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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26146
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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HI My west highland terrier may have westie lung disease (WLD)

Customer Question

HI
My west highland terrier may have westie lung disease (WLD) or a heart problem- the vet isn't sure yet. We started meds for WLD, Corvental and Prednisolne, on Tuesday. He seems to be panting more. how long should we expect to wait before we see improvements, if in fact he has WLD? My concern is that if it is a heart problem instead then his lungs might be filling up and I'd rather take him back and change the meds if we should be seeing improvements by now.

Symptoms - cough on any exertion, rapid breathing and panting, crackling lungs, increased eating eating, even before the meds. Cough started just after Christmas. Vet couldn't hear a murmur but isn't sure because the lungs are very noisy. WE are not insured and are not in a position to have loads of tests.
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry to hear of this with Arthur. To answer your question directly, Arthur may not respond at all to his appropriate therapy for idiopathic pulmonary fibrosis. Once severe generalized crackles and wheezes are heard and a marked inspiratory and expiratory effort is seen, we expect to find alveolar fibrosis with mineralization - essentially end-stage pulmonary disease. Cardiac failure certainly should be considered as well but X-rays of patients in cardiac failure will look very different than those with chronic pulmonary disease.

We don't need loads of tests at this time. Two X-rays of Arthur's chest should suffice to clarify whether heart or lung disease is his primary problem. If you prefer, a simple and relatively inexpensive blood test called the cardiac troponin I can be run which identifies patients with primary cardiac disease. A negative result, however, doesn't rule out all types of cardiac disease.

Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

thanks Michael


is the overeating normal for these conditions?

Expert:  Dr. Michael Salkin replied 3 years ago.
You're welcome, Gill. Polyphagia (increased hunger) is consistent with corticosteroids such as prednisolone. Seriously ill dogs with cardiopulmonary disease aren't expected to feel well enough to be overeating without the aid of such drugs. Of course polyphagia is also seen with diabetes mellitus and Cushing's disease - both of which would also cause polydipsia (increased thirst), however.

Please continue our conversation if you wish.
Customer: replied 3 years ago.

I think he is drinking more. I had a westie with cushings and suspect he may have the condition. If he has we probably won't do anything about it as I know in the long run it won;t help. Diabetes is something different so we may have a general blood test to see what if anything it shows.



Thanks for your help MIchael - you have confirmed what I already thought.


 


 

Expert:  Dr. Michael Salkin replied 3 years ago.
It's my pleasure. I'm going to check back with you in a few days for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.
Customer: replied 3 years ago.

Thanks again. We will be going back to the Vet next Tuesday so won't know much for a couple of weeks

Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you. I'll reset my follow up more appropriately.
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26146
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and 2 other Dog Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for your kind accept. I appreciate it.

I'll speak to you soon.

Please disregard the info request.
Customer: replied 3 years ago.

Hi Michael


My westie is not getting any better. I am dropping him down to 1 steroid every other day with a view to stopping them altogether. - His increased appetite is driving him crazy so we have quality of life issues here. His blood test came back completely normal so Diabetes is ruled out. How quickly can I stop the steroids do you think? Don't think the Corvental is doing any good. Had him on Vivtonine for a while (Corvental Shortages) and that didn't do anything.


 


I think we need to get an X-ray to see how bad his lungs are.


 


I have also been considering two alternative treatments. One being cold laser therapy and the other, enzymes - serrepatose and nattokinase and Q10. Have you heard anything about any of these treatments?

Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for getting back to me. I'm sorry to hear of this with Arthur. If steroids aren't helpful, yes, it's better not to give them...if for the only reason he's driving everybody crazy. Diabetes is ruled out. Is Cushing's still a concern?

Yes, radiographs of his lungs are essential. There's no reason to consider cold laser therapy until we know what we might laser. I couldn't find serrepatose by googling. Perhaps you meant serratiopeptidase thought to be helpful in addressing inflammation. Unfortunately, there are no scholarly studies of this enzyme in dogs. Nattokinase might be of value when addressing cardiovascular disease (which we don't know is present in Arthur). Please see here: http://www.ncbi.nlm.nih.gov/pubmed/19358933

Q10 functions as an antioxidant. The best I can say is that it won't be harmful. Until we clarify what's going on in Arthur, it's best not to be administering non-proven remedies.

Please continue our conversation if you wish.
Customer: replied 3 years ago.

Is it ok for me to just stop the steroids without tailoring them off?


 


here is a link that talks about Serrapestese.


http://www.webmd.com/vitamins-supplements/ingredientmono-1115-SERRAPEPTASE.aspx?activeIngredientId=1115&activeIngredientName=SERRAPEPTASE


 

Expert:  Dr. Michael Salkin replied 3 years ago.
Sorry, I missed that question earlier. Please tell me what Arthus weighs and what dose of prednisone he's been taking.

Yes, that's the enzyme I'm familiar with. We have no idea if it's of value in dogs. Once again, it shouldn't be harmful, however. I found a recommended dose of 80,000-320,000IU daily but keep in mind that no scholarly testing has been done on this enzyme in dogs.
Customer: replied 3 years ago.

one 5mg x once daily which I have just dropped to one every other day. Arthur is 13 kgs .


 


I think I will try the enzyme as we have nothing to lose.

Expert:  Dr. Michael Salkin replied 3 years ago.
I'd continue the 5mg every other day for four more doses and then stop. Keep me posted, please.
Customer: replied 3 years ago.

will do - thanks.

Expert:  Dr. Michael Salkin replied 3 years ago.
It's my pleasure. I'll set a follow up for a week from now.

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