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Want to donate to the Rottweiler
Health Foundation towards SAS research?
Click below
To donate to DIRECTLY Dr Stern's Rottweiler SAS research
Please see the note from Dr Stern's lab below
"Thanks
so much for your interest in supporting our research into cardiac
genetics.
If
you would like to make a donation to the laboratory,
you can do so through the center that houses our laboratory - the
Center for Companion Animal Health. There is a form or a link at
the following website https://give.ucdavis.edu/VETM/V435LABthat directs you to giving
instructions.
If
you choose to make a donation - please be sure that your donation
says: Center for Companion Animal Health - STERN LAB on the
donation. After completing a donation please notify us at jstern@ucdavis.edu
and we will then follow the donation and
ensure that it makes it to the appropriate project / fund.
If
you wish to make more than an individual donation or organize a
donation event, please contact Dr. Stern or our development office in
order to ensure that funds are appropriately directed."
Sub Aortic Stenosis (SAS) is the
most
common congenital heart defect in Rottweilers.
Rottweilers
are affected with SAS on all continents and almost all bloodlines.
Many of the presumed heat stroke or poisoning deaths are later found
(if a necropsy is done) to have been SAS deaths.
SAS
involves the narrowing of the out-flow tract from the left ventricle
leading to the aorta. When there is a narrowing of the
tract, the heart must pump harder to get blood through the smaller
opening. As the SAS-affected dog matures, his/her heart develops a
thicker muscle to push harder, which (in
moderate to severly affected dogs) leads to an irregular heart
beat, a lack of blood to the heart, congestive heart failure, or sudden
death.
SAS is diagnosed in living dogs by a cardiologist performing a
dopplar echocardiograph exam of dogs. Severe
cases can often be tentatively diagnosed by auscultation.
Practitioner exams even if by echo are NOT definitive!
Note that sedation or anesthesia is detrimental to accurate evaluation.
Additionally SAS can be diagnosed by a cardiologist based upon
narrowing, a ridge, velocity or all three. You dont need all three to
be diagnosed with SAS, some dogs only have ONE at the time of
evaluation.
Research
is indicating that
the mode of heritability can vary by breed, and originate at different
gene locations. For example Newfoundand SAS is a totally different gene
location than Golden Retrievers and Rottweilers, and Newfoundlands NOW
have a
DNA test!
NEWS!!!
Rottweiler friends this is going to be long but please read.
Sas update from Dr Sterns
Sas is “looking” to be recessive in Rottweilers , Bullmastiffs and
Goldens
Yes recessive
Here’s my notes from a follow up conversation with Dr Stern
1- pattern of inheritance really does not matter until we have DNA test
Any dog that is part of a pair that produces one should be assumed part
of the process (recessive or dominant variable penetrance)
2- vet cardiologist are not all using most modern equipment or
techniques. So not all are equal. The newer advanced cardiac form helps
but not totally
3- velocities
If lvot reading is taken subcostal (under ribs probe pointing forward )
then anything under 2.0 m/s is acceptable
If lvot reading is not taken subcostal (below ribs) then lower levels.
Lvot taken subcostal (under ribs) will only rarely be under 1.7
(I’m not changing my personal velocity criteria (under 1.7)but
I’m giving you this info)
4- in some pedigrees if recessive but common it can appear dominant
even if it’s not
His exact words “Remember that if the gene is common in the carrier
state then a recessive disease can look dominant in some pedigrees”
5- yes there can be two types like in newfs No guarantee what they’ve
seen is the only type but all he’s seen in his samples indicate
recessive is most likely
6- continue to echo ALL breeding dogs until DNA test comes out
AND make sure the lvot is taken subcostal (below ribs) in these cases
all dogs under 2.0 m/s can be used but if they produce sas realize they
likely carry it and change your plans for those dogs
7- if lvot is not subcostal or you don’t know then 1.7 is a reasonable
safe goal
8- when planning breedings keep the fact that sas is likely recessive
in mind *do a pedigree analysis and research, looking for affected dogs
, *patterns (some popular dogs clearly throw lots of sas), *use only
echoed breeding dogs
* consider all dogs that throw sas as a probable carrier
9- continue to submit samples to the study and hope the DNA market for
testing is found soon
To submit a sample contact lab at jstern@ucdavis.edu
Read the full study article here https://www.frontiersin.org/articles/10.3389/fvets.2019.00052/full?fbclid=IwAR0yRMtSZa-A8OyacOEt980MoO6OeIafoCX1xs12ajkt0Jslf9dPOpMGOtk
Also
read the Rottweiler Health Foundation post 3/2/19
An update on SAS research grant.
