Millie was a 10-year-old, female neutered Cavalier King Charles Spaniel (CKCS) dog. She had been with her owner, Claire, since birth. Millie was described as a well dog, in good body condition score with no outward clinical symptoms. But at her annual check-up, Claire was about to get some bad news.
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Millie presented to the practice for her annual vaccinations and preventative healthcare appointment one January. During the clinical examination, Max – the vet – detected a moderately loud (grade three out of six) systolic heart murmur when listening to Millie’s heart.
Heart murmurs in older dogs
Max discussed this with Claire, whom, having had the breed for years before, was aware that Cavaliers as a breed suffer quite commonly with mitral valve disease (also known as mitral valve insufficiency or degeneration, or endocardiosis). He went on to explain that nowadays, investigation and treatment options had progressed and that in addition, management had changed quite significantly. As such, it would be prudent to get Millie examined by echocardiography (a heart ultrasound) as soon as possible, to confirm the presence of mitral valve disease, assess its severity and to help determine whether any medication would be necessary at this point. Millie’s owner was shocked to hear the news; however, she trusted her vet and knew that he would be making the most appropriate investigation and treatment recommendations.
The next week Millie came in to have her echocardiogram performed
The vet discussed matters further with Millie’s owner and also thought it would be sensible to perform chest x-rays, take a blood pressure measurement and to obtain some blood samples to assess Millie’s overall health. This would be sensible as, following the echocardiogram, there may be a subsequent need for medication. Millie’s owner had already consulted her health insurance policy documents at this time; and realised she had full lifetime insurance cover for Millie. She was therefore reassured that the vet was proposing to undertake a comprehensive set of tests to assess Millie’s cardiovascular system and overall health; whilst also knowing that there would be no concern in the future covering Millie with ongoing insurance cover.
Millie was a calm gentle dog and underwent the echocardiography conscious without the need for sedation. Sadly, the results did indeed confirm the presence of mitral valve disease. And the measurements sadly had already reached an abnormal level (compared to the expected measurements for her breed and weight).
Millie was described as being in Stage B2 Mitral Valve Disease
This is where there is a moderate heart murmur on auscultation, coupled with heart enlargement. Millie’s X-rays showed an enlarged heart too, but there was no concern with heart failure yet. Fortunately, there were no signs of fluid building up in the lungs or great vessels of the chest. Her blood work was unremarkable; her liver and kidneys were working well and there were no other concerns raised. And her blood systolic blood pressure was at the high end of normal, as might have been expected.
Following the investigations, the vet called Millie’s owner to discuss the findings
Max said that it was advisable that Millie start medication at this stage. Recent research has conclusively proven that early medication can delay the onset of heart failure and slow the progression of the heart into failure. He also went on to describe additional helpful measures that could be taken by Claire, for example learning to count Millie’s resting respiratory rate at home and modifying her exercise regime. Claire was also encouraged to assess Millie’s exercise stamina and tolerance, moving forward, and listen out for the development of a cough.
A month’s worth of medication was initially prescribed
The plan was to see Millie back at the end of the month, to listen to her heart again and check for any rare side effects of the medication. In addition, this review would enable the plan going forward to be further explained and determined. Max explained to Claire that pimobendan would likely be a medication that Millie would stay on for life. Furthermore, given that mitral valve disease is degenerative and progressive in nature, that it would be prudent for Millie to undergo further heart ultrasounds periodically to look for any progression and change to the heart disease. If changes were to occur, or symptoms to develop, additional medication and investigations may well be recommended.
The medication was expensive – especially as she’d need it for life.
So Claire was enormously grateful she’d taken out a lifetime insurance policy for Millie many years ago. Whilst she had no prior need to have made an insurance claim previously, it now meant that at least the financial worry of looking after Millie was negligible and she could focus all of her energy upon Millie ensuring that she maintained a good quality of life for the foreseeable future.
There are so many medical conditions which, once diagnosed, require treatment and monitoring on a long term and potentially lifelong basis. Millie was a prime example of this. The availability of a health insurance policy meant but Millie could continue to receive optimal veterinary care moving forward.
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