# Enlarged Heart, Constant Pneumonia



## wee32 (Mar 6, 2009)

Hi all -

This is my first post here. If anyone has info, I would really appreciate it. My Golden/English Setter mix Holly appears to have some problems that are supposedly common to Retrievers, but I can find almost no info about it.

She is 5 years old and has been in good health her whole life except for a pink nose & pink pads on her feet. We just moved to Texas, and she immediately began to be sick.

After fiddling around with one vet who was in a race to drain us financially before she died, we found a really great vet who immediately referred us to the Texas A&M Vet School, where Holly has an appointment on Monday. Thankfully we live within driving distance now, which makes it feasible to take her.

Basically, her heart is seriously enlarged & is pushing her trachea up. She is now having back-to-back episodes of pneumonia and bronchitis. She has it again after less than two weeks well, and we are crossing our fingers that she will even make it to her appointment with the cardiologist at A&M on Monday.

She has had a weird, infrequent cough all her life, but it appeared to not cause her any problems so we ignored it. She never demonstrated it for a vet. Now it has turned suddenly into a terrible strangled-cat sound many times a day, and appears to be related to the heart pushing on the trachea.

She is supposed to have an ultrasound and some other tests on Monday, but if it comes back that she has a heart defect or tumor and we're faced with either 1) spending many thousands on open-heart surgery that may or may not work, or 2) letting her suffer with non-stop pneumonia and feeling horrible until her heart gives out... then we'll likely have her put to sleep on Monday.

I'm a stay at home mom and Holly is my dog. She's been my constant buddy for 5 years now, shadowing me around the house and lying on my feet whenever I'm still. I can't imagine what I'll do without her. We also have an extremely decrepit 12-year-old Saint Bernard. We wouldn't have guessed in a million years that the Saint would likely outlive her.

In the meantime, all I can find are vague references on vet sites that say "golden retrievers are overrepresented" in heart tumor / enlarged heart cases. We nearly lost her to pneumonia, and would have if my mother-in-law (bless her heart) wasn't such a worry wart - so I wonder if most dogs don't survive this condition long enough for much to be known about it.

My poor girl feels terrible and doesn't want to get up this morning. As much as I love her, watching her suffer is worse than the thought of losing her. I'm very sad this week about her.

Does anyone know anything about this, or been through it before?


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## Ljilly28 (Jan 22, 2008)

This is such a very sad post, and I am very sorry about what you are going through. Holly is just too young for any of this, and the sorrow comes through in your words. Does Holly have cardiomyopathy(sp)? The only thing I know about enlarged hearts in dogs is that it can be made worse by lamb&rice foods without taurine replacement, and that extra taurine and vitamin C alongside the medicines prescribed by the vet may help. Low sodium diets like (Hill's h/d) and enalapril are maybe what your regiular vet has your dog taking right now? It isnt a good prognosis in humans, but I am not sure about for dogs. The complication with her trachea is a heartbreaker. It must be very hard to see her feeling so sick. All well-wishes, hopes, and prayers are with you as you go university specialists. Vets on that high level can do amazing things. If they cannot, and you have to say goodbye so she wont suffer, you will know you did everything you could.

There seem to be lots of (complicated!) interventions the specialists might try to get some quaility of life back for the girl, even simple things like fish oil and less sodium. Best, best luck with this!

Googlescholar can be better than regular google for vet info, although sometimes you have to pay for the small vet journal articles. Sometimes, there's good free info. When it's my own dogs, I get too scared to process info very well. . .the panic makes it hard for me to think so the forum really helps.