RESEARCH PROGRESS REPORT SUMMARY
Grant 02520-MOU: Identification of Genetic Markers for Familial
Subvalvular Aortic Stenosis in
Rottweilers
Principal Investigator: Research Institution: Grant Amount:
Start Date: 2/1/2018 Progress Report:
Report Due: 1/31/2019
Joshua Stern, DVM, PhD University of California, Davis $44,320.00
End Date: 1/31/2020 End-Year 1
Report Received: 2/15/2019
(The content of this report is not confidential and may be used in
communications with your organization.)
Original Project Description:
Subvalvular Aortic Stenosis (SAS) is a heart defect characterized by a
fibrous ridge located below the aortic valve. Affected dogs are at risk
of developing heart valve infections, congestive heart failure or
sudden death. Severely affected dogs have an average lifespan of 19
months. SAS is an inherited heart problem reported in Rottweilers. The
goal of this research is to identify causative genetic mutations and
develop a reliable genetic test for this condition in Rottweilers, to
aid breeders in making informed decisions to reduce the prevalence of
this condition. Once a chromosomal region of interest is identified via
a genome wide association study (GWAS), whole genome sequencing (WGS)
will be employed to identify variants associated with SAS. The top
variants identified via WGS will be submitted for Sequenom analysis to
prioritize variant pursuit.
Funding for the research is provided through the collaborative efforts
and generosity of the Rottweiler Health Foundation. The AKC Canine
Health Foundation supports the funding of this effort and will oversee
grant administration and scientific progress reports.
Publications:
Ontiveros, E. S., Fousse, S. L., Crofton, A. E., Hodge, T. E.,
Gunther-Harrington, C. T., Visser, L. C., & Stern, J. A. (2019).
Congenital Cardiac Outflow Tract Abnormalities in Dogs: Prevalence and
Pattern of Inheritance From 2008 to 2017. Frontiers in Veterinary
Science, 6. (Same link as I posted above)
Presentations:
Poster: Identification of genetic markers for familial subvalvular
aortic stenosis in Rottweilers. Conference: The 2018 National
Veterinary Scholars Symposium
Report to Grant Sponsor from Investigator:
Subvalvular aortic stenosis (SAS) is one of the most common inherited
heart problems reported in Rottweilers. For this study we aim to report
the top variant(s) associated with SAS in this breed. We recently
published a manuscript and determined that the prevalence of SAS in
Rottweilers is 1.17%. (Diane Richardson comment-this is among submitted
samples, I believe the actual incidence in real world is far higher)
We also have completed the first aim of this study, and pedigree
analysis results for the Rottweiler breed has been publish in Frontiers
Veterinary Journal. A genome-wide association study analysis was also
completed, and the region of association has been identified. We are
currently waiting to receive whole-genome sequencing results to proceed
with bioinformatic analysis. We are continuing to recruit affected and
control Rottweiler samples for Sequenom variant segregation analysis.
These are the single hardest "grades" or
"diagnosis" to accept.
To have your dog graded as Equivocal or worse,
affected with mild SAS
and yet the cardiologist tells you the heart looked and sounded perfect
on echo, with perhaps very slight aortic insufficency, aortic regurge,
turbulance etc.
and that your dog would have PASSED a simple auscultation exam. So you
get a grade you never expected. HOW can this be you want to know?!
