I saw Bear a few days after starting these meds. He was improved, but had several coughing fits when he was excited in my office. Taking a history, there was no evidence of exercise intolerance or syncope, so CHF seemed not terribly likely, tracheal collapse more likely. I sent him home on Minor Buplereum, and they had instructions to lower the other meds: halving the Enalapril, tapering down the Pred, and discontinuing Lasix, other than PRN for rapid breathing at rest. He is doing well, and I sent him for an echocardiogram, to completely rule out CHF. Results: mitral valve disease with reflux, enlarged pulmonary vessels, focal areas of bronchointerstitial thickening w/o lung consolidation, variable lumen widths of trachea.
So the dog has some cardiac compromise, tracheal collapse and some lung inflammatory process, all fairly mild. My inclination is to reserve inotropic medication for some later date when he really needs it, but not sure if using meds early is preservative of cardiac function. I suspect that the pulmonary issues may be allergic-- new kitten in house for 4-6 weeks before this episode. He's also a squirmy, reactive little Pom.
Here is the question!!
I am happy with XCHT for tracheal collapse, but was wondering if switching to CHJLGMLT would continue to impart all the benefits of Minor Bupleurum, but do a better job dealing with his cardiac insufficiency and reactiveness?