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  #1  
Old 24th July 2002, 06:52 AM
Peggy G's Avatar
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Holter Monitor Test

Does anyone know the approx. cost of a 24 hr. holter monitor test? Scarlet is almost 2 yrs. old and I was thinking (*especially* after reading the below) about having it done (by our regular vet-not a specialist. that is, if our regular vet does them). I have had 3 different vets (Scarlets 1st vet, an ER vet & her now regular vet) tell me that Boxers are prone to this ugly disease (why do they feel the need to tell me this!) and well, I dont care for the idea. In addition to the cost, any input anyone has would be greatly appreciated.

Boxer Cardiomyopathy - This is a disease in which the heart muscle of the dog deteriorates. In Boxers, it seems to affect the parts of the heart that regulate the heart beat first. Therefore, in contrast to other forms of cardiomyopathy in which a long deterioration in function known as "heart failure" occurs, the first sign of a problem maybe that the heart has a sudden spasm of abnormal beats, resulting in sudden death. The form that Boxers are prone to is particularly difficult to deal with, because as described above, the first symptom may be sudden death, so that by the time the owner suspects a problem, the dog is dead. Also, dogs may not develop the actual disease until well after breeding age, making screening before breeding almost impossible.

However, many experts now agree that the best way to detect the disease at the earliest possible stage is to perform a test called a Holter monitor. This test involves recording an EKG for 24 hours, and reviewing for abnormal beats. It is recommended some form of Holter monitor screening be performed annually on any Boxer, starting at a year of age. This will help screen out of the breeding population affected individuals as soon as possible, and will help those who may be affected get the earliest possible treatment. Studies do suggest that early treatment may help prevent further deterioration of the heart.
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  #2  
Old 24th July 2002, 07:43 AM
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A Holter will run probably $150-250. It's never a bad idea, IMO. If she does have VPCs (abnormal beats), you're better off knowing as medication can be quite successful at controlling them - and the breeder will want to know as well. A regular vet can usually hook up the Holter, it's interpreting the results that can be tricky. The tapes have to be sent in regardless. There are companies that rents out Holters to owners, Lifewatch is one (www.lifewatchinc.com) and so is Beverly Glen. I think the ABC site (http://clubs.akc.org/abc/abc-home.htm) has info on others in either the Health or Genetic Diseases section. I've dealt with Lifewatch and the report they send back is quite easy to understand - we didn't even need to see the cardiologist.

 
  #3  
Old 24th July 2002, 08:47 AM
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Peggy...If you can find a boxer club in your area often they own a holter that they will rent you when you join the club. However, it is tricky to get it to stay on for the full 24 hours and a vet might have more success. Lifewatch one of the places that will read your tape is $80.00 for the reading.
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  #4  
Old 24th July 2002, 09:32 AM
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I only paid $60 for the reading from Lifewatch. Did you use their monitor? Also, sometimes you have to send the tape back to the place you got the monitor, as not all places can read all tapes.

Thanks for that bit about getting the monitor to stay on - here's a site with good hookup instructions: http://www.veterinarycardiology.com/holter_monitor.htm

If you follow these instructions exactly, unless the dog is very adamant about getting the monitor off, it should stay on quite well. I strongly suggest having two people - it makes it *much* easier! My middle boy even rolled around on his back a few times (until we could stop him, of course - who knows what he did in his crate overnight, though!) and it stayed on.

 
  #5  
Old 24th July 2002, 09:48 AM
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Julie..I was going to use my breeders. She bought one for $900.00 and lets all her babies use it at 2 yrs. Of couse with Molly we never got that far because she was diagnosed with BCM so early. She sends her tapes to lifewatch and I thought she said $80.00 but I could be wrong. When I went to see Molly for the 1st time the breeder was testing one of the other dogs and she showed me how to use it. The poor boxer baby was not to happy about the holter "suit" and tried desperatly (sp?) to escape. Eventually he got tired and passed out in his crate.

 
  #6  
Old 24th July 2002, 12:15 PM
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Lacy had a holter monitor in August 2001, and it cost us $290.00 ($70 office visit, and $220 for the holter monitor). We had it done by a cardiologist since several months prior to that we had a doppler echocardiogram done by a cardiologist. That was about the same price ($90 initial office visit, $220 echocardiogram). Our regular vet referred us to a cardiologist... he said he could do these tests himself, but more than likely he would need to speak to someone who was a specialist in the field, so why not just go straight to the specialist. It was probably better that we did, because some of the things our regular vet was worried about (her murmur and he thought her heart was a little enlarged), the cardiologist had absolutely no concerns with.
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  #7  
Old 24th July 2002, 03:06 PM
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Thanks everyone!

