Kliff (last name of parents, Spring) is the most adorable geriatric patient on the planet—perhaps on all planets for all we know (save Pluto since we now know it no longer deserves that designation). I love Kliff.

Kliff is a big, red Doberman. He’s been my patient for about eight years now. For all that time he’s never failed to be anything but a perfect gentleman. When I saw him on Thursday, however, he was coughing, ouchy, and out of sorts. When we laid him gently on his side to take a chest X-ray he actually snapped a little—at the air, really, but that was enough. That’s when I was sure something was seriously wrong with him.

Although his chest didn’t sound too bad through the earpieces on the stethoscope, the chest X-ray told a different story: congestive heart failure.

Congestive heart failure happens when the heart can no longer push the blood around the body efficiently enough. As a result, the blood sort of gets backed up so that the liquidy stuff in it seeps out into the delicate lung tissues. This causes inflammation and sometimes infection—the result of which we call pneumonia. Hence the cough and the out-of-sorts thing.

Kliff has always been incredibly healthy—except for his arthritis, which has gotten progressively worse in the past six years. He’s been on some combination of NSAIDs (Rimadyl or Metacam, in his case) and joint supplements (glucosamine and chondroitin sulfate) since then. The NSAID dosages have increasingly been upped as his joints have deteriorated. For the past twelve months he’s even started to get a small dose of opiates (Ultram, AKA Tramadol) to accompany his NSAIDs.

Through all this Kliff been a great patient. He’s responded to the changing mix of drugs as if his body read the textbooks—no side effects, just the appropriate response to everything. Dogs like Kliff make me look like a superstar vet.

Today was another story. Kliff was in dire straits. The first inkling I’d had that his heart was giving out was back in June when I’d picked up a low-grade heart murmur. We talked about an echocardiogram at the time (a heart ultrasound) and perhaps some preventative cardiac meds but his owners were convinced Kliff’s joints wouldn’t last long enough for his heart’s problems to catch up with him.

So much for that theory. Kliff’s joints (albeit pharmacologically assisted) have most certainly outlasted his heart’s normal function. Now we have to mix in the cardiac drugs to bring his heart up to speed. But his owners are still convinced he won’t last the therapy. So no cardiac workup for Kliff. At least they agreed to some meds, which I chose almost haphazardly based on his current symptoms and breed, since I couldn’t perform further tests.

Two days later, Kliff is home and comfortable. He’s taking two supplements and five drugs. Hopefully he’ll be down to the supplements and just three or four drugs within the month. Like he’s always done, Kliff has responded to all the meds just like he was supposed to. He’s got back all his energy and is still improving daily. Who knows how long he’ll last now?

Hopefully his owners will see that Kliff is one of those lucky dogs capable of anything and they’ll go for the echocardiogram to stave off even worse impending cardiac disasters. He’s doing so well, though, I don’t think they’ll ever realize how fortunate they are. I can`t exactly blame them--he`s one in a million.