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Sunday 4 December 2016

My smartphone helps me to manage my dog's heart disease

A free smartphone app makes it easy for Helena to monitor her dog's breathing

Princess is a typical example of the Cavalier King Charles Spaniel breed. She has never growled at anyone and she's exceptionally good natured. There's one catch: Cavaliers have an inherited tendency to premature ageing of the heart valves, which often causes them to become leaky at an early age.

Princess was just three years old when she developed a heart murmur. She had been brought to see me for her annual health check and vaccination, and when I listened to her heart, I could hear a faint swishing noise.

A healthy heart makes a clear "lub-dup, lub-dup" noise of the type that most people would recognise: it's sometimes used in movies and music. When there's a leaky valve, the sound changes, so that it is more like "lub-shhh-dup, lub-shhhh-dup". This is called a "heart murmur".

A minor leak does not cause any ill health, since the heart can compensate by beating more strongly. But when I first noticed that Princess had a heart murmur, I told Helena that if Princess ever started to cough, or to have other signs of being unwell, she would need to start on daily medication.

I continued to check her heart every time she came in for her annual check, and although the murmur gradually grew louder, Princess continued to show no signs of being unwell.

Then, in March of this year, she developed a number of problems. She began to cough regularly, she stopped wanting to go for her daily walks, and most obviously, she lost her appetite.

Princess normally loves her food, and when she started to turn down her breakfast, Helena knew that there was something seriously amiss, and she brought her to see me.

When I examined Princess, I noticed that she was breathing much more rapidly than normal, at over 30 breaths per minute. X-ray pictures of her chest confirmed that her lungs were being swamped with fluid because of her failing heart.

It was time to start her on long-term medication for heart failure caused by her leaky heart valves.

I prescribed a combination of four different tablets for her, to be given up to three times daily.

Each drug works in a different way to lessen the strain on her heart and to help it beat more strongly. She responded well, and when she came back for a review two days later, she was like a different dog.

Her breathing had slowed down to normal, she had stopped coughing, she was enjoying her walks, and most obviously, she was hungrily wolfing into her breakfast again.

Princess has been doing well since then. I've set Helena up with a new and useful way of keeping me informed about her progress. There is a smartphone app called 'Cardalis' that makes it easy for Helena to monitor Princess's breathing rate. She just has to tap the screen every time Princess breathes, and after 30 seconds, the breathing rate is calculated and stored.

Once a week, the app automatically sends an email to me, with a graph of her daily breathing rate. Studies have shown that an increase in the breathing rate is the first sign that a dog on heart medication is deteriorating and requires intervention.

medication

This week, I saw Princess in person for her three-month check. She's in good form, with her heart condition well controlled by the medication. She'll be staying on the same dose of her drugs for now. I don't need to see her again until September, but I'll continue to see her almost every week.

When the email of her breathing rate lands in my email inbox, I always check it out immediately.

It's reassuring to see that my little friend Princess is continuing to breathe slowly and comfortably.

> Leaky heart valves are common in Cavaliers

> Treatment is only needed once signs of heart disease are seen

> Smartphones are a new and useful way of monitoring patients

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