Really concerning symptoms after exercise in dog w/ congenital heart murmur -- Video Added #15

[supaflyskye]

We have already been to see the vet, & have another appointment on Monday for chest x-rays & a blood pressure reading.

I have a 6-y/o muttly mutt – about 53lbs (the runt of her litter) & aesthetically speaking looks mostly like a German Shorthaired Pointer/Pitbull mix, though I know she has a wide variety of different breeds in her genetic background. She has had a grade 2 (out of 6, vet says if graded out of 5 it would be more like “not quite a 2”) heart murmur since birth, but it has never caused her any problems historically. She has always been a very high energy, playful dog – nothing makes her happier than to run & jump, stretch her legs & have fun.
But recently, over just the past ~week or so, she has completely lost her stamina & has been displaying some very concerning symptoms after exercise.
After even only just 3-5 minutes of actively playing, she becomes very exhausted. And what is most distressing – she becomes very weak & uncoordinated. She stumbles around crashing into things, if she can even walk at all; her legs give out on her & she falls down and is not able to stand back up. This only lasts for around ~15 minutes though, then she seems to be just fine & recovering from exercise normally.
I started hosing her off after exercise, to try & help cool her down more quickly; and I tried to make our play sessions a bit less “intense,” but it seemed to have no effect on how quickly she wears out and ends up weak & uncoordinated.
This is just so very strange for this dog – normally she can tear around for literally hours w/ virtually no sign of fatigue. She is practically a perpetual motion device.
She is not coughing excessively during/after exercise or anything like that…it’s mainly just this dramatic weakness & lack of coordination. She’s eating & drinking well, doing her potty business normally, etc. When the vet was looking at her yesterday, he seemed a bit perplexed & told me that just based off examining her in the office, that he’d think she was practically the ideal picture of a perfectly healthy middle-aged dog.
He (the vet) gave me some things to look for and to try if she has another “episode” in the interim before we get started on further diagnostics at our appointment on Monday. He said it could be any number of things – a problem w/ her heart, a blood sugar issue, a condition affecting the muscles, or something else entirely.

I’m just very worried about my dog, she is literally my best friend in the world…& I don’t like being basically unable to help her or do anything about the problem, while just sitting around waiting for answers, essentially.
Has anyone seen something like this before?

EDIT: Here, have a photo of Nika noodling just for funsies – https://scontent-sjc2-1.cdninstagram…61605888_n.jpg

[snowblaze]

With the sudden onset, this may not be the problem, but there are several types of exercise induced hyperthermia and malignant hyperthermia found in dogs. it has to do with calcium channels not working correctly and is still being researched. If her temperature spikes up during an episode, it may be something to consider. [h=3][/h]

[stargzng386]

Try to videotape an episode for the vet to be able to see it. Hopefully they can figure out what’s going on.

[jetsmom]

What temperature are you exercising in?

[Marshfield]

Cardiologist visit asap

[supaflyskye]

@jetsmom

What temperature are you exercising in?

It is hot. I live in SW Florida…it’s always hot. We’ve been having highs in the low 90s lately, very humid.
In the summer months though I try to get most of Nika’s exercise in during the cooler parts of the day, & stick to the shade as much as possible.
We just spent basically the whole month of July up at my family’s summer house on the beach in New England – it was hot there too (& we do not have A/C up there), but not nearly so humid. I first noticed Nika seemed to be lacking in stamina/unusually quick to fatigue right after we arrived back home in FL, & I figured she just needed a little time to adjust back to the nasty Florida summer weather, since she’d been 100% fine – her usually tireless self – throughout the entirety of our time up North. We stopped walking because she was wearing out so quickly & would end up “all plopped out & stretchy” after not even a couple miles, & I switched to keeping her exercise mainly to playtime in the yard (usually either fetch w/ the frisbee or chasing the lunge whip as if it were a giant cat toy) so that she’d have an easier time keeping to the shade and so I could more readily cut things short if she seemed to be really wearing out.
However, we’ve been back in FL for 3-4 weeks now, & she’s only becoming more & more quickly and dramatically fatigued, & has now (last Friday was the first time it happened) started to display this weakness & lack of coordination after exercise.
I don’t doubt that the heat certainly plays a part in exhausting her more quickly, it’s what I initially assumed to be the cause of her decreased stamina …but really, it’s virtually always hot & disgusting here – it’s not uncommon for us to have temperatures into the high 80s even in the dead of winter (December, January). In the past Nika has had no trouble taking long walks or playing extensively even in the summer heat; but lately she is collapsing & unable to stand after literally less than 5 minutes of playing, even w/ short breather breaks worked into those 5 minutes. Nothing like that had ever happened before a week ago.