The facts are simply that the
equipment we
currently
have is not
sensitive enough to image all the tiny defects, BUT research and
necropsies HAVE proven that these elevated velocities- especially when
accompanied by aortic insufficiency, aortic regurge, turbulance etc-
really are extremely
slight affected dogs.
IF you were to open your dog's heart up, you would
be able to see the
miniscule defects (and in a test breeding Newfoundland study they did
just that, sacrificed some of the animals produced and examined the
hearts).
THIS is why I am such a STRONG advocate of breeding
Rottweilers (and
preferably all Rottweilers having heart certifications done) being
echoed BECAUSE auscultations can and do MISS mild and equivocal
affected dogs!!!
Dr J. Stern has agreed to create a short document
about this for me at
a future date but for now his short quote sums up the above facts: "a
device that images from outside the heart could never be as accurate as
looking directly at the inside of the heart. As such, The
presence of a subvalvular ridge on echo is not a requirement for
diagnosis of mild or equivocal SAS. Simply the velocity has been
used by cardiologists for years."
Dr K. Meurs & Dr J. Stern have conducted U.S.
studies for the
Golden
Retrievers,
Newfoundlands and Boxer breeds. Dr Meurs conducted a very limited
retrospective pedigree study for
Rottweilers through the RHF (Rottweiler Health Foundation) but this
study was hampered by a serious LACK of participants. Since I receive
calls and emails monthly from owners of afflicted dogs I KNOW this was
not caused by a lack of incidence of SAS in our breed. Instead the lack
of participation is directly linked to the number of breeders/owners
who
decline to participate!
Dr Stern is
currently collecting blood samples
from both
affected
(as
diagnosed by Cardiologist echo) and cardiologist echo clear dogs (proof
of
clear being an OFA certificate showing the C-ECHO suffix or a
cardiologist report) and they have
began a DNA evaluation of these samples
Preliminary findings are
that the gene(s)
is/are probably
similar as that which afflicts Golden Retrievers (but not the SAME one)
and the
likely on just a single chromosome.
A DNA test for this is
highly likely, IF
steady funding of the
research happens.
The Newfoundland breed got their test because of
steady, generous funding AND participation. One Newfoundland study had
6,000 dogs participating! Rottweiler people are FAR less likely to
donate samples or money.
Rottweiler Familial Subaortic Stenosis
Study
They are currently
STILL looking
for DNA samples
from
Rottweilers with
a diagnosis of Subvalvular aortic stenosis (diagnosed by Doppler
echocardiogram) or proven clear of Subvalvular aortic stenosis (as
cleared by a cardiologist echo ) to advance their study to
identify a gene for the disease.
MANY THANKS to all for
helping
Darla's death (and that of other affected dogs) to help other
Rottweilers in the future.
Darla's
Diet
Here
is the special diet and
supplements (developed through
conversations with many herbal, holistic and natural nutrition educated
people) we fed my Darla. She lived more than twice the length of time
the vets gave her when she was diagnosed at 7 1/2 weeks old with grade
III SAS by a board certified Cardiologist using dopplar echocardiogram.
Darla was
supposed to be dead by 6
months of age, she lived to be 14 months old.
We are not veterinarians and we
strongly encourage you to work with a veterinarian who is open minded
to natural and holistic methods.
We do not make any representation that
following Darla's Diet will cure your dog- there is NO cure. What I do
not want to say, but I must, Is that SAS WILL eventually kill your dog.
Your dog may live weeks, months or even years post diagnosis- but the
sad reality is that SAS WILL end your dog's life one day.
We DO NOT promise that following
Darla's Diet WILL definitely extend your SAS dog's life. NO ONE, not
even veterinarians, can make that guarantee.
