That was a great post, Lamont.  Very informative.  Myra

>From: Lamont Yoder <[EMAIL PROTECTED]>
>Reply-To: The Cavalier King Charles Spaniel List
><[EMAIL PROTECTED]>
>To: [EMAIL PROTECTED]
>Subject: Re: [CKCS-L] MVD Question
>Date: Sat, 27 Jul 2002 22:36:39 -0400
>
>"I've re-read the information I have on MVD, and unless I misunderstood it,
>it states that the dog should be put on medication (enepril?), even w/o
>symptoms."
>
>  Kris,
>     You are in the same boat that many Cavalier owners are because when
>you
>want to argue starting ace inhibitors (i.e. enalapril) for afterload
>reduction prior to symptoms, there are studies that support this and
>studies
>that support waiting until symptoms appear.  It makes the decision very
>difficult when different research negates the others and the opinion of
>your
>vet or cardiologist frequently depends on what research he is emotionally
>connected to or was involved with conducting in the past.  Certainly for a
>grade 1 or 2 murmur that is asymptomatic, I agree with Carol and I'm not
>aware of any research that supports starting them at that low grade.  There
>are enough side effects of ace inhibitors, one being renal insufficiency
>over long period usage that it doesn't really support starting a dog with
>such a low grade murmur.  Now if you had a grade 4 murmur, it makes the
>decision a little more grey, but at the same time there is no way to
>guarantee that the rate of progression will be rapid and could be delayed
>with ace inhibitors.  This is why it is so important to look at not only
>the
>age of onset of a murmur but also the rate of progression - look at the
>ancestors and see:  Did they stay at grade 1 for 10 years and progress over
>their last year?   Did they go from 1 to 2 to 3 to 4 very slowly and once
>they hit 4 progressed to end stage failure in a year?
>
>This again certainly doesn't guarantee anything, but it helps you guess
>what
>might happen.  Someone I knew very well years ago had imported a bitch that
>didn't get a murmur until she was 7 1/2 years old, but she was dead from
>heart failure before she was 8.  Meanwhile, Char neutered her old boy Basil
>when he was 2 1/2 because he had a murmur and it progressed to a 4 when we
>had to put him down for arthritis and his inability to move around 3 months
>shy of 17.  There are just no guarantees are there?
>
>best of luck,
>Lamont Yoder
>Sunbury, Ohio
>
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Myra Savant  Gardengate Cavaliers


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