German Shepherd dog

I had a friend tell me about an article she read that claimed some studies had led researchers to believe that lamb based foods may cause enlarged hearts in large breed dogs, but I have never been able to find the article. Could anyone shine some light on that one, too?

The primary cause of heart enlargement in canines, just as in humans, is a problem within the heart itself. This can range from arrhythmias which compromise the ejection of blood, to problems with valves, to idiopathic causes (genetics),  to cardiac tissue being compromised by lack of blood flow and so severely damaged that it cannot function as it should. Right pulmonary malfunction for a variety of reasons can also lead to the heart having to work harder. Tumors like hemangiosarcomas can also invade the heart tissue. Essentially, if the heart has to work harder to move blood, the muscle fibers will enlarge over time leading to an enlarged heart. Eventually, this enlargement compromises the ability of the heart to do its work.

The important thing is to get a complete and correct work up and diagnosis. There are many things that can help a dog with this problem and the sooner it is caught, the better. Of course, often the serious signs do not manifest until the dog is middle aged and by then, a lot of damage can already have occurred. Don't waste time looking for silly things like something in the environment etc. That only compromises any chance you may have to find the real problem and treat it. If it is an enlarged heart, there will be no cure possible, but the main cause, if found, can be treated. As I said, this will likely be a heart or lung problem.

Good luck.

Hodie,

I think we might have been posting at the same time.  I can't get my scanner to work, so i will just type in what we have thus far on his bloodwork. 

Apparently, they are most confused by the Sodium and Potasium levels BOTH being so low.  They say, if anything, one should be high with the other low.  From what I've been reading on the subject, we really need to get an ultrasound of the heart done.  According to my vet, he has not detected any type of mumor.  We have an appt with a Internal Med. specialist, is that a good place to start?  I kinda agree that we shouldn't be wasting our time on trying to find something environmental, simply because I have 3 other dogs, in the same area as him, who all appear to be doing just fine.  (then again, so was he up until a few hours before this happened.)  But I am glad they have ruled that out.  I just was hoping that someone who might have had something similar happen could possible give me a direction to start looking so we didn't waste anymore time. 

Christine

Just based on what you post here the information is, at best, incomplete and makes a guess as to what is going on very difficult.  Did they take the dogs' temperature? The dog probably is dehydrated and that can account for some of the abnormalities in counts.  There are clear abnormalities here and whether they are a result of the test process or are real values is a question I would have. Tests are only as good as the equipment and the techniques for blood drawing and processing are.

For example, does the dog really have an enlarged heart or could there be a tumor there as well? Or does he have pulmonary edema, for example? Did they do a Coombs test on a blood smear? Are the potassium and sodium levels correct? What is his capillary refill like and what is the color of his mucous membranes? There is no assessment here of his kidney or liver function. Nor is there a complete blood count. How can they even begin to guess without more information? 

Taking this dog to a specialist is a good idea since your vets seem stumped. Certainly more information is needed to make a guess at a diagnosis. This is best done by getting the dog to a specialist as soon as possible. There are a multitude of questions that require more information before answers can be suggested. The process begins by getting appropriate tests results. The seizures suffered by the dog may be simply because of metabolic issues and that in and of itself suggests kidney problems......

Good luck.

If he is found to have DC, you may want to read up on the use of carnitine in treatment because I'm not sure that message has gotten to the veterinary population yet.

Here is a good starting place. http://www.ncbi.nlm.nih.gov/pubmed/8576569   One of the reasons I know about it is Dr. Winters practices at a local children's hospital and back in the early 1990's was spotlighted by our local paper because she was saving children who had cardiomyopathy with this treatment (even tho at the time it was very difficult to get in this country) that everyone else had written off for dead.

For other board members just a FYI. Dr. Winter's also mentioned that carnitine had been used for years in Europe for the treatment of diabetes and she felt that every diabetic should be on it.  I ended up doing a fair amount of research about that because my sister was diabetic. This amino acid helps the liver process proteins and fats and is a major supporter of the cardio-vascular system. It is now available as an over the counter supplement but if used please be aware in diabetics it will affect blood glucose levels AND the amount of medication or insulin that is needed so it should be done with the treating physician's knowledge.

Once again god speed and our thoughts are with you.

I'd like to see the blood tests repeated. Low serum potassium indicates congestive heart failure, which fits in with the enlarged heart and fluid in the lungs. Low sodium could be the result of haemodilution, due to the dog playing in the water, and drinking more than usual. That, of course, would now have gone back to normal, assuming the dog's kidneys were able to get rid of the extra fluid. (Congestive heart failure also affects kidney function, and the dog would tend to retain fluid, thus the excess fluid in the lungs.)

The white blood cells (WBC) and neutrophils (Neu) both being high would indicate an infection.

The glucose being high (VERY HIGH!!) would indicate acute stress, diabetes, Cushing's disease, hyperthyroidism or pancreatic insufficiency.

Was the hematocrit normal (HCT)?  What's normal for the WBC count in dogs? Does anyone know?

Normal white Blood Count (WBC) : 6.0 - 17 x1000/ul - this value is really not high on the dog in question. 

Normal Glucose (GLU): 77.0 - 125.0 mg/dl  - depending on a lot of factors, again this value is high, but not astronomical. Stress, diabetes, high progesterone and other causes can lead to higher than normal values. This is not a value of concern unless it was known when the dog ate, and it could be duplicated. Time of drawing should always be minimally 12 hours of fasting which clearly cannot be the case in an emergency.

