Q. I have a 9-year-old Akita who has recently lost 20 pounds. She was at a healthy body weight to begin so the weight loss is dramatic. She has no other physical symptoms except for a cough after exertion. Her blood counts, chemistries, stool studies, abdominal ultrasound, and chest X-rays have been normal. We have lived in Texas, Tennessee and now in Colorado. What other disease processes should we be considering?
A. Your Akita has many of the signs of progressing heart disease. Significant weight loss and a cough after exercise are two of the main signs of a dog’s failing heart. Heart disease in humans and dogs is quite different. The No. 1 cause of heart disease in dogs is congestive heart failure due to a leaky mitral valve (the valve between two of the chambers of the heart), not heart attacks caused by blocked coronary arteries.
However, with normal chest X-rays, the diagnosis becomes more of a conundrum. Is there a heart murmur? Sometimes chest X-rays can appear somewhat normal, but there can be significant underlying disease. Is your dog negative for heartworms? With a history of living in Texas and Tennessee, heartworm disease should be on the list of possible diagnoses. A simple blood test will rule this out.
An echocardiogram (an ultrasound of the chest) would rule out cardiac disease such as congestive heart failure or heartworm disease. Your dog should be re-examined with a special emphasis on listening to the heart. It may be worthwhile to have a veterinary radiologist review the previous chest X-rays for subtle signs of disease.
The other disease that would be a concern is cancer, possibly located in the chest. A mass near the trachea, lungs, or heart may have been undetectable on X-rays, but may be more apparent on re-examination or an echocardiogram.
Hopefully a follow-up exam, repeat chest X-rays, and an echocardiogram will give you some answers. A weight loss of 20 pounds, as you suggest, is dramatic, and signifies a big time disease. Hopefully it is one that can be successfully diagnosed and treated.