# Heart Murmur/Enlarged Heart -- Many Diet Questions (Long)



## MyRescueCrew (May 8, 2008)

_Forgive me in advance if this is long-winded._

I took Jake to the vet today, and I am saddened by the news. I posted awhile back about him slowing down even more noticeably lately, and I felt that I wanted his heart re-checked. Quick re-cap - Jake was rescued after being dumped at a diff. clinic I worked at last year. He was going on 10, came with several health probs, most likely why he was dumped. He came to me with a heart murmur - stage 2.

Well, the vet listened to Jake's heart last week per my request and said his heart murmur sounded the same, still about a stage 2, not quite bad enough yet to call it a stage 3. I felt that was good, and that was that. Something kept bugging me, I just noticed he was more out of breath and more sluggish than when I got him (in august) last year. I kept contributing it to his (not that darn old) age and his arthritis.

Well, I took him back today and told the vet I wanted an EKG ran on him. So, we hooked him up and did the EKG and printed out several pages of rythmes. Jake's heart is not breathing properly -- the vet said it shows weakness on the (I believe right) side. Also because some other line thingy was jumping, he said it indicated Jake definitely had an enlarged heart, and we're going to do an x-ray next Wednesday (machine was down today, and he's on vacation after today till mid-next week).

Now, this brings me to some questions: my mother's dog came from the pound last year with several heart problems and he's on H/D. No, I do not want Jake on H/D (he was for about a month, but he hated it and vet didn't see the need to continue at the time. And I hate the ingredients). I was looking on Hill's website about the H/D to see what makes it so special, besides the low sodium. This is what I found (this is for dry):

Product characteristics:
Sodium Low 
Magnesium Added 
Chloride Reduced 
Energy Increased 
Protein Reduced 
B-Complex Vitamins Increased 
Phosphorus Reduced 
Taurine High 
Potassium Moderate 
Carnitine High 

Average Nutrient Content:
Protein 14.5 min 
Fat 16.5 min 
Carbohydrate (NFE) 50.4 
Crude Fiber 2.5 max 
Calcium 0.50 min 
Phosphorus 0.35 min 
Sodium 0.12 Maximum 
Potassium 0.69 
Chloride 0.28 
Magnesium 0.122 
Taurine 0.10 min 
Carnitine 200 ppm Minimum 

First off, Jake is now on Nature Variety's raw diet. I converted the nutrients on the raw to dry matter basis, and nearly everything is better than the H/D product. Including the high tarurine, high carnitine, low sodium, lower phosphorus, high b-vitamins, ect. 

Here's my questions on that: it says protein reduced. Why? Is high protein bad for a dog with heart problems? On a dry matter basis, the RAW will come to 41% protein, fat at 18%. 

Secondly, the H/D has a sodium of 0.12%, and the RAW has between 0.17% and 0.2%, depending on the flavors. How much sodium is too much? Is 0.2% too much for a dog with his heart problems? What about when I supplement with fresh-from-the-butcher meats, like fresh chicken, ect.? Does fresh meat have much natural sodium?

Third, H/D said Chloride reduced. The RAW does not give a chloride percentage (though I can call the company and ask). What is chloride, what will it do, and what percentage should it be?

Fourth, H/D said Potassium was moderate. H/D is 0.69% and Raw is 0.60% on a dry matter basis. Is this good? Bad? Is too much, or too little, potassium bad for the heart?

Next, I plan to supplement Jake with Taurine (and L-Carnitine) as I read this is good for a dog with heart problems. I found one site that said for dogs, a good dose is 500mg's 2-3 times a day. But does not give a weight range. He's 24 pounds, is this too much? Almost all sites said you cannot overdose, but I wanted to be certain.

I also plan to supplement with Vit. E, 200 IU 2 times a day. 

Lastly, for a dog with these types of heart problems, and his given age, is there any other supplements that would be beneficial to add? I've heard B12 or B Complex, but then I also heard that too much B Vitmins are not good. Anyone know? I also heard about Vit. C (the powdered Scorbate C, like from a specialty pet store), anyone know about that?

Any organs, meats, ect. that I should add to the diet that would be good for the heart? If so, how much and how often? Any meats or organs I should avoid?

Thanks so much in advance! I'm worried sick about him, and I'm sure I'll only get more neurotic in time, LOL.


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## cbrons (Jul 23, 2008)

