[Martha M]

Thanks, will do!

[Martha M]

Thank you so much, Bobby dog, for your kind words. I am indeed grateful for the vets I’m working with, including my regular main vet who happens to be a close friend and is keen to “do a deep dive” on all this with me.
Sounds like you’ve read the Tufts.edu article by Lisa Freeman (the update on diet-associated DCM). If you’re interested here is a link to the research article my cardiologist sent me: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209112
I’ve switched my other lab to a new diet along with Sophie. Like you, I see no reason to risk her health until all this is sorted out.

[Martha M]

Thank you, crazy4cats. Sophie was bitten by a rattlesnake while hunting and got a lethal dose of venom. During the course of trying to save her life they could not get her heart under control (she was throwing constant VPCs – premature ventricular contractions). Although she managed to survive the bite and subsequent infection following 2 doses of anti-venom and antibiotics, they decided to pursue the heart issue with an echocardiogram and discovered the DCM. Needless to say, we were completely stunned and devastated. She had never displayed any signs or symptoms of this condition. And she’s a 7-year old retriever who works hard in the cold weather during duck season.
To answer Michelle G, DCM normally begins to affect the left ventricular wall (as it has in her case), weakening the heart muscle, and progresses to congestive heart failure. Sophie has a second part to her DCM and that is the arrhythmia she was experiencing in the emergency hospital. It’s not uncommon for this to accompany DCM, but it does put her at risk for sudden death. So she also takes a second heart med to regulate the arrhythmia, along with taurine supplementation. We have taken her to an outstanding veterinary cardiologist who happens to be in Nashville (we’re in Memphis) and she has confirmed the diagnosis. Sophie is in the occult phase of the disease (very early) and we are working closely with the cardiologist in the slight hope that it could be reversed.
And yes, crazy4cats, we definitely do suspect the DCM is diet-related. I’ve fed my retrievers Orijen for years, thinking I was giving them the best I could. When Champion opened their U.S plant in KY a few years ago they changed the formula and started adding a number of legumes. Sophie had thrived on Orijen until that time but then started having stools that weren’t so great, enough that I would have to give her pumpkin to correct it periodically. In retrospect, how I wish I had switched her to something else then, but we had no idea.
Before anyone goes nuts over my response that I believe this to be diet-related, allow me to clarify. Yes, in Sophie’s case we DO SUSPECT that (frankly one reason is because of the number of legumes used in the formula and how her digestive system clearly reacted to it). Even though the named legumes in Orijen are far down the ingredient list with excellent meat sources at the top, there are a grand total of 6 of them, in addition to green peas. This is known as ingredient splitting – name them separately and they are lower on the list, but if taken together as an entire group of legumes it would push them much higher on the list, and it consequently boosts the protein total as well, even though they are plant proteins.
But there are so many things they don’t know yet about what’s causing this rise in DCM in breeds not known to contract it. Of course there is a lot yet to discover. Unfortunately for us, we don’t have the luxury of time. There is considerable suspicion that, in some dogs, legumes can interfere with the synthesis of taurine needed by the heart muscle. It’s very possible that Sophie is one of those dogs. We did test her taurine levels using a whole blood sample and they were within the normal range but the cardiologist told me just yesterday that may not necessarily tell the whole story about how her body is utilizing it, or not; and there could be other diet-related metabolic issues in her case, as well.
She had called to say she was sending me a research article detailing the results of the study that was done on the group of golden retrievers and it was extremely informative. All the dogs diagnosed with DCM in the study had been consuming diets with similar characteristics, including grain-free, uncommon protein based, or legume-rich formulas (several had been fed Acana, and 1 had been fed Orijen; 52 healthy dogs were also part of the study). “Significant improvement in echocardiographic parameters and normalization of whole blood taurine concentrations from baseline to follow-up visits were observed in all but one dog after implementing a diet change and supplementation with taurine +/- L-carnitine.” Our cardiologist personally knows of two dogs that a change in diet successfully reversed the disease and knows of other cases where that has occurred, as well. Which is what makes me cling to hope.
Of course there is no way to know if a different diet will help Sophie or not – I can only pray that it will. We’ll be returning for another echo in 6 months to see what, if any, changes there have been in her heart and will hope for good news. It has generally taken at least 6 months to demonstrate if a diet change is having any affect.

