Cardiovascular (Heart) Disease in the Irish Wolfhound
Cardiovascular (Heart) Disease
Notably, Dilated Cardiomyopathy (DCM), Atrial Fibrillation, and Ventricular Premature Complexes or Contractions (VPC).
Most novice and current owners do not realize that advanced annual cardiac screenings, to include Electrocardiograms (ECG) AND Echocardiograms (Echo) are paramount in the care and maintenance of your Irish Wolfhound. Typically, these screenings are performed during the adult stages of growth (beginning at two years) and onward throughout their senior years. However, regular electrocardiograms (ECG) are recommended earlier on to monitor any conditions that may develop. I implore all Irish Wolfhound owners to please read my DogMusings Blog Post title, "Irish Wolfhound Heart Health" for a brief but important explanation on necessary, annual, full-scale heart evaluations. Afterwards, please read the "Holter ECG Ambulatory Monitor" article for more details.
OFA Required Annual Testing
The Orthopedic Foundation for Animals (OFA) breed testing information effective April 1, 2016, states that the OFA in consultation with the American College of Veterinary Internal Medicine (ACVIM), has instituted the Advanced Cardiac Database (ACA) which has become the new standard for cardiac exams and replaced the previous OFA Congenital Cardiac Database. Moreover, all exams for the new Advanced Cardiac Database are limited to boarded veterinary cardiologists with Diplomate status in either the ACVIM (American College of Veterinary Internal Medicine/Cardiology subspecialty) or the ECVIM (European College of Veterinary Internal Medicine/Cardiology). No general practitioners or other specialists can submit examination findings.
Adult congenital clearance only remains valid for one year from the time of the exam. This is because congenital heart disease can affect our breed from early, mid to late onset ages and is why I am explicit and direct when I urge that each and every Wolfhound over the age of two should have annual, advanced heart evaluations.
Advanced heart evaluations performed by BOARD CERTIFIED Veterinary Cardiologists include:
1—An EKG, ECG or Electrocardiogram which shows electrical currents of the heart and will reveal, but not always, arrhythmia’s or abnormal rhythms.
2—An Echocardiogram (Echo) shows the physical condition and structure of the heart. One of the devastating and leading causes of death in our breed is Dilated Cardiomyopathy which essentially is the diminishment of the heart’s ability to serve as a pump. DCM is diagnosed by Echocardiography, which demonstrates the chamber dilation of the ventricles and wall thinning, and indicates, if any, decreased pump function through the heart. During an Echo the heart is evaluated in real-time, live action. This cannot be done by any other procedure. During the procedure, the Diplomate takes measurements which, in turn, they cross-reference with standard measurements for the breed to determine if they perceive a thinning of the walls, enlargement of the ventricles. If so, then the Wolfhound may be in the early stages of DCM.
ANNUAL Echocardiograms are required for the Advanced Cardiac Database and “is viewed as a critical component by the ACVIM/Cardiology group in order to even consider diagnosing dogs as normal when many cardiac diseases of concern to breeders can develop at any time in the dog’s life.”
Clinical signs of DCM occur secondary to either decreased delivery of oxygenated blood to the body (lethargy, weakness, weight loss, collapse), or to congestion of blood in the lungs (coughing, increased respiratory rate and/or effort, abdominal distention) or both. Cardiac dilation, decreased oxygen supply, and increased oxygen demand secondary to elevated heart rate and ventricular wall stress may predispose to the development of cardiac arrhythmia’s arising in either the atria (atrial fibrillation, supraventricular tachycardia) or in the ventricles (ventricular premature complexes, ventricular tachycardia). Arrhythmia’s may predispose affected dogs to sudden death.
Unfortunately there are far too many IW owners who think they know-it-all and assert that their local veterinarian listened via auscultation (Stethoscope) to the hounds heart and no arrhythmia’s were detected. Even worse, there are general veterinarian practitioners who believe that EKG’s will suffice and that the odds of an Echo or further, a Holter monitor diagnosing any arrhythmia without an irregular EKG is essential lay impossible and therefore contraindicated. Straightforwardly, no Diplomate would agree with this notion. Simply because an EKG does not reveal aberrations does not clear the hound of arrhythemia’s, DCM, abnormalities of the pericardium, possible tumors, blood clots, etc.. ONLY an Echocardiogram can do so.
Negligent treatment by unknowledgeable general Veterinarians are risking the well-being of many companion wolfhounds and I implore the owners to be their Wolfhound’s health advocates. Ask questions, disagree, schedule the annual Advanced Cardiac Assessments yourself with a Board Certified Cardiologist. If you have to drive several hours each way — so be it! Trust me when I tell you that doing so may SAVE your IW’s life in the future as well as a world of heartbreak.
If the Board Certified Specialty Practice requires referrals then advise them that you do not have one as you disagree with your general veterinarian about the advanced cardiac screenings your HIGH RISK BREED requires. Repeat what I have stated above and inform them that the Advanced Cardiac Database (ACA) has become the new standard for cardiac exams and that all exams for the new Advanced Cardiac Database are limited to boarded veterinary cardiologists with Diplomate status in either the ACVIM (American College of Veterinary Internal Medicine/Cardiology subspecialty) or the ECVIM (European College of Veterinary Internal Medicine/Cardiology). Keep in mind that you are not required to submit any findings to OFA.
Lastly, consider that as part of the Advanced Cardiac Database both the Boxer and Doberman breeds are required to submit Holter Event Monitor results (24-hour ambulatory EKG) in addition to Echo & EKG. If the annual gold standard for Boxers and Dobermans includes Holter Monitor results then it should be the gold standard for Irish Wolfhounds as well.
It is my considered opinion that annual heart testing on all adult Wolfhounds, from two years onward, should include an annual Holter ECG Monitoring which is a 24-hour recording to monitor for irregular heart rhythms. Undiagnosed or unknown malignant VPC's can result in feinting, collapse (syncope) or worse, sudden cardiac arrest.
I will be straightforward, if you desire this breed then you must be prepared for the expenses that come with them, and at the risk of sounding crass, you need a fat wallet. Yearly cardiac evaluations can cost, depending on your region, $400-$750 per a Wolfhound. If your Irish Wolfhound is diagnosed with cardiac disease, pharmaceutical expenses for their heart health management can be costly as drugs regularly increase in cost. The annual costs for cardiac drugs will outweigh any annual cardiac screenings with a Board Certified Cardiologist. Parenthetically, the drugs used for treating heart conditions are the same ones used for humans. See my Expenses page.
As a disclosure, I must state though that I do not concur with the statement set forth on the Irish Wolfhound Foundation website suggesting that we have experienced a decrease in overall heart conditions in our breed. I especially disagree with the suggestion that VPC arrhythmia's are mostly benign in Irish Wolfhounds. In my considered opinion, numerous hounds have or develop malignant ventricular arrhythmia's and these can be diagnosed by comprehensive annual heart health exams and controlled early on with life-saving, and life-prolonging drugs. I have received too many inquiries and calls from people looking for a puppy or advice who had lost an IW to heart disease or who have an IW diagnosed with such and the hound is faring poorly. I always inquire as to when the heart condition was diagnosed and 100 percent of the time the owners informed me that it was recently diagnosed and all said they had NOT had ANY advanced annual heart screenings performed on the wolfhound prior. Not one. The reality is that people do not take responsibility and educate themselves about the breed of dog that they have and are then heartbroken when a chronic, manageable disease is diagnosed at too late a stage.