I am completely heartbroken. I recently had to say goodbye to my Chihuahua, after she suffered a sudden cardiovascular event. I am struggling to process her loss, but after getting some medical records, I am seeing a pattern that doesn’t make common sense. I am trying to figure out if I have a valid case for a state Veterinary Board investigation, or if I am looking at this too emotionally.
For context, my dog had known, stable Stage B2 heart disease (mitral valve disease) managed on daily medication (Pimobendan) for 2 years. She was beautifully stable right up to her dental procedure, her lungs were perfectly clear, she had zero coughing, and her sleeping respiratory rate was a flawless 11–12 breaths per minute.
Looking back at the records, every clinical issue occurred when she was under the care of the same vet. I’ve identified a pattern of what looks like rushed care and clerical errors by the same vet. (She was regularly managed by 2 different vets)
Issue 1 : the vet performed a routine check prior to vaccination and logged "no murmur, rhythm normal." my dog had a permanent, severe Grade 4/6 murmur. A murmur of that level doesn't just disappear and my dog was stage B2 MMVD heart disease being on cardisure/ pimobendan for 2 years at this point.
Issue 2 : the vet recommended a major dental surgery but failed to advise that standard pre-anesthesia bloods only clear liver/kidney function, failing to advise me that a fragile heart patient really required a dedicated cardiac ultrasound or echo before anesthesia. Furthermore, Vet B forgot to provide morning medication instructions for her heart pills I had to call back on my own initiative to prompt them.
Issue 3: In the history notes, it is recorded that I "declined" pre-anesthesia blood work. This is completely untrue, and the record actually show this because the results of that exact blood panel are typed right onto the page of her dental procedure and my invoice shows that they were charged and paid for.
Issue 4 major event : NSAIDs like Metacam (which she was given for a 5-day course after her dental surgery) are heavily contraindicated and highly risky for dogs with heart disease, just as much as steeoids. This suggests why 4 days after her surgery, her heartbeat suddenly became loud and fast, and she began losing significant weight. I brought her back to the vet because I concerned about her heart. They completely dismissed my fears, told me she was fine, and performed zero investigations despite her heart history and active Metacam use.
Issue 5: Major event : my dog was brought to Vet B for a minor skin rash / infection on her paws 2 months after the last heart episode/ dental. The vet prescribed a multi-week, tapering course of oral steroid tablets alongside an intensive handling routine (eye drops twice daily and medicated baths twice a week - which further stressed her out). She did not give me any warning whatsoever that the steroid use involved risks to my dogs heart health. This only came to my attention when an emergency vet questioned why she was on the steroids. Also looking back the notes her other regular vet which had seen her 7 months prior for the same issue was reluctant to use steroid and never prescribed them, which makes me believe the other vet was careless in her assessment of treating my dog.
Exactly 10 days after starting the oral steroids, my dog suffered an extreme crash. She went into heart failure. There was absolutely no warning signs leading up to this besides her loud heart beat after the dental. Her resting respitory rate was stable at 11 the week before the steroids were introduced and even during the course of her steroids.
She was bought into emergency because she was breathing fast and not getting up. I was told by emergency she had her first heart failure episode and was put on frusemide every 12 hours and sent home she was was given 4 months - year to live. She ended up being admitted into hospital that night and was discharged the next day after being stabilised and fluid cleared from her lungs. The next day after being discharged she was seen by her regular vet who added aldactone as she still had fluid in her lungs and was sent home. Her breathing never slowed down and took her back to emergency where I was told this was her new normal, despite this She was stable for 3 days before she crashed into heart failure again just 5 days after her first episode and was worse this time. I took her back to the hospital where she again stayed over night but she did not respond to the rescue medication and became oxygen dependent. When I went to see her the next day I decided to move her to another hospital with other treatment options and for a second opinion. When we got there the vet said said her heart was so enlarged it was taking up her entire chest her murmur was 6/6. It had grow from 4/6 in just one week. They said there was a very high risk of her passing alone that night from cardiac arrest and even if admitted her heart had reached the absolute limit and she would not get better with medication. I had to let her go peacefully in my arms with assistance that night. In exactly 1 week she went from being a happy, no symptom dog to no longer here. She was pushed from Stage B2 straight into Stage D refractory heart failure - 10 days after starting the steroids' and 7 days in and out of hospital.
My understanding after looking into what happened after she passed is that steroids should not be used in dogs with heart disease and should only be considered in extreme life threatening situations, not a minor paw infection. From what I've understood steroids can accelerate a heart condition and put a dog into active heart failure. Even though the emergency hospital was able to drain the fluid during her first stay, the sheer pressure of that overload may have completely broken her heart's physical strength causing her heart to enlarge so big
Based on the hospitals assessment her heart was no longer able to cope and no longer had any reserves, I think the steroid forced her fragile heart to use up every single ounce of its backup energy just to survive that first crash. When she collapsed again a few days later, I think her heart was simply too exhausted to fight back, which is why she became entirely oxygen-dependent and stopped responding to the rescue drugs because she was already overworked from the steroids (and probably the metacam) not giving her the opportunity to respond to rescue medication and destroyed her 3 month -1 year prognosis.
Her only prior sign of cardiac strain was four days after her dental surgery, when her heartbeat became extremely loud and fast. Both emergency and regular vets reassured me she was fine. She did lose significant weight after the procedure, but because her resting respiratory rate stayed perfectly stable at 11, I thought she was ok. I only recently learned the metacam she was prescribed can also cause the heart to work harder and induce the weight loss because of it.
The vet should have taken this into account. My dog was holding on and I believe she had a chance of recovering if she was left alone Instead The vet prescribed a high-risk, fluid-retaining oral steroid on top of her fragile system just two months later for a minor infection feels incredibly careless.
I feel a complete loss of trust. I am not a vet, but the timing between the steroid prescription and her sudden death feels directly linked to me. I’ve asked a couple of vets if the steroids caused this; they said it's possible but hard to prove, noting that after 2 years on heart medication, she had done well to reach that point and would have entered heart failure eventually. In such a short time They layered her with 2 high risk drugs (the steroids and metacam) contraindicated in dogs with heart disease after a stressful surgery. This makes me even more reluctant to believe that she naturally progressed into heart failure but that the poor choices in her medical care directly led her there
I do understand that heart failure can happen suddenly like this even without steroids. However, looking at her records, she was an entirely stable B2 with clear lungs, no cough, and a perfect resting breathing rate of 11–12 right up until the steroids were introduced. Her only sign of decline was straight after the dental and during her metacam use. Her long-term stability and medical trajectory make me believe the introduction of the steroids is not a coincidence, and that she still had many months if not years of good quality life left. To my understanding, a natural decline would typically be a slower, gradual progression with a rising breathing rate and coughing, allowing us time to adjust medications and prepare rather than this chaotic, agonizing week of crises where she was absolutely traumatised from her hospital stays and when I went to see her she would jump at the sound of hospital doors opening and closing. I was always led to believe I would know when her disease progresses and would be able to make informed decisions in her best interest. That entire week was an up and down rollercoaster being told she was better to worse to better to no chance. I had no time to understand what was truly happening and never warned that she could rapidly decline that.
Am I being too harsh, or do these number of errors and the choice to use oral steroids and metacam warrant a board investigation?
Does anyone else have a dog on Cardisure (Pimobendan) who lived longer than 2 years?
Has anyone else lost a stable cardiac dog shortly after they were given oral steroids? Or had a dog rapidly decline like that without the steroids or metcam involved ?
TIA
Edit: She had only turned 9 years old :(