boiled white meat chicken and I hand feed it to her, bit by bit. She’s been eating it.
• her breakfast has nothing but organ meats like liver, heart, and maybe if she’ll eat it, some raw beef. She’s lately taken to sometimes eating this again, but only from that farm I mentioned. The fattier chunks of raw beef from another brand she won’t eat. Bless her, she knows what she likes! I’ve also just started very slowly adding Green JuJu’s freeze-dried Just Greens for fiber but she’s not feeling the veggies, so I may try Inulin, a great source of fiber, and mix that into her food.
• her evening supplements again in a wad of tripe with chicken.

I know the raw green tripe is healthy for her. It is high in protein and amino acids that will help build muscle and repair tissue. Tripe is also loaded with digestive enzymes and probiotics that will improve her gut flora and digestive system.

A Great App For Respiratory and Heart Rate

 

One of the things I’m doing every day is calculating Sophie’s resting respiratory rate. This tells the vet whether Sophie is having respiratory distress. The normal range for dogs should be in the mid to upper 20’s per minute, but for an older dog with a heart condition, even going into the 30’s and 40 isn’t something the ER vet was concerned about, if everything else seemed ok. It’s getting into the upper 40’s and above where you’re running to the ER.

The app is called SRR Counter and you can get it from the app store. It’s very easy to use; you press the 15, 30 or 60 seconds bar (I use the 30) and it opens into a  window with a timer and a big blue box with the word Breath and that squiggle icon for wind. I sit by Sophie, I don’t have to touch her, and I tap the blue box on the wind icon each time she breathes. The app will stop when it gets to 30 seconds, will multiply the number of breaths by two and give you the breaths per minute.

You can do this for their heart rate too, by holding your hand on their heart and counting and pressing the window in the same way.

It’s a very handy tool to keep tabs on how rapid their breathing or heart rate is and great info for the vet, when you have an animal with a condition that requires that.

Sophie would volley between as low as 26 or 28 and as high as 44. It just depended on where she was at in that moment. Lately, she’s been in the low to mid-30’s and we’re happy with that.

Sophie’s Second Acupuncture Treatment

 

She went for her second treatment on May 9. Again, Dr. Birdwell was very patient, as Sophie moved around and those tiny needles fell out around her. I did manage to keep her still for fifteen to twenty minutes, enough for the treatment to do its work. Dr. Birdwell, who also practices chiropractic for animals, adjusted Sophie that visit, too.

This time, I didn’t see the drastic change in Sophie’s tremors. She was peppier when we got home and that was good. But, it was also the same day I did the Sepia 10 dose protocol, and that could have had something to do with it. We will continue to have acupuncture treatments once a week for now to support Sophie’s body to heal.

One thing I have to mention. Thankfully, I have insurance for all of the animals and Sophie’s been on Trupanion since we got her. In fact, she was already a Trupanion “client” when I took that picture of her above, at five months old. So, there are no pre-existing conditions. I find it odd that they don’t cover acupuncture or any complementary treatments, even though they are known to produce results. And, they treat a scheduled office exam the same way as an emergency room visit and cover neither. They are definitely helping with many things, which is wonderful, since we know how quickly costs add up when you’re caring for a sick animal. So, I’m grateful for that.

What We’re Seeing Now

 

There is a trend developing. Mornings aren’t as good as late afternoons and early evenings. Sophie has low energy in the mornings but perks up to even being bouncy and playful in the late afternoon. One exception, thus far, was yesterday where she decided she wanted to go for a walk at 10:30 in the morning and bounded to the door, excited to get out and about.

Every time I see her do this, like her old self, it brings tears to my eyes; I’m so so happy she is feeling better.

Dr. Sagrera and I experimented last night with giving her the Standard Process Canine Cardio supplement with her dinner as I wasn’t giving any heart supplements in the evenings. Maybe that would impact her energy in the mornings. It didn’t today so we’re pulling that back and seeing how she does in the morning.

It is a dance of both doing what the conventional and holistic vets know works and experimenting with it for Sophie’s own bio-individuality, how she is expressing her congestive heart failure.

Today, I am happy she seems better. Every day is a new adventure when you are living with an animal with a debilitating dis-ease.

Next Friday, May 19, after being back on Lasix 3 times a day for 10 days, Sophie will be having another echo cardiogram. We’ll see the state of her heart after some treatment. In my next post, I’ll share that and any tweaks we’re making to help Sophie get well.

To their best health ever.