[Martha M]

Yes, the shortage for this insanely expensive Vetmedin is deplorable. It has been going on for some time and the latest update from a pharmacy I’ve used is that they were recently told not to expect any updates any time in the near future as to when it would be readily available. I own a working Labrador retriever that was diagnosed with DCM this past November, and the difficulty I’ve had in obtaining this med threw me into a complete panic.
Saw this thread and signed on to post the following info that I hope will be helpful for some of you in the same boat:
Because of the shortage many vets (including my own) have turned to compounding pharmacies to have Pimobendin compounded for their clients. Vetmedin is the chewable form of Pimobendan. There is an online compounding pharmacy which makes Pimobendan (see link at the end of my post) in a Flex-Dose tablet (not a chewable, btw) which is scored in such a way as to offer an amazing dosing flexibility. The tablets are scored twice on one side to allow for easy dosing of 1/3 of a tablet and once on the other side to allow for easy dosing of 1/2 of a tablet. The pills are designed so that they are easily snapped into with your fingers and they offer 4 strengths which will provide dosing options for most prescribing needs (3.75mg, 7.5mg, 15mg, and 20mg). The cost savings is SIGNIFICANT. My 62-pound lab requires 10mg twice a day; so, for me, the 20mg tablet snapped in half is perfect. AND, you can order either a 30, 60, 90 or 120-day supply at one time, which is also SIGNIFICANT.
To give you a cost comparison – for my dog, a bottle of 50 (10mg) Vetmedin tablets costs $89.99 through KVSupply.com, which was the best online price I could find; and it lasts only 25 days. That makes the cost of Vetmedin for me $3.60/day for a 25-day supply.
I can get a 120-day (4 months) supply of Pimobendan through this compounding pharmacy for $199.95 which works out to be $1.67/day – less than half the cost of Vetmedin through the least expensive supplier I’ve found. The cost per pill depends on how many pills you choose to order, and the 120-day supply works out to be the least expensive per day, but even the 30-day supply @ $69.95 is way cheaper than Vetmedin. And shipping is free, as well.
I have thoroughly vetted the company, which carries a voluntary PCAB accreditation through ACHC. They compound medications for both humans and pets. Understand that compounding pharmacies are different from those that offer commercial medications. The only difference between the Vetmedin chewable and the Pimobendan tablet is that the Vetmedin chewable has fillers to make it appealing to dogs and the plain Pimobendan is just that – no fillers.
The only other thing I should tell you is that they are currently licensed in only certain states, so depending on where you live you may not be able to order from them. Thankfully that is not an issue for me. They are licensed in over 30 states, however. My own state of TN was recently added to their list a couple of months ago; so if your state isn’t on their list yet and you are interested I would continue to check with them, even call (they are extremely helpful and are very much aware of the issues the Vetmedin shortage is causing).
Following are some links I would encourage you to check out: the compounding pharmacy, (CareFirst Rx), the states where they are licensed and the accrediting organization that provides their PCAB (Pharmacy Compounding Accreditation Board) accreditation. I have spoken at length with ACHC as well and they were also very helpful. Not sure if these will post as actual links but you should be able to copy and paste the URLs if not.

CareFirst Rx – https://www.cfspharmacy.pharmacy/veterinary-medicine/veterinary-cardiology/pimobendan-tablets-compounded

Map of states where they are licensed – https://www.cfspharmacy.pharmacy/shipping-info

ACHC – https://www.achc.org/accreditation-locations.html

Hope this will help some of you, at least.

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