What we do feel, is that by following
Darla's Diet:
You
MAY extend your dogs life, You MAY enhance your dog's quality of
life, You MAY improve your dog's overall
health-aside from the SAS, You MAY slow the progression of SAS in
your dog.
This diet
and
supplement schedule DID
(in our opinion) extend Darla's life , and certainly improved it's
quality. Darla had a VERY fun and interesting life!
SUPPLEMENTS
8 weeks old to 4 months old:
AM
10
mg Co Q10 (according
to a
recent article I read, IF you
use dry capsule Co Q 10 use a bit more. It is supposedly not as usable
as the liquid caps.)
1
teaspoon Flax seed oil
(must
be refrigerated)
125
mg L Carnitine (we
used
1/2 of a 250 mg capsule)
500
mg vit C
200
IU Vit E
2
capsules of Hawthorn or
1
dropperful if we could get liquid
1
Cranberry capsule
1
teaspoon apple cider
vinegar
Noon:
10
mg CoQ10
1/2
of a human multi (no
colors added)
2
capsules Hawthorn
PM:
10
mg Co Q10
1
salmon oil gel cap
125
mg L Carnitine (we
used
1/2 of a 250 mg capsule)
500
mg vit C
200
IU Vit E
2
capsules of Hawthorn or
1
dropperful if we could get liquid
1
Cranberry capsule
1
teaspoon apple cider
vinegar
At
6 months old the above was
increased slowly over time (between 4
months & 6 months) to the below:
(only
CHANGES are
listed,
if an item is not listed
then it stayed the
SAME as above)
Co
Q 10- AM & PM 20
mg and at Noon 10 mg
Vit
C- 1,000mg AM, 500 mg
Noon
& PM
Vit
E - 400 IU AM &
PM
Hawthorn
3 capsules AM, 2
Noon
& PM
L
carnitine- 250 mg AM,
125 mg
PM
NEW
item- Ginko Biloba- 1
tablet PM
At
10 months old the above was
increased slowly (between 8 & 10
months)to her adult amounts
(again
the only ones
shown are those that changed from
the original)
Co
Q 10- 30 mg AM, PM and
Noon
Vit
C- 1,000 mg AM &
PM.
500 mg Noon
Hawthorn-
3 capsules AM,
PM
& Noon
L
Carnitine- 250 mg AM
&
PM
Ginko
Biloba- 1 AM &
PM
DIET
We
added pieces of beef or buffalo
heart (about 1" square) OR 1 whole
chicken heart, to her AM & PM meals when we could get it
I
also fed her about a
mostly raw
diet and I think that made almost as
big a difference as the supplements did. If we ran out of meat OR
supplements you could really see a difference in her energy level and
behavior.
We make our own raw diet and I will tell you how
below, BUT you can buy
a premade raw diet like Oma's Pride, Halshan's, Purely Primitive,
Victory, Primal, or Bravo, etc.
The important thing is few or no grains and fruits
and mostly red
meat with some veggies
For one dog the prepackage, premade raw diets are
the easiest. They are
a bit pricey but it takes quite a bit of work to make your own.
You'll have to decide for yourself which will work
best for you.
To hand make your own version of Darla's Diet, you
will need either a
good juicer or a good food processor. These are
to grind the veggies. If you use a juicer you mix the juice and pulp
back together after grinding.
Below is the Darla's
Diet recipe.
Sometimes I fed Darla this
solely and sometimes I fed her 50/50 raw and high quality puppy kibble.
(Healthwise is the brand we
used.) During rapid growth spurts is usually when
I fed her any kibble, just to keep up with her caloric demands easier
I make this in a large container and mix it really
well. Then I scoop
it out into semi packed 1 cup portions and make patties out of it and
freeze 4 patties together in ziplock quart size freezer bags. As you
will see it makes
quite a bit.
Usually dogs eat approximately 1/2 to 1 cup of THIS
raw ground diet for
every 1/2 cup of dry they were eating. BUT you have to watch your
individual dog's weight because, some don't need anywhere near this
much!! Raw is much, much more digestible than kibble, so some dogs
utilize it MUCH better.