She’s been really going crazy having not had enough exercise recently…but I’ve now been scared to let her play, since every time she does she ends up scaring the crap out of me w/ these symptoms.
I asked the vet if I should avoid exercising her…and he didn’t really give me a firm answer. Initially he did not seem to understand just how quickly these symptoms come on, & suggested that I just “take it slow & easy” and only play w/ her for “maybe 15 minutes at a time, several times a day.” When I emphasized again that I thought 15 minutes of actively playing might actually kill her, and that we had not been able to even get 5 minutes in before she completely lost her coordination, he seemed kind of surprised & just went on some more about how she seemed so perfectly fit & healthy standing there in the office.
I will have to do what @stargzng386 suggested & take a video if it happens again before our next appointment, so the vet can properly see what is going on.

[supaflyskye]

@Marshfield

Cardiologist visit asap

My usual vet seems to think it best that she get her chest x-rays & B/P reading from them, then an ultrasound from the cardiac specialist (if necessary?). Because apparently it will be only about ~1/3 of the cost to have them do it versus the specialist, & they can just as easily just send the x-rays/etc over to the specialist if/when necessary.
I hope that this is indeed the right move.
I was definitely not complaining to my vet about potential costs or anything…in fact I stated directly that I was much more concerned about making sure my dog was healthy than I was about any monetary issues, & that I was willing to do whatever was necessary or recommended in order to ensure her health…but he seemed to make a big deal out of the basic diagnostics being much more affordable at their clinic versus the specialist, indicating it would be best to do what we could at my usual clinic before having further testing done by the cardiologist. I’m all on board for that, I’m certainly not going to complain about paying less money – as long as it will not result in any potential detriment to my dog’s health.

[GoodTimes]

Follow the advice of your regular vet. I’m a cardiac sonographer (human echo’s) and what you’re describing doesn’t really sound cardiac to me. Granted I don’t know if it’s stenosis or regurgitation based on your description. If you put your ear to her chest can you hear a murmur (whooshing sound)?

[supaflyskye]

@GoodTimes

Follow the advice of your regular vet. I’m a cardiac sonographer (human echo’s) and what you’re describing doesn’t really sound cardiac to me. Granted I don’t know if it’s stenosis or regurgitation based on your description. If you put your ear to her chest can you hear a murmur (whooshing sound)?

Thanks for your input.
Yes, I can hear the murmur if I put my ear to her chest/stomach, or feel it w/ my hand if she’s positioned the right way. Sort of a ba-boom-woosh heartbeat.

[S1969]

@supaflyskye

My usual vet seems to think it best that she get her chest x-rays & B/P reading from them, then an ultrasound from the cardiac specialist (if necessary?). Because apparently it will be only about ~1/3 of the cost to have them do it versus the specialist, & they can just as easily just send the x-rays/etc over to the specialist if/when necessary.
I hope that this is indeed the right move.
I was definitely not complaining to my vet about potential costs or anything…in fact I stated directly that I was much more concerned about making sure my dog was healthy than I was about any monetary issues, & that I was willing to do whatever was necessary or recommended in order to ensure her health…but he seemed to make a big deal out of the basic diagnostics being much more affordable at their clinic versus the specialist, indicating it would be best to do what we could at my usual clinic before having further testing done by the cardiologist. I’m all on board for that, I’m certainly not going to complain about paying less money – as long as it will not result in any potential detriment to my dog’s health.

Why didn’t they do hen you were already there? What did the vet do at the first appt? Did they pull blood for standard labs?

[supaflyskye]

@S1969

Why didn’t they do hen you were already there? What did the vet do at the first appt? Did they pull blood for standard labs?

They did nothing at all except a quick physical exam! I was kind of surprised & thought that they would at least pull blood.
We were squeezed into the last slot of the day when we were there on Wednesday, & the vet said he wanted us to come back Monday for “the last appointment before lunch,” because Nika was very nervous (she’s always anxious at the vet’s office) & he did not want to overwhelm her or end up being very rushed to get everything done thereby making the experience much rougher on her. He indicated that in being there on Monday right before lunch, that we would have plenty of time to make sure she was calm & relaxed (to make a B/P reading more readily possible) & to ensure everything goes smoothly & is not unnecessarily frightening for her …which I do appreciate, I suppose…but I am also very concerned & want answers ASAP!

EDIT: The vet I saw Wednesday was a different vet than I usually see (the clinic has several veterinarians working there), & I did really like that he was a much “softer touch” w/ Nika – he did not make her get up onto the moving table because she was anxious about it, & did not have the tech forcibly hold her still & away from me when he was examining her, just basically let her sit in my lap through the whole thing because she was still as long as I was petting her. Nika really liked him. But I honestly think I would’ve preferred that he be a bit more…alarmed? Haha, if that makes any sense at all. Because I am alarmed by her symptoms.

[Kyrabee]

Get the ultrasound sooner than later. Heart failure has an insidious onset. My dear little beagle…it was summertime and hot. Neither dog ( elderly siblings–13yo) was very active so I didn’t push the exercise…dog days of summer and all. When the weather cooled off and we went to resume our walks, poor Peanut couldn’t even make it around the corner. We started work-up and after about 3 weeks when I finally got the diagnosis of CHF, she did not respond to any of the meds. She did have right sided heart failure which is harder to treat but damn. I had to euthanize her less than 2 weeks after her diagnosis. I don’t know if that 2-3 months would have made any difference but by the time I took her in she was getting quite edematous and labored breathing and she had none of that over the summer.