I would probably feel more comfortable having my vet hook it up on Scarlet but I could figure it out myself if I had too. If I go the vet route, do I then ask that he send the results to Lifewatch or would that be an insult to him? (Like saying I dont trust you to read it correctly?) Or do most vets send it out anyway? Julie, did you rent the hoter from Lifewatch? If so, how did the rental program work?

From puppyhood, a murmur has never been detected on Scarlet. But if I understand correctly, just because a murmur isnt dectected doesnt mean your dog cant drop dead of Cardiomyopathy. I cannot stand the thought!

I guess I could assume this but will ask anyway...are VPC's the same as a murmur? Are murmurs a separate issue from cardiomyopathy? Are murmurs a prewarning sign? I thought the only prewarning sign was your dog hitting the ground.

 
  #8  
Old 24th July 2002, 03:22 PM
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Peggy some worriesome news for you..it is possible for a holter test not to detect BCM even if a dog has it. It is the most effective test for BCM though. Your dog would have to throw the rapid VPC's during the test for it to catch it. This is why the color ECHO isn't that reliable. For the color ECHO your dog is only hooked up for about 6 minutes. The dog may not throw the VPC's in that amount of time. In a 24 hour period there is a much better chance that the dog may have the VPC's and the test will catch it but it isn't a guarentee. Most people get on a scheduel and the dog gets the test every couple years.

Here is a link to a site that will answer all your questions

http://www.boxergallery.com/articles/cardiomyopathy.htm

Last edited by matilda8255; 24th July 2002 at 03:29 PM.

 
  #9  
Old 24th July 2002, 07:00 PM
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OK, back up.

Color Echo does not address cardiomyopathy - Echocardiograms look at blood flow velocity which is related to aortic stenosis.

EKGs look at heart rhythym, which is related to cardiomyopathy. And yes, an average EKG (and some are only 3 minutes) generally does not catch cardio. A 24-hour Holter is better, and if the dog has a bad case they will generally throw VPCs several times during that period. (Nothing guaranteed, of course - you know these dogs can never make anything easy! )

Murmurs are not related to cardiomyopathy; they also are related to aortic stenosis. Generally, if the dog does not have a murmur by age 2 it does not have aortic stenosis (as determined via auscultation by a board-certified cardiologist, of course). Or, if it does, it is not severe enough to affect length or quality of life.

VPCs and murmurs are different. VPCs (or PVCs, they're called both but the latter makes me think of pipes) are premature contractions of the heart originating in the ventricle. These are also called ventricular ectopy. The Arizona Boxer Club has a good explanation of cardio in layman's terms - www.boxerclubofarizona.org and scroll down on the right page, it's something about Dr. Meurs' report to the ABC I think.

As far as the Holter goes: If your vet is experienced with hooking up Holters, by all means go to him. If he's just as new at it as you are, you might want to save yourself the dough and do it yourself.

I didn't rent the Lifewatch Holter - a friend has one - so I'm not sure how the whole process works. I think it costs $90, but I'm not sure if that includes the reading or not (if not, it would end up being $150 total). The BU website www.boxerunderground.com has the contact person information on their Links page. The tapes have to be sent in to generally wherever you (or your vet) got the Holter from - most vets don't have the equipment to actually read the tapes and send it out. I got my results back in about a week.

 
  #10  
Old 24th July 2002, 07:37 PM
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I am sorry I meant the EKG. So many tests I get confused.

 
  #11  
Old 24th July 2002, 11:35 PM
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I'm so glad I found this thread. I was planning on asking my vet about this on Friday. I want to have Chewy tested, and later get Stella tested. I have more info now - and more research to do.

Thanks!
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  #12  
Old 27th July 2002, 03:01 AM
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Question I'm so confused now!

Well, today I asked my vet about getting a 24 hour holter test done for Chewy. My vet is saying something different than everybody on this thread.

He said that the best test to detect cardiomyopathy is an ultrasound. He said that since it is a structural problem (and he showed me diagrams in a vet book), then the ultrasound can show any structural abnormalities - such as thinning of the walls of the heart and any enlargement of the heart. And it can even detect problems with blood flow.

He said that a 24 hour ekg will just show if there is any arrhythmia - irregular heartbeat - and that is not necessarily a big deal and not related to cardiomyopathy. I'm thinking that Boxer cardiomyopathy is a little different than regular canine cardiomyopathy. Is this true?

He fully knows that Chewy is a boxer, but is he just maybe unaware that BCM is different? I need help with this. Which really is the best test and exactly why? Is my vet misinformed? He has been a very good vet, but I realize he may not know everything. Please help!!!