As an example my old dog with bladder cancer, ate
just 2 cups of raw a
day when she used to eat 3-4 cups of dry! So she actually ate less cups
but the same weight of food (2 cups of raw = about 1 lb, 4 cups of dry
Healthwise kibble= about 1 lb)
I mix together:
5-7
lbs of 75% lean
ground
beef
1-2
lbs of ground turkey
or
chicken
1
can of Jack mackerel
(rinsed
well and mashed-the bones are
fine for pups over 12 weeks old)
1
can pink salmon (rinsed
well
and mashed-the bones are fine
for pups over 12 weeks old)
1
clove garlic (run
through
the juicer/processor with the
below veggies)
1
can pumpkin-optional
1
egg including crushed
shell
Plus
an assortment of any of
the
below veggies (ground to a pulp
or they won't digest at all) to equal 4-5 lbs- I used whichever I could
find, not all at once- just make sure you have green and either carrot
, an orange fleshed squash or sweet potato mixed the majority of the
time
(greens + a carotene producing veggie)
sweet
potatoes or yams
carrots
either orange and
purple
green
beans
chinese
cabbage
napa
cabbage
celery
beet
greens
dandelion
greens (not too
many)
swiss
chard
kale
parsley
squash
(summer, zucchini,
acorn etc..)
As
you feed this to your dog
add
one 400 mg Calcium Citrate
tablet per every one cup/1 patty of the raw mix, plus 1 spoonful whole
milk yogurt. DO NOT mix
these in with the food ahead of time
Add the other supplements listed in the beginning of
this page as you
prepare each meal.
As you can see it's a good bit of work to do it
right
If you choose to feed a prepared raw diet (like
Halshan's, Aunt
Jeni's, Oma's Pride, Bravo, Purely Primitive, etc), instead of making
your own, check the labels. If the mix contains ground bone then do not
add Calcium Citrate to it.
If you have any questions at all or just need some
hand holding let me
know!!
IF your SAS dog is a Rottweiler, PLEASE, submit
his/her blood,
pedigree, cardiologist info etc to Dr Meurs who is collecting samples
to run the DNA and try to find a marker for this
horror. Submission form is above
Doppler
echo
by a board certified cardiologist is the GOLD STANDARD and
best screening tool we CURRENTLY have UNTIL a DNA test is developed. It
has been proven that dogs CAN pass a cardiologist auscultation
examination with a "perfect" sounding heart and yet fail an echo exam
and be diagnosed with SAS.
Remember even echo "clear" dogs still have a chance
of producing an SAS
positive puppy because UNTIL we have a DNA test nothing is a 100%
guarantee of "clear". You greatly increase the odds of producing
healthy, SAS free puppies though by only using breeding dogs who have
been "cleared" via a cardiologist performed echo. Just as only
utilizing hip "clear" dogs increases your odds of producing puppies
with normal hips. Performing pedigree analysis of the cardiac
statistics of all relatives-siblings, cousins, aunts, uncles,
grandparents etc- assists breeders immensely as well.
(When
reading
the below LVOT
numbers they are assumed to be accompanied by a clean/normal heart, no
murmur associated with a defect and no abrupt LVOT accelerations)
A
cardiologist performed Doppler echo will
allow
you to evaluate velocities
(LVOT) and breeding risks to the best of our current abilities.
Rottweilers
"should" only be used for breeding if
LVOT is 1.7 m/s and below for the "best confidence level"
possible.
Breeding
dogs
with LVOT 1.71-1.89 m/s will give you
an "element of
risk".
Dogs in
1.9
m/s and above range whether the
cardiologist deemed them
"passing" OR Equivocal BUT with NO cardiac structural defects, LVOT
accelerations, turbulance/regurge, valve leaks or murmurs; brings the "greatest breeding risk"
(only surpassed by dogs not echoed!) and should only be done under
certain VERY strict conditions, with dogs possessing exceptional
qualities and ONLY ever
to dogs with LVOT below 1.7 m/s!
