In the Irish Wolfhound breed, regular annual heart evaluations or workups consisting of electrocardiography (ECG or EKG), echocardiograms, and an ambulatory heart monitor (ECG), e.g., Holter Monitor are essential and indispensable. In layman's terms, an ECG provides heart rate and rhythm information. An Echocardiogram is an ultrasound of the heart muscle measuring the heart's chambers size, the thickness of the heart walls, its valves, and blood flow. The Holter Monitor is a mobile ECG device that is strapped to the wolfhound's chest with electrodes for a minimum of 24 hours.
I advise all wolfhound owners to begin undergoing routine yearly heart workups, with all three of the procedures above, at approximately two years of age, and then annually from there on out for the remainder of the Wolfhounds' life. I urge doing so despite that an owner or breeder believes their wolfhound is in good health because Veterinary Board Certified Cardiologists are the only qualified individuals to determine the heart health of your Irish Wolfhound. Sadly and frustratingly, I have received one too many puppy inquiry calls from deeply saddened owners who lost their beloved wolfhound, and when I inquire as to the cause of death, more often than not I am told heart disease. After I delve deeper into the time span between when the wolfhound was diagnosed and when they died, it usually was within one year or as soon as six months between diagnosis and prognosis.
What a terrible, unfortunate pity as many of these early deaths could have been avoided. Today, there exists many pharmaceuticals that have proven to be life-savers, extending the hound's quality lifespan after being diagnosed with a cardiac disease. Often it is no longer a terminal prognosis but a manageable chronic illness. One of my dearest friends' Irish Wolfhound male lived to 12 years of age with managed cardiac disease, and I too had a wolfhound male residing in a companion home who lived to 11.5 years before he died and whose heart disease was controlled with medications.
However, each time I questioned these grieving wolfhound owners, I was informed that he or she never had annual heart evaluations performed on their wolfhounds. It was ONLY after the hound was symptomatic presenting multiple characteristics of progressive heart disease or even congestive heart failure did they seek medical care. What is more, ALL of these dog owners reported that their breeders had not shared any measurable amount of health advice, but most certainly no recommendations for heart monitoring. Eventually, as is usually the case with the general dog owning population, these dog owners believed that their wolfhound's annual check up with their local veterinarian was an adequate health provision with many meekly and bleakly offering the excuse that their vet listened to their dog's heart with a stethoscope.
This is NOT adequate heart healthcare for a breed predisposed to congestive heart disease.
Most Wolfhound owners, as well as many breeders, are not aware that many affected dogs can have a normal health examination. Even more, on occasion, an astute local doctor may pick up on a premature beat and listen for others. During this snapshot in time, however, there may not be others detected and no further follow through is prescribed. They would be wrong, especially involving the Irish Wolfhound breed and requires further evaluation by a Veterinary Board Certified Cardiologist, DACVIM. Importantly, in my considered opinion and experience, your general practice veterinarian should NOT prescribe any heart medications.
Single ventricular premature complexes (VPC's) warrants and requires further investigation by a specialist where a proper diagnosis is achieved not only by a EKG and Echocardiogram, but more importantly, by an ambulatory heart ECG Holter Monitor. A Holter monitor verifies the frequency of VPC's occurrence and duration, and if any dangerous couplets, triplets, and ventricular tachycardia occur. These are serious arrhythmic complexities which can result in sudden cardiac arrest. Sadly, twelve years past I had a veteran wolfhound collapse and who died in front of me, in my home, from sudden cardiac arrest. He had been diagnosed and was receiving treatment for VPC's, and it was heartbreaking as I could not save him. In the early stages, the average pet owner would not be able to recognize symptoms unless the wolfhound collapsed and lost consciousness (syncope), and, left undiagnosed, often these arrhythmias develop and grow more severe, though it is not always definitive that the disease will progress. Nonetheless, it bears reiterating; affected Wolfhounds can be asymptomatic.
Typically, if any abnormalities are detected by an in-office ECG and Echocardiogram, the Board Certified Cardiologist will urge that a Holter Monitor is attached to the wolfhound and worn for a minimum of 24-hours. It is a vital tool for analyzing arrhythmias, identifying and counting premature ventricular complexes, and characterizing heart rates (tachycardia). Then and only then can a proper diagnosis be given on the state of your wolfhound's heart health. Additionally, any prescribed drug protocols are determined by the Veterinary Board Certified Cardiologist, DACVIM, and NOT by your general practice veterinarian. Repeat follow-up Holter monitoring, typically within several weeks after the commencement of medications, is entirely necessary until such time that a 24-hour recording establishes that the Irish Wolfhound is responding well to the drug therapy. Even then, a wolfhound's owner must continue with recurrent follow-up visits with the specialist, as frequent as every 3-6 months or as directed by the cardiologist once the drug therapy has been determined successful in suppressing the arrhythmias.
Unfortunately for us, we had a veteran wolfhound diagnosed with malignant arrhythmias (couplets and triplets) via a Holter monitor evaluation, and she was receiving antiarrhythmic medications. We were planning for her annual echocardiogram recheck and repeated Holter evaluation when suddenly she failed, and we discovered that she was in congestive heart and subsequent renal failure. Just prior, she was asymptomatic, there was no syncope, yet she developed congestive heart failure. I can only stress that you must adhere to a strict follow-up Holter monitoring schedule while managing Irish Wolfhound heart disease as serious heart developments can occur over a short period. I must bear the burden thinking that if I had gotten her in earlier, we could have discovered the progression and treated it with additional medications.
Prudently and importantly, many Cardiologists recommend conducting an annual 24-hour ECG Holter monitor on a regular, yearly basis throughout a healthy wolfhound's life -- even if there are no electrical issues initially detected. I believe this is a very sensible and wise course of action, and one I wholeheartedly concur with as twelve months can mean the difference between life and premature death.
Why use a Holter monitor if an ECG and Echocardiogram detect no ventricular arrhythmias (abnormal heart rhythms)? Well, for one, the in-office ECG and subsequent echocardiogram are for brief periods and are not representative of what may be occurring over the course of 24 hours. Therefore, the Holter monitor will provide comprehensive real-time data over a twenty-four-hour-clock. Parenthetically, there are one or more cardiologists who believe that VPC's can be inconsistent, varying in numbers or frequency from day-to-day and if cardiac disorder is suspected then another Holter monitor assessment is recommended. However, most importantly for the healthy, unaffected Wolfhound; annual Holter recordings create a baseline for future heart monitoring in which the data obtained from this spotlight in time will be valuable in creating an archival recording. The ability to have this vital information for the doctor to review and compare to future recordings will be instrumental to your wolfhound's longevity and quality of life. In a breed that has prevalent congestive heart failure, Holter monitoring is a necessity, though expensive, and that is the price we have to pay for loving Irish Wolfhounds.