I can't say anything with certainty for dogs but I do know that it might be best to go check out some stuff at the grocery store.. particularly low-sodium turkey... there definitely some options out there. I don't know, do vets give dogs beta-blockers? Maybe talk to the vet about using some human medications... Atenolol is an ancient beta-blocker that is cheap, effective, and has been around since God was a boy... Hypokalemia is often seen in humans with a variety of heart issues, there you could also see if the vet could write an Rx for potassium chloride (or supplement with something OTC that is high in potassium), you might have to crush the pills up because they are absolutely huge. I don't know about the vitamins, I could again just speak for humans. B-vitamins 6, 12, and 9 (commonly known as folic acid/folicin) help remove free radicals (the most common being the artery-damaging homocystein). I think you'd be best cutting out any type of processed kibble just...and this is because I assume these products, out of necessity, have preservatives -- the most common and most cheapest one being salt (sodium chloride). I would talk to the vet and a trusted pharmacist in your area if I were you but I definitely think it would be great to get some low-sodium raw meat. And by the way, supplementing with any of the amino acids will not do much good if the dog is deprived of protein, as a lower levels of protein = lower levels of free-forming amino acids which leads to lower levels of protein synthesis (look-up "limiting amino acids" if you want a more in-depth explanation). Supplmenting L-Carnitine is supposedly effective, acting protection against oxidative stress particularly in myocardial cells... I'm pretty sure concurrent supplementation with Vitamin C is essential for the metabolism of carintine but again, check with your vet and pharmacist.


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## MyRescueCrew (May 8, 2008)

Hi there, thanks for the info!

The vet supports the addition of the taurine, l-carnitine, vit. c and e. He said it can only help, not hurt.

As far as protein, he will be getting 41% protein, which is a lot. I was curious if that is too much protein for a dog with these particular heart problems. I know the H/D claims it had lowered protein, but I am curious as to why. I did do some research since posting this thread and found several websites that touted that high protein is actually good for heart problems, except with end stage heart failure and/or end stage congestive heart failure (neither which are a problem in this case) and which the protein should then be lowered.

The sites also stated that high protein, especially quality protein and those found in raw diets, will actually help the heart, and lower protein diets, or those with poor quality proteins, will add undue stress to the heart. I guess on that particular subject, I just wanted to make sure that all this information is correct, and if anyone knows why H/D still has 'lowered protein' in the food, which I find is too low at 14%. Again though, Jake is not on H/D, I am just using it as a comparison.

We did talk about medications, and he said he would make the decision next week after reviewing the x-ray we are going to take, to determine just how bad the enlargement on his heart is. If it's bad enough, he wants to start him on Enalapril (Enacard), but only after determining the need once we see the x-rays.

His raw diet is very low in sodium at 0.17 to 0.2%, compared to his dry kibble that he was previously only that was 0.35% plus the added can food, which made his total sodium intake nearly 0.4%. But with his raw diet now, we've cut his sodium intake nearly in half, from 0.4% to 0.2%.


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## briteday (Feb 10, 2007)

I can't tell you what's right or wrong about the protein issue. What I can tell you is that when there are chronic heart problems there tends to be kidney problems that develop as well. If the heart is having a hard time exchanging fgasses (oxygen, etc) fluid tends to build up in the system. That makes things harder on the kidneys, thus kidney dysfunction develops in most cases and is almost always present in end stage heart failure.


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## Patt (Feb 12, 2008)

Personally I would go with whatever your vet recommends for food and medications. Another thought would be to contact a pet nutritionist. 

Sending lots of positive thoughts his way.


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## CinnamintStick (Jul 25, 2008)

When my favorite cat had a enlarged heart we supplemented with Taurine. The size of her heart did not go down. About 6 months later breathing was very labored. From ex rays we could see fluid build up. When my vet removed some of the fluid we found that the fluid was blood. Had no choice but to put her to sleep.

I am more familar with reversing heart disases in humans though a vegan no fat diet.


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## MyRescueCrew (May 8, 2008)

Briteday, I'm going to request that a CBC be done next week as well to check his organs, I was already thinking about having that done to begin with, but now I definitely will. 

As far as diet goes, the vet's not much help in the nutritional area. He's a "Dog Chow" believer and is not much for all the newer holistic diets or grain free diets. He's not against them necessarily, he just doesn't "see the need". However, I found a holisitic veterinarian down in New Orleans that'll cost me a life savings just to step foot in the door (had no idea they were that expensive!) so I'm going to try and work on saving up a bit extra and take Jake to see him. But it won't be in the immediate future.

As I said, Jake doesn't have congestive heart failure, but he's been diagnosed with a Stage 2 heart murmur and an enlarged heart with weak 'pumping' on the (I believe right) side. So, when researching the protein thing online, I am still finding conflicting reports. Besides some saying to reduce the protein in end-stage heart failure (which I now understand why) many claim to raise the protein in the beginning and middle stages. However, a few other reports say to lower the protein, not drastically, but somewhat in all stages of heart problems. But none of them say how much to raise or lower, and how much is too much.

I'm worried now that 41% may be too much, even though it's coming from a raw diet with quality proteins, which is supposed to be easier on the organs.

*Confused*


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## Patt (Feb 12, 2008)

How about a consult with a cardiologist? Perhaps he would be more helpful.


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## briteday (Feb 10, 2007)

Maybe there is a local veterinary college that you could consult with.


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## Patt (Feb 12, 2008)

briteday said:


> Maybe there is a local veterinary college that you could consult with.


Good suggestion. http://www.vetmed.lsu.edu/vth&c/


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## CinnamintStick (Jul 25, 2008)

There is also http://www.petdiets.com/ that says We have no stake in the pet food industry, so feel comfortable posting your questions here and expect an unbiased response.


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