Heart Murmur Medication

[Leema]

On a recent vet check, my vet suