Sinus Bradycardia in Dogs
Sinus bradycardia (SB) manifests as a slower-than-normal rate of impulses in the sinus node, also known as the sinoatrial node (SAN). This node serves as the initiator of electrical impulses within the heart, prompting its contraction. While often benign and potentially beneficial, slow sinus electrical impulses can lead to fainting if an underlying disease disrupts the cardiac autonomic nerves, which regulate the heart’s activity.
SB is a common occurrence in dogs, particularly in breeds such as cocker spaniels, dachshunds, pugs, West Highland white terriers, and female miniature schnauzers. Moreover, it is more prevalent in young dogs than in older ones, with its frequency diminishing as dogs age, unless an underlying condition triggers it.
Symptoms and Types
Your dog might not exhibit any symptoms if it is highly active or involved in athletic training. Generally, sinus bradycardia (heart rate slower than 60 beats per minute, although this depends on the animal’s environment and size) becomes more noticeable when your dog is resting. Some other common symptoms linked with sinus bradycardia include:
- Lethargy
- Seizures
- Difficulty tolerating exercise
- Loss of consciousness
- Episodic muscle coordination issues (ataxia)
- Excessive slowing of breathing (hypoventilation), particularly under anesthesia
Causes
Sinus bradycardia can be attributed to various factors, including:
- Athletic conditioning (not unusual in athletic dogs)
- Hypothermia
- Intubation
- Excessive sedation
- Sleep
- Underlying diseases such as respiratory, neurological, and gastrointestinal disorders
Diagnosis
Your veterinarian will conduct a comprehensive physical examination of your dog, considering the history of symptoms, overall health status, and any potential incidents that may have contributed to the condition.
A full blood profile will be carried out, including a chemical blood profile, complete blood count, and urinalysis. These tests can identify substances that might be causing a slow heart rate and detect any blood deficiencies or indications of kidney issues. X-rays and ultrasound scans may be utilized to visually assess the internal organs, including the heart and kidneys, for any abnormalities. An electrocardiogram (EKG) recording will examine the electrical activity in the heart muscles, identifying any irregularities in cardiac electrical conduction, crucial for the heart’s contraction and rhythm. In some cases, a 24-hour heart monitoring may be necessary to confirm the diagnosis.
Treatment
The course of treatment will be determined based on any underlying diseases identified. Many dogs may not show clinical signs and therefore may not require treatment. In dogs without structural heart disease, heart rates as low as 40 to 50 bpm (beats per minute) can still maintain normal cardiac output at rest. Treatment approaches vary significantly and hinge on the cause of sinus bradycardia (SB), the ventricular rate, and the severity of symptoms.
In cases of critical condition, hospitalization may be necessary, allowing for intravenous fluid therapy and stabilization of the dog’s health. Activity restrictions are typically not advised unless the dog exhibits symptomatic SB associated with structural heart disease. In such instances, exercise restriction will be recommended until medical and/or surgical interventions stabilize the condition.
Living and Management
Further monitoring will be prescribed by your veterinarian based on the final diagnosis. Symptoms, if present, should improve with correction of the underlying cause. However, the long-term prognosis varies depending on the nature of any structural heart disease that may be present. For instance, treating symptomatic SB with a permanent pacemaker typically yields a favorable prognosis for rhythm control.
