‍CONDITION:  FAIR + - GOOD, languishing

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‍HABITUS:  GOOD, weight maintained at 62 pounds

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‍STRENGTH:  0/4 rear limbs, first time difficulty getting into and out of car

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‍APPETITE:  REDUCED, but always ready for a “cookie”

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‍GI:  Regurgitation and emesis (vomiting) three times in a week. Meals are prepped in bite-sized pieces so he does not lose balance while standing bent forward. Standingn to eat gives Henry a break from lying down to eat.

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‍ENGAGEMENT: Bright, alert, responsive. Henry’s reaction to decreased energy had been acceptance. He has recently he become bored while resting, gnawing on the corners of pillows or pulling stuffing out of bedding.

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‍COR:  Irregular rate, one episode of significant tachycardia too rapid to count where Henry was in distress. An appointment was made with a Cardiology Veterinary Specialist, details follow.

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‍RESPIRATION: Rapid despite lowered heart rate, his resting respiration remained at 100 breaths per minute.  Mouth was dry. On May 11, 2026, pulse rate 92 (60-100) resp 110 (24-35)

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‍Henry's onset of symptoms occurred around the end of March. He had made great progress, initiating play and becoming engaged in play. He even made a ball squeak. Henry’s heart rate became consistently rapid and pounding. His respirations were high and he was exhausted.

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‍Use of his body was limited. In the morning, he walks out of his kennel and  lies down without using the dog door or eating. Every movement appears to be an effort.

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‍Henry still perks up at favorites: cookie, his friends Kaos and Mr. Bones. He wants to go for a ride or a walk. He still has bursts of energy, to spend at his favorites: he will leap into the back of the car and over the seat, ready for his ride. Henry will scamper to meet Kaos or visit Mr. Bones’ house. He wants to walk with his buddies, but uses his cart as needed. 

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‍Henry’s Evaluation by a Cardiologist Veterinary Specialist:

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‍Physical examination revealed a bright, alert and responsive dog with increased respiratory rate (40 BPM; excited panting) and normal effort. There was no auscultable murmur. The heart rate averaged 120 and varied with ventilation. Mucous membranes were pink and refill time was normal. Jugular venous evaluation was normal. The remainder of the cardiovascular physical examination was unremarkable.”

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‍Electrocardiogram documented sinus arrhythmia with an average heart rate of 112 bpm.

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‍Echocardiography Henry was not sedated, was cooperative and imaged very well. The right heart is anatomically and functionally normal. There is no anatomical or Doppler echocardiographic evidence of pulmonary hypertension. Both the pulmonary and tricuspid valves are anatomically normal.  Peak trans-pulmonary flow velocity 1.1 m/s, flow velocity contour and pulmonary distensibility were all within normal limits. Left ventricular wall was normal as was lumen diameter. Indices of systolic function are within normal limits. The left atrial diameter is normal. Both the aortic valve and the mitral valve are anatomically normal. Peak trans-aortic flow velocity and trans-mitral flow velocity are both normal. E:IVRT and E/E’ are normal suggesting normal left ventricular filling pressure. There is no evidence of pericardial effusion or a cardiac mass lesion. 

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‍Clinical Assessment Today’s examination documents normal cardiac anatomy and function as well as a normal electrocardiogram.

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‍Henry requires rest and mental stimulation. Nutrition supplementation of CoQ10, HMB *(beta-hydroxy beta-methyl butyrate), bovine muscle support and more continues. 

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‍Henry still uses the pool for short dips and he paddles around, but some days he does not use it at all.  He meanders out to the yard and lies in the sun. Hydration is important to prevent renal damage or further muscle damage.