Don't forget that each type of equipment can give slightly different readings and will have slight differences in ranges of normal. also, each breed, and each dog may have values that differ from what is considered "normal".

The high glucose reading does not necessarily indicate diabetes. Ilness and stress can both cause high glucose readings plus with every everything else going on ( electrolyte imbalance etc) it's not surprising.  As Hodie noted repeat testing is in order .  Certainly is something that needs to be kept an eye on tho and short term also needs to be dealt with just so that healing is not affected.

Sunsilver, heart related problems in humans due to diabetes are usually the end result of long term diabetes not sudden onset. Sorry to hear about your friend. I have lost two family members to diabetes and so understand the loss .

Christine we're all hoping for a good outcome. Our thoughts are with you.

THANK YOU ALL FOR YOUR SUPPORT AND SUGGESTIONS!!!!! 

I am happy to announce that Shive is now at home, and resting nicely.  I got a wonderful suggestion from a board member...  And she was right on the money!!!  I BOW DOWN TO YOU, OH GREAT ONE!!!!! :) 

WATER INTOXICATION.....causes both low sodium and Potasium levels together.  Here is what the vet and specialist both agree on...

"Intake of to much water, to fast, caused his body to go into "shock", causing the seziers.  Since we don't know if or how many he might have had between 3pm and 7pm (when we found him), this could have caused the fluid in the lungs, and making the heart work harder, causing it to show inlarged on the xrays."
 

Second blood test showed his Sodium and Potasium levels normal range, his protein was still at 5.4 (levels are from 5.4-8.2).  On the low side, but not dramatic.  However, his WBC and NEU are higher then what they were last night, but vet said that could be because of the fluid in the lungs and his body trying to fight it off.  Sunsilver....the workup i have says that normal NEU is 3-12.  His was at 14.7 last night, and over 16 today, and his WBC was 17.53 last night, and was over 18 today.  Again, vet didn't seem to concerned, but sent him home with antibiotics!  Normal GLU is 60-110...his was 235 last night, over twice the normal high.  It was still a little high today, but had come down...(sorry, don't remember what that one was, but know it did come down)...so they are thinking it was up due to stress.  Because of his temperment, they had to keep him sedated the entire time he was there (he is NOT a people person outside the family)  Also, the second set of xrays today, showed his heart just fine.  It's all greek to me....all I know is that he's home!!! :) :) :)

Don't get me wrong....he's not out of the woods yet, but good enough to come home.  Vet felt that he would be more comfortable here, and there was really nothing more they could do.  The vet wanted me to take him home this afternoon, and I flat out told him NO, until we talked to the radiologst and specialist.  When I finally heard from them, I was in his office in 20 minutes to pick him up! :)  And we still have our appt. with the specialist in Columbus, tomorrow! :)

Again....thank you all very much for your suggestion, thoughts and prayers! :)

Christine

 If the white count is rising, he does have an infection of some sort. I don't buy the water intoxication as it would just be really, really difficult to drink so much water that it would result in a problem as you describe unless he has a specific type of problem and this would likely have shown up before now.

An "enlarged heart" does not disappear overnight. Bloodwork should have immediately been done to rule out kidney and liver and other hematologic problems. In any case, water intoxication would more likely have produced hypoglycemia, not hyperglycemia. I am also not confident that both hyponatremia and hypokalemia would appear in such a condition for physiological reasons I have been taught.

Keep that appointment. Sometimes vets make explanations fit the story told by the owner, especially when they do not know what else to suggest. There is a lot more to investigate before accepting this diagnosis in my opinion.

In any case, I am glad the dog seems to be doing better. Good luck. 

 There is epilepsy that can appear and drinking "too much" water (which for another animal would be "normal" may be able to precipitate it. In very rare cases in humans there have been long distance runners, for example, that drank so much water that they essentially diluted critical electrolytes down below life sustaining levels and suffered cardiac arrests etc. So yes, it can happen, but as I said above, there are a multitude of reasons to keep the appointment with the specialist. My guess is the dog had already suffered a seizure when you found him unresponsive. Earlier, he was in trouble and that was manifested by a lack of energy which was assumed to be his being sleepy and lazy from the days' activities. The important thing is to find out why he seized.....that may well lead you back to the answer for this.

Keep us posted. It is an interesting case for certain.

Best wishes and I hope the dog does well.

That's great news, isn't it? I worked for 4 vets over a 15 year span. One was associated with the vet school here at Penn, a genius IQ and graduated summa cum laude from Northwestern. A truly brilliant diagnostician;  IMO the most important skill needed for any vet to be worth his or her salt.  Every now and then even he ended up without a diagnosis and the dog went on to get better with a shot gun treatment protocol to never have a relapse. Your dog could well be one of those puzzling cases that is never "solved" 100%.

Some vets do not appreciate it at all  when owners offer diagnostic or treatment "suggestions" so be careful and try to assess whether or a particular vet might be receptive to that sort of thing. Some consider it a form of critisicm and retaliate in ways you do not want to hear about, the least of which is jacking up the bill.  It seems they can't handle - so and so said this or that may be wrong with Rintie. Might be better to say - I was trying to read up on these symptoms and was wondering if it might be this or that. Since I'm not a vet I thought I'd ask  your opinion.......

Good luck with him. I have a feeling he is out of the woods now.