If I had do-overs, I would have taken her in when she had more issues with exercise in July or August but I attributed it to the heat. That certainly didn’t help but I think we would have had better luck to treat earlier.

Good luck with your pup.

Susan

[barngirl77]

Since your dog has a history of a heart murmur I think that having a cardiologist perform an echocardiogram and an ECG are important. Your dog may also need to wear a Holter monitor to detect an arrhythmia that may only occur during exercise. However, I think it is also important to do blood to rule out metabolic and electrolyte abnormalities and Addison’s disease. I also think that a neuromuscular disorder is a possibility and would consider testing for myasthenia gravis.

[supaflyskye]

Update:
Per the vet today, both Nika’s B/P & chest x-rays were “perfect.” Basic full blood panel currently being run, results should be in tomorrow, looking for Addison’s most specifically I think.
If basic bloodwork comes back w/ no issues of note, she will be tested for myasthenia gravis.

I was very hesitant to do much active exercise w/ her, but did play w/ her for a few moments (about 4 minutes), long enough to get a video to show the vet. He did indeed seem more “alarmed” (for lack of a better word) after watching the video, although her symptoms captured therein were much milder than during the previous “episodes” she has had – I was quite reluctant to let her go “all out” while playing & cut it short quickly once she began showing signs of fatigue.

I will try to get that video uploaded tonight, so you all as well can better see what exactly I am referring to.

I’m very concerned still.

[supaflyskye]

Vet called w/ lab results – everything completely normal on basic blood panel.
Will be back into the clinic tomorrow to have blood drawn for the myasthenia test.
=/

Here is a link to the video I took showing a mild episode of the symptoms she is having, after about 4 minutes of playing (pretty early in the morning, it was not too hot, relatively speaking – I don’t think any higher than around the mid-80s at most?):
https://youtu.be/eZ1BQxe_kB8
PLEASE ignore my horrible annoying & repetitive voice through the whole thing. :dead: I’d been playing w/ her out in the front yard & we had just come inside, I was trying to get her to come out onto the back patio so I could hose her down & maybe help her recover more quickly. I wasn’t able to get her out there though until about ~10min after taking this video, when she was starting to feel much better. When she’s having one of these episodes, it’s almost as if she can hardly even hear me or process anything I ask of her (to come to me, to lie down, etc, etc), when normally she is extremely attentive & responsive at virtually all times – almost like she’s in some kind of daze.
I don’t know, I don’t know, I just don’t know.

[horsenut_8700]

If it was my dog I would still be pursuing a cardiology consult asap. Good luck- I hope you figure out what it is.

[jetsmom]

The reluctance to walk almost reminds me of a horse tying up.
I think you need a cardiology consult, as suggested by posters above.

[Polydor]

No suggestions but lots of jingles!

P.

[Lazy_Palomino_Hunter]

Hey OP - just wondering if you had any updates on your girl?

[supaflyskye]

@Lazy Palomino Hunter

Hey OP - just wondering if you had any updates on your girl?

Blood was drawn for the myasthenia gravis test on Wednesday, but I’m told it will take 7-14 days to get results back. So now we’re basically just playing the waiting game. =/
My vet doesn’t seem to indicate there’s anything essential we should be doing in the interim.

I am in the process of drafting an email regarding the issue, to my aunt who is a small animal vet w/ her own practice out in CO, basically just in order to get some kind of “second opinion.” I am mainly inquiring as to her thoughts on the necessary urgency with which I should be pursuing a consult from a cardiac specialist. My vet almost seems to be…“going out of his way” is not the right term, but he seems to be putting a lot of emphasis on things being done at my usual clinic where he works. The way he talks about it is almost like he would view it (any diagnostics/etc needing to be performed by a different facility) as some major hassle or inconvenience (to me?) that I should want to avoid if possible, despite the fact I have emphasized to him more than once that I am far more concerned w/ the health of my dog than anything else, and am fully ready, willing & able to do anything reasonably necessary or recommended in order to ensure her immediate & long-term health.
^^ I am not sure if what I am trying to convey there comes across making sense, as it is written; I hope so. I’m sorry, I sometimes have trouble getting my thoughts out in a readily understandable format.
Anyway, the email to my aunt is taking me a while to get finished up, because I tend to be a very…wordy person & a slow writer, & I want to ensure that I am thorough in explaining everything so she has all the pertinent details to give me the most informed opinion possible. Hopefully should get that sent off this afternoon though.
I thought about emailing her last week, but my other aunt (her sister) has just a recurrence of brain cancer & I know she has been preoccupied by that, I did not want to bother her unnecessarily.

I’m rather stressed out just sitting around waiting.
Thank you all for all your suggestions though! I do really appreciate it. There are some things which I will be bringing up w/ the vet next time I talk to him (BCC, cardiology, +).