> furosemide, an ACE-inhibitor, digoxin, and sodium-restricted diet. Fluid retention is controlled with furosemide (2–4 mg/kg PO q8-12h) and sodium restriction if possible. Digoxin therapy is initiated unless there is a contraindication (moderate renal failure, complicated ventricular ectopics). An ACEI is prescribed for once daily use (with a typical dose of 0.5 mg/kg PO for enalapril or benazepril), and the dose increased to twice daily after one or two weeks of home care. Where available, pimobendan (a phosphodiesterase inhibitor-calcium sensitizing inotropic drug with vasodilating properties) should be considered based on limited but promising clinical studies. Spironolactone (12.5 to 25 mg PO q12h in a large dog) may be added to block the cardiotoxic effects of aldosterone and impede sodium retention in the distal nephron. A beta-blocker may be considered to blunt the cardiotoxic effects of the sympathetic nervous system; however, heart failure must be well controlled first. The beta-blocker of choice in human patients is carvedilol. This drug is both a beta-blocker and alpha-adrenergic blocker (which helps to reduce the afterload on the left ventricle). Carvedilol also had anti-oxidant properties that may benefit the myocardium. Unfortunately, the prescription drug (Coreg) is expensive. Dosing can be difficult even in large dogs that may not tolerate the negative inotropy of any beta-blocker. Thus, low initial dosages are mandatory (start with ¼ to ½ of a 3.125 mg carvedilol tablet q12h). Drugs such as propranolol (0.1–0.25 mg/kg PO q8-12h) are easier to dose, but have the disadvantage of greater “inverse agonism” (inactivating the active state of beta receptors) and causing greater negative inotropy. Metoprolol long acting (3–12.5 mg q12h) has been studied in experimental canine heart failure, but the drug is difficult to dose at less than 12.5 mg, which is too large for an initial dose. While there are clear theoretical benefits of beta-blockers in canine DCM, one’s practical ability to initiate and maintain treatment may be very limited and CHF can worsen (often with pleural effusion). Certainly, when AF complicates CHF, either a beta-blocker or diltiazem (0.25 to 1.0 mg/kg PO q8h) is prescribed to control ventricular rate. Nutraceuticals (taurine or L-carnitine) are used empirically in selected cases. When DCM occurs in spaniels or small breed dogs, taurine supplementation (500 mg q12h) is recommended. Fish oil supplements containing omega-3 fatty acids may improve appetite and reduce cardiac cachexia (EPA–30 to 40 mg/kg PO q24h; DHA 20 to 25 mg/kg PO q24h). Serious ventricular arrhythmias in the setting of CHF are managed with mexiletine (5–8 mg/kg q8h) plus a low dose beta-blocker. Sotalol can be tried in larger dogs (40 mg q12h) but can worsen CHF. A Holter EKG should be used to assess therapy.


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## Karen519 (Aug 21, 2006)

*Holly*

Poor Holly. My heart goes out to you-I know how you feel-it is so hard to see our dogs in any kind of pain. 

Right now my Ten Year Old Golden Ret. Smooch is putting little weight or no weight on her right leg. Vet had said she had arthritis in the spine. Don't know if she spraied it getting off couch this morning or if it's worese than that.

What did the Vet say about Holly?


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## paula bedard (Feb 5, 2008)

I'm so sorry. You mentioned you've moved to Texas. Do you think that she might have allergies on top of her heart condition and these may be exasperating her other health issues? In my human family those with allergies are also predisposed to pneumonia. I hope you can find a regimen that can manage her health issues. Another member has a elderly dog with heart issues, he's on meds and seems to be doing well. Prayers for your sick girl. Please keep us posted on her condition.


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## fuzzbuzz (Aug 3, 2008)

Well wishes and prayers going to you and Holly.


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## tippykayak (Oct 27, 2008)

I think two long consults with canine cardiac specialists are your best bet. If the enlarged heart is congenital and not the result of long-term heartworm or hookworm infection, I'm not sure what they can really do except go in there. A cardiac specialist can give you very realistic odds and cost estimates. Once you have the test results and one consult, you can make an appointment with another specialist without incurring all the testing costs again. Just have the results forwarded (or take them yourself) to the second doctor. Getting two different opinions can help you make a very well-informed decision.

Getting one doctor's opinion, if you feel you can really trust him or her, is just fine, but don't be afraid to go for two if you can afford the second exam/office visit cost.