NOTE:
there are currently two sets of velocity (LVOT) guidelines.
The version
directly above is strict, and provides the best level of
breeding confidence AT THIS TIME
(until a
DNA test is developed).
The other
is the newer
ACVIM/ARCH version which is somewhat
less
strict and which I and the
cardiologists I have used over the years, believe may allow too many
higher velocity dogs (that may be silent affecteds) to be
bred.
The ACVIM/ARCH
guidelines are at the bottom of this text.
MY
personal recommendation at this time, is to only breed echoed dogs with
LVOT below 1.7 m/s.Preferably with
siblings and relatives who have also been echoed and
their LVOT and reports available.
For those
for whom this is too
strict of a criteria; I offer a second
set of breeding recommendations
below, based upon
differing categories and sub categories. These were created
with the help of the
cardiologists I have spoken
with over the years
Category
1
***************************************
For
dogs without KNOWN
SAS in their background and
whose parents (and better yet
siblings too) are cardiologist cleared; then a cardiologist
(or 2nd best- a
specialist) auscultation is generally considered "acceptable" at this
time by many, BUT will
still allow MANY dogs with elevated velocities yet no murmurs to be
blindly bred, incorrectly assuming they are totally "clear"!
HOWEVER,
a cardiologist performed echo will allow you to evaluate velocities
(LVOT), structure, blood flow patterns and breeding risks to the best
of our current abilities. I do
not personally recommend breeding without an echo being done and the
LVOT evaluated. (see above)
Category
2
(FOUR different
sub categories: read close)
***************************************
1- Dogs
who are either Imports
themselves
(and thus have no cardiac testing
background since the vast
majority of overseas breeders do no cardiac
screening),
OR
2- are the offspring of an Import (even if the import is
cardiac
cleared)
OR
3- are the offspring of non imports that are not screened OR the
offspring of dogs who have any type of Practitioner cardiac clearance
OR
4- whom have a relative with either
a
velocity 1.9 m/s and above OR a relative is affected with or died from
SAS
Those dogs that
fall into this category should have a Doppler echo done
by a cardiologist (or second best- specialist) and should ONLY be added
to a breeding program if their velocity (LVOT) is 1.7 m/s or below for
the lowest risk of SAS.
See the top of the breeding
recommendations for more details about
breeding utilizing LVOT numbers. At NO
POINT is
a Practitioner
certification EVERacceptable.
(IF
looking at an OFA cardiac certificate the last letters tell you who did
them C-ECHO= cardiologist
echo, S-ECHO= specialist
echo C= cardiologist
auscultation S= specialist
auscultation, P-ECHO= practitioner
auscultation, P=
practitioner auscultation)
MY current practice is
to bring BOTH the OFA and ARCH cardiac forms with me to the cardiac
exam and submit to BOTH organizations.
The OFA
form will allow your evaulation to be seen in a searchable database
along with all your dog's other health tests and the ARCH form will provide you with more detailed
information and will also add statistical data to a semi searchable
database of ONLY cardiologist performed cardiac evaluations (you get a
certificate from both groups).
See Annie's
page for links to both certifications
I
base all of my above recommendations on conversations with Researchers
from
2000 - 2006, extensive reading of the current and past research, and
conversations with the cardiologists I have personally used over the
past years
since 1995.
Here are the newer
ACVIM/ARCH Standards (current as of 2011)
In dogs
without ANY
structural changes, etc and with no murmur (except innocent
functional murmurs)
LVOT Velocities of less than 1.9 m/s - deemed clear
LVOT Velocities of 1.9 - 2.4 m/s - deemed equivocal; breeder assumes a
risk level
LVOT velocities above 2.4 m/s - breeding not recommended
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