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Canine pulmonary hypertension is a condition where there is an abnormally elevated systolic blood pressure. This is documented to be at about >70mmHg and is known to be the top number measuring pressure as the muscles of the heart contract. Diastolic pressure is the lower number and measures pressure when the heart is resting. In normal heart function, the right ventricle (the lower right pumping chamber of the heart) receives blood from the right atrium (that amasses blood from remote places of the body) and disperses it to the pulmonary arteries that are responsible for carrying the oxygenated blood to the lungs while ridding the body of CO2. When a dog suffers from pulmonary hypertension, vasoconstriction occurs, resulting in the narrowing of the blood vessels thus restricting blood flow. In addition, it produces an increasing amount of vascular resistance, where the resistance must be overpowered in order for the blood to circulate to the lungs and the other organs of the body. With the passage of time, the lungs, arteries, and heart become impaired. The lining walls inside of the arteries thicken and do not allow an adequate amount of blood to flow freely to other major areas and organs of the body. The minuscule capillaries in the lungs become restricted, forcing the heart to work harder to push blood through, leaving very low oxygen levels to circulate in between the heart and lungs. As the heart works to overcome vascular resistance, the right ventricle of the heart dilates and expands, and the left ventricle fills with blood abnormally. In all essence, your dog will suffer from low levels of oxygen that inhibit his health.
Canine pulmonary hypertension is a rare disorder that occurs as a result of a variety of diseases and ailments. With this condition, elevated blood pressure forces a greater resistance to oxygen-rich blood passing through to the pulmonary veins, arteries, and capillaries that lead to the bronchi, causing heart failure. Middle-aged to older small breed dogs are prone to this condition.
There are two types of canine pulmonary hypertension.
Primary Pulmonary Hypertension
Secondary Pulmonary Hypertension
The most noninvasive way to perform blood pressure analysis on your dog is to use the standard oscillometric method that uses a sensor attached to a cuff that is wrapped around one of the limbs. The sensor has the ability to monitor pulse pressure readings within the blood vessels. Standard testing for your pet during this diagnostic visit will include complete blood count, serum biochemistry, and urinalysis. Chest x-rays may be able to shed light on other illnesses that could be present, and provide evidence of right-sided heart enlargement, neoplasia, or pneumonia. A test may be conducted to eliminate a diagnosis of heartworm invasion as well.
The use of ultrasonography or an echocardiogram (cardiac ultrasound of the heart) is most effective as a non-invasive procedure to help eliminate possible underlying causes for the pulmonary hypertension. Cardiac catheterization requires anesthesia and is extremely invasive, a catheter is inserted into the central pulmonary artery to assess measurement of blood pressure. However, it can be only performed by a surgeon who is both highly qualified and experienced, therefore it is uncommon because it is costly and intrusive.
If your dog is suffering from symptoms of severe oxygen limitation such as syncope or cyanosis, oxygen therapy must be immediately given in order to stabilize him for treatment. Treatment for a known underlying disease process will be paramount. Diuretics (Spironolactone, Furosemide) can be used in relation to congestive heart failure. Heartworm disease medication can be given monthly or be given via intravenous injection. If your dog is suffering from a chronic lung disease such as pneumonia or bronchitis, bronchodilators (Theophylline) work well as a vasodilator to lower pulmonary artery pressure. Antibiotics and corticosteroids may be prescribed to reduce inflammation.
If the hypertension is caused by thromboembolism, medications are used to inhibit coagulation and platelet numbers (thrombocythemia). Vasodilator therapy will likely be long term. A newer medication that is used is called Sildenafil Citrate (Viagra in humans) or Tadalafil (Cialis), which are medications that possess the ability to pacify the lungs, allowing blood to flow liberally and reduce the pressure of the heart. Studies have shown that the uses of these medications result in significant lowered pulmonary arterial pressure.
The outlook for recovery for canines with pulmonary hypertension can be average to poor. Medication is used to alleviate and treat the symptoms to prevent deterioration but do not provide a cure. With Sildenafil therapy for example, the survival rate has been reported to increase a pet’s lifespan by up to 2 years. Prior to this new therapy, patients succumbed to fatality days after receiving the diagnosis. The best way to treat hypertension in your dog is to do all means to prevent it from worsening. In addition, be sure that your dog is not stressed or anxious, and try not to allow him to get too excited.
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1 found helpful
Hi my dog has pulumary hypertension she had all the tests needed. She was put on viagra she is a boston terrier 13 years old. The medication makes her so weak and she has not eaten in days but she does drink. They now gave her mirtazapine she has been on that for 48 hours no change also on atenolol. I took her to ER they said vitals are stable so my question is . Is there ANYTHING else that can be done? Any injections to keep her around a while longer? Shame they don't do surgery as i would pay whatever it cost. Any advice would be great i asked about steroids they said they don't use that yet when i look on google i see some vets prescribe for that somethimes thanks so much
July 26, 2017
Treatment of pulmonary hypertension is generally treated with medication that dilates the blood vessels reducing the blood pressure by increasing the volume available. Drugs like Viagra (sildenafil) and Cialis (tadalafil) are the treatments of choice; Viagra dilates blood vessels which is why it is used for erectile dysfunction (was an accidental discovery), but the side effects can include headaches, dizziness, lethargy etc… Other medications maybe more suitable but would be dependent on the underlying cause (heart valves, parasites, medications etc…); this would be a conversation to have with your Veterinarian. Regards Dr Callum Turner DVM
July 26, 2017
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