When you do talk to specialists, remember that they are passionate about doing the work they're trained for, which means they may advocate major surgery even when the chances of its success are slim. Trust your heart: only you know what's best for your own dog, and the decisions about Holly's life and health have been entrusted to you, not to the doc. If you feel that it isn't right to put her through something traumatic if the chances are success are too small, that's your decision to make, even if the doctor is saying "we may be able to give her some quality of life after she recuperates."

Changes in diet and the addition of some meds may be able to help, so be sure your specialists explore those avenues carefully with you. You may be able to buy her a surprising amount of happy, relatively healthy time with these less invasive changes.

Get all the information you can, look your beloved dog in the eyes, and ask yourself what's best for her. Do that. Our stewardship of these awful decisions is part and parcel of the bargain we make when we give our hearts to those tiny puppy faces looking up at us.

Keep us posted. The members of this forum can be an amazing support group and resource for information.


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## amy22 (May 11, 2008)

Im so sorry your sweet girl Holly is going through this. My prayers are with her and your whole family. Please let us know what the Specialist says.


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## Ljilly28 (Jan 22, 2008)

> When you do talk to specialists, remember that they are passionate about doing the work they're trained for, which means they may advocate major surgery even when the chances of its success are slim. Trust your heart: only you know what's best for your own dog, and the decisions about Holly's life and health have been entrusted to you, not to the doc. If you feel that it isn't right to put her through something traumatic if the chances are success are too small, that's your decision to make, even if the doctor is saying "we may be able to give her some quality of life after she recuperates."


This is a absolutely best piece of advice/wisdom, and I agree wholeheartedly with Tippykayak about this. Specialists can accidently make you feel guilty bc they are so deeply involved with their specialties and are scientifically, passionately curious and oriented toward treating(of course they are) when realistically the dog cannot recover. Sometimes though, not treating is the best way to keep faith with a good dog, and only you know that. You are the specialist in your own girl. Hopefully there will be some medicine and nutrients that can buy you some time and peace of mind rather than a huge surgery.


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## BeauShel (May 20, 2007)

I am so sorry that you are going through this with your girl. She sounds like a real fighter and you are doing your best. I had a small dog that problems with his trachea and heart basically almost the same thing and he was put on prednisone. It did help but he still did the almost like honking sometimes. Hopefully the people at the vet hospital will be able to give you some help and you can have several more years with her. 
We are here for you and are hoping for good news along with you. I will say a prayer for the both of you today. Please let us know what they say.


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## fostermom (Sep 6, 2007)

I am so sorry that you and Holly are going through this. I just wanted to let you know that I am sending good thoughts and prayers.


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## coppers-mom (Jan 9, 2009)

How heartbreaking.
I wondered about the allergies being part of the problem soo, but don't have any first hand experience with it.
My prayers and thoughts are with you and Holly and I hope they help her with meds or something reasonable. I sound an old Golden about 7 years ago and his heart was enlarged, but it was due to numerous pellets throughout his body from being shot (according to my vet). He coped pretty well. I hope you get more time with Holly. Saying good-bye is so hard.


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## magiclover (Apr 22, 2008)

I am so sorry to hear about your Holly. I hope you are able to find the answers to your questions whatever the answers may be. I hope you would be willing to share pictures of your girl with us here.


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## wee32 (Mar 6, 2009)

*Wow -*

You guys are simply amazing. I *really* appreciate all the well wishes and information.

She goes in on Monday & we'll have to see what they say. It is a teaching hospital at a vet school and we're seeing a cardiologist, so I know they'll want to take everything to the furthest possible conclusion just out of curiosity and the desire to learn!

I also know that Holly has been my good dog and deserves the very best life possible, even if it is shorter than we had hoped - and that doesn't include being a pincushion for vet students. So we'll have to weigh it out carefully, whatever they say.

