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Tachycardia

by amymatthews - November 22, 2009

I saw a 13 year old FS bullie-cross for hindend weakness last week - gets worse later in the day. On exam, red-pink tongue suggesting Heat. The real kicker was the HR of 240 - thank goodness it was intermittent. When it was 120, the pulse was weak but not mushy, though sometimes hard to pick up. She's seen her RDVM with some frequency over the past year, but I suspect there may have been more boarding visits (which the owner may perceive as "seeing the vet") and med-refills than actual exams. The plan is an EKG and echocardiogram with the primary vet.

Have you had any success with herbal approaches to control tachycardia? Although this dog has some stifle DJD, I suspect the weakness (and perhaps the collapse the owner described that occurred about a year ago!) is more likely related to the heart.

I'm wondering if Hoxsey or Si Miao San could be tried safely in this dog, esp if a cardiac mass is seen on echo.

Hopeful,
Amy

by naturevet

November 22, 2009

Hi Amy,

We probably need all the work up to be completed before we decide what to do, especially if you're thinking it's a heart base tumor. But we have had success in slowing hearts down. For example, most clinical cases of hyperthyroidism in cats will experience significant slowing of their hearts on Zhi Bai Di Huang Wan (which may fit this dog, too, if there is no cardiac pathology). Given my poor track record of late in giving you not particularly useful advice, I'm going to say let's get all the facts, ma'am, before we speculate further than that.

Steve

by amymatthews

November 22, 2009

:)

by amymatthews

November 23, 2009

Good decision to wait! The owner chose to do no work up, but at the exam today, the dog's heart rate was fine at 126 (every time I checked). I'm even wondering if it was sinus tachycardia associated with skeletal pain, though I've seen an awful lot of painful dogs and had never encountered a heart rate like this before.

Alright, so let's flip this question around. What do you think about a dog with significant arthritis (stifles, elbows as the primary sites) who is better when she first gets up in the morning, worse at the end of the day? She does still look like she has Heat, even more so than before in some ways - the pulse is still rapid (though within a more normal range), now the pulse is strong even a little excess, and the tongue is red-pink and a little narrow. So perhaps Si Miao San....? Given how strongly we know her heart can react, I'd love your thoughts on how safe that would be.

Thanks as always! Your advice is always useful.

Amy

by naturevet

November 24, 2009

Hi Amy,

If the pulse was quite superficial and obvious, then I'd try Si Miao San, and assume this hot dog was traumatizing itself over the day, aggravating joint inflammation with exertion.

If the pulse was on the deep side, I'd wonder if the dog was Qi and Yin deficient, leading to exhaustion as the day progressed. At the very least, I'd think of a Yin tonifying, cooling formula, like Zhi Bai Di Huang Wan.

One of them should get the ball rolling in the right direction.

Steve

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