"Nell" Collison, an 11year old Border Collie came in to the surgery this week for her usual annual health check and "M.O.T."

Her owner had become aware that her battle to keep her teeth clean was being lost. The progressive build up of tartar and calculus meant that the only way to avoid extractions and return her teeth to their original glory was to schedule for an ultrasonic scale and polish.

It was also discussed during her examination that a heart murmur which we had been monitoring for a number of years had become more noticable. A murmur graded 3 out of 6 was now graded 4 out of 6. "Nell" was not demonstrating any clinical symptoms associated with heart failure which was encouraging.

When the heart muscle begins to fail to do it's job properly in pumping the blood around the circulating blood vessels the body realises there is a problem. This is because various "safety gauges" are triggered when the flow and pressure fall outside preset normal limits. Consequently, chemical messages are then sent to make the heart muscle bigger in an effort to improve it's capabilities - a similar process to that which happens to limb muscles when bodybuilders exercise.

These changes take place prior to the patient showing physical symptoms such as a cough or difficulty exercising. Currently, there are drugs available (ace inhibitors) which can assist the heart tremendously when it starts to fail. They effectively make the task of pumping the blood around the circulation easier substantially reducing the strain on the heart.

These drugs are expensive and whilst they undoubtedly allow our canine patients to thrive they are best utilised at the beginning of heart failure. Fortunately for "Nell" her x-rays taken at the time of her dental procedure showed her heart to be within normal limits and therefore medication at this point would be of less value. Knowing when medication is not indicated can be just as important as when it is. For the moment, Mrs Collison can concentrate on keeping "Nell's" teeth clean!

Terry Dunne BVMS, Cert SAO, MRCVS

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