I'll update when we find out. Thank you all SO much - I'm going to go back & reread now -

Wendy


ETA: the one thing we do know is no heartworm/hookworm - she has always stayed on her meds, and they tested her twice in the past month just to be sure. She has had periodic tests with annuals & never tested positive. Also no fungal (common in dogs from New Mexico, where we just moved from). And NO valve problems or murmurs, which is why the vet here said it was beyond what she can do. I gather she suspects a heart tumor (she teared up when she was telling me all this) and doesn't believe surgery would be likely to prolong her *happy* lifespan (life without quality is not much of a life!). But I'm so curious to see if the cardiologist finds this, or something else entirely. Maybe something treatable with meds! I can always hope -

You can't see the golden in her as much from this angle except for her coloring, but she is ALL retriever in the back end!


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## coppers-mom (Jan 9, 2009)

_I also know that Holly has been my good dog and deserves the very best life possible, even if it is shorter than we had hoped._
I'm sure you have given her a great life. I've been through losing them way too early and it just well, ain't right.
Maybe they can help her without being too intrusive. I hope, I hope. I'll pray for you all. I at last hope yu have a good weekend with psecial Holly treats and loves.


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## hotel4dogs (Sep 29, 2008)

Has she always had the pink nose and pads, or is that new? If it's relatively new, maybe there's an autoimmune component.
How very sad, I feel so bad for you. I hope the specialists can help you out. Please keep us updated.


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## Ljilly28 (Jan 22, 2008)

I teared up like your vet reading your post. I really respect your ability to walk the shadowline between doing everything possible and doing too much, mentally preparing for different outcomes keeping in mind what is best for your dog. It is so, so hard, and your heart and head both seem in the most right place possible at such a time. I am so very sorry, and also hoping for good news.


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## marshab1 (Aug 28, 2006)

Good luck on Monday and definitely let us know what you find out. You'd be amazed at the amount of info this group of people can come up with to help give you more info on the prognosis. And if you have to make the hard decision to put her down, the people here will understand like no one else. 

And you are right quality of life is so much more important than length of life.


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## Tahnee GR (Aug 26, 2006)

Holly is a beautiful girl-love that smiling face 

I know this is very hard for you, but you are doing the very best you can for her and I know that you will make the best decision for her.

Thoughts and prayers for Holly


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## 3SweetGoldens (Feb 28, 2007)

I am so terribly sad to read your post. It has brought tears to my eyes as well, and I will be praying for the best outcome for Holly. I know with the love you have for her, that you will make the right decision, what ever that may be for her. I will be praying there is something they will be able to do to help her have much more quality time with you. Please know you and Holly are in my thoughts and prayers.


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## Ardeagold (Feb 26, 2007)

Sending lots of good thoughts to your sweet girl.

If it IS DCM (Dilated Cardiomyopathy), definitely ask if there's any chance that taurine supplementation would be helpful. Sometimes it is.

Please let us know what you find out.

Hugs to Holly and to you.


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## BeauShel (May 20, 2007)

She is beautiful and looks so much like a golden mix that was saved and is being cared for by one of the forum members. the thread is by lovealwaysjami. I cant get over how much they look alike.

Well my wishes and prayers are for good news on Monday. Hopefully it will be something that can be fixed and give her a good quality of life. You are a very loving and caring person and she knows you are doing the best for her. Trust your instincts too. Sometimes some of the vet students havent worked on their bedside manner so if any of them upset you speak up.


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## jealous1 (Dec 7, 2007)

Holly looks like a beautiful, well-loved dog. I so agree with tippykayak who has unknowingly helped me in the past year with regards to my JC. JC is one of my shelties that late last summer I didn't think would make it to his 14th b-day. He has been diagnosed w/ chronic renal failure and one vet didn't give me a whole lot of hope, another said he had seen dogs go for a long time with this diagnosis but did not offer any advice on how to take care of him, and still another who was very helpful and encouraging about some experimental products, but still wants to continuously do bloodwork and keep him on a strict diet. Well, JC has defied a lot of the odds and gets what he wants as far as eating (steak mixed w/ a small amount of canned food, the latter of which he usually ignores). I get up at least once in the middle of each night to take him out and try to spend as much quality time with him as I can. Even though he sleeps alot, he still enjoys life, his treats, and his walks. I pray that I will have the strength and wisdom to recognize when it will be his time to go to the bridge and I think with the help of a lot of folks on this forum, I am at peace with all of my decisions regarding his care. I will keep you and Holly in my prayers that Monday brings some good news for both of you. Thank you for thinking of her first.


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## Jackson'sMom (Oct 13, 2007)

What a beautiful girl your Holly is! I'm so sorry that you and she are going through this. I think you're very wise in taking her to a veterinary teaching hospital. Please give your girl a smooch, and let us know what the expert says on Monday.


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## Finn's Fan (Dec 22, 2007)

Wendy, fingers crossed that the cardiologist at the vet school has the answers and the treatment that will help your lovely girl. Don't be so sure that they'll do every test known to man just for the teaching aspect; if a prognosis doesn't look hopeful, I think most vet school specialists will tell you that. In my experience, it's when they're unsure initially whether something is effectively treatable that they pull out all the stops. Please do let us know how your visit goes....


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## 3 goldens (Sep 30, 2005)

What a beautiful girl she is. My first dog was an english setter puppy i got for my 11th birthday back in '56 and i owned many, many more. Trrow in the 2 irish setters and 5 goldens---i have had the best of all worlds with those breeds.

My golden girl kaycee had an enlarged heart chamber. It could not be detected by listening, but was found due to chest x-ray when she was almost 7 i think it was (without looking for records). Her esophagus actually arched over it. My vet put her on a very low dose blood pressure tablet every day and a baby apsrin every other day. I was surprised to find her energy level picked up--she thought she was a puppy again--aftr being on those meds for a few weeks but sadly i lost her to cancer last may 25 at 8 yrs. 9 months. 

I really can't be of any help as kaycee's case was different from holly's. But at a&m, i know you will get great results. The c lumber spaniel tht won the westrminister dog show this year (i believe he was 10) was at death's door and the vets at a&m saved him 4 or 5 years ago. 

I am wishing you and holly all the luck in the world. And you have your line of thinjking on the right track as to diagnosis and what should be done for her, not for you. I know from experince that we keep them for ourselves, we let them go for themselves.


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## Karen519 (Aug 21, 2006)

*Holly*

How is Holly doing?


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## wee32 (Mar 6, 2009)

*Good. Grief.*

Here is the full synopsis:

Vet #1:
"This dog has a chronic lung problem. We want you to bring her back every 7 days while we give her an assortment of weird drugs. The sum total cost of this to you is going to make the mortgage payment on our building! Oh, and we do notice an enlarged heart, but we don't care about this! Here's our bill for $1900 so far."

Vet #2 (Second opinion):
"The lungs are filling up because the heart is a problem. It is enlarged for mysterious reasons. Your dog is going to die, and soon. If you want to confirm this diagnosis, take her to Texas A&M. I can't take your money."

Texas A&M:
"Your dog is a bit fat. Other than that, we see nothing wrong with her. Here's our bill for $700."

SOOOO...
was she just not over the pneumonia? was it all the weird medications? did her heart get rapidly better when I changed her to an all-raw high-taurine diet three days before the A&M appointment? were both of the first two vets smoking crack? What??? A&M suggested she might still have an immunology problem, but this would take many hundreds of dollars more to investigate. Then she said, "maybe she was allergic to what you were feeding her before."

I saw the first two sets of x-rays where her heart was measured against her ribs, and it appeared very different in the A&M x-rays - much smaller. So they may have all been taken from the wrong angle, four sets of x-rays at two different vets, all taken wrong? Also, the pneumonia that I clearly saw at the 2nd vet's was gone by the time she got to A&M. I'm extremely exasperated.

In the meantime A&M said she could exercise (build back up to it from the pneumonia) and she is happy, though still coughing all the time for no reason anyone understands, so there we are.

And she won't die? At least not of any of this? My husband said, "I guess the proof will be in the pudding, how long she lives and what she eventually dies of." SIGH.


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## Penny & Maggie's Mom (Oct 4, 2007)

Wee, where are you??? If you are in the Metroplex, I have a vet that is VERY Very good and down to earth. His prices are very reasonable and he has a common sense approach. He's very up to date and I credit him with saving my springer from AIHA. Let me know if you want his name, etc.


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## Ljilly28 (Jan 22, 2008)

Wow- I wish I could say I can't believe this story, but it's all too familiar. The watchword for serious vet emergencies is "second opinion", in your case, a third! Vet #2 sounds extremely nice. I wonder if you self-treated it with the taurine???????? Holly maybe got some kind of magical miracle- for 2,600$ plus. I bet you are so relieved, but I completely empathize with that lingering doubt... how could the xrays look so different. Did vets 1 and 2 know each other? Could they possibly habe used the same set of Xrays rather than taking new ones. I cant believe both could take wrong angles(??). The fact that she's still coughing is the most frustrating part of the story. 

I have 2 extremely healthy dogs, and a third who was born with anaplasmosis and is always worrying me with something. His CBC is always low on red and white blood cells, and periodically he gets odd staph/ blue green algae sicknesses. He's been falsely diagnosed with everything from pancreatitis to some scary cancer called histo(?). He's probably has 4,000$(literally) worth of tests in his 20 months on earth, and there doesnt actually seem to be anything wrong with him beyond a mild case of cat-scratch fever and some CBC/blood test numbers that are just always going to be a bit off the norm. But the lingering doubt is there(mainly fueled by my vet). Is it anemia or not? Is it some exotic bacteria or not? It drives me nuts.


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## tippykayak (Oct 27, 2008)

Goodness gracious. I'd tend to give the university vets some credence, not knowing your other vets' credentials. 

I wish I had a magic prescription to make Holly all better or magic instructions on how to cope. I can only say what I would do.

I'd keep treating the pneumonia, work up to some exercise, and try to establish a zen-like perspective on the whole thing. We don't know when our dogs are going to be taken away from us anyway; you just have to confront that issue much more directly than most. We do crave definitive answers to health problems, but it's not always that simple.

Control what you can about this situation and chalk the rest up the mysteriousness and messiness of life. Today you have a loving girl who's alive and in your arms, and tomorrow is a gift either way. And if you ever get too nutso about the whole thing, just come on here and vent, and we'll talk you through it.


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## 3 goldens (Sep 30, 2005)

Go with the a&m vets. Love your girl every minute and make the most out of the years you are gonna have with her.


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## coppers-mom (Jan 9, 2009)

I know it is frustrating and irritating to spend all that money and not get a diagnosis. I hope she just keeps getting better and proves the first two wrong!


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## punima23 (Jun 1, 2011)

*have a similar condition*

noddy male golder diagonised with ccf i too have to decide the medication soon has cough and sometimes infection in the lungs. intially he was treated for acidit and i refused to do the endoscopy and did the ecg and x-rays please any one tell me if has cardiomegaly or enlarged heart or just like holly with only allergy or wrong diagnosis please help i live in india have posted this 3 different forum in the same group you can also mail me at [email protected]
thanks and all the best


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## punima23 (Jun 1, 2011)

i got noddys 2d echo i have posted this almost every where as i was new in the forum and paniced a lot if this could catch some vets attention i cross posted in other forus even as replies. noddy golden male 12-15 year adopted male diagnosos ccf [email protected] im posting his 2d echo i have posted his x rays as well thanks for any help any tip any this will give me a positive feel please does any one have a clue of enlarged herts in goldens?


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## Penny & Maggie's Mom (Oct 4, 2007)

I'm so sorry you found us under such sad circumstances. I hope the vets at A & M have answers and a way to easily give her back some quality of life. You are doing the very best for her by taking her there. I'll be saying some prayers for Holly, you and your family. Please keep us posted.


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## Beebee (Dec 7, 2017)

For Holly. I am so so sad to hear of your dilemma. I had a beautiful G.R. He had an enlarged heart. His breathing was difficult. The vet got a lot of money out of me. I then realised that it was not helping him. ?? I am very very sad and feel depressed just before Christmas. I loved him so much and will miss him. All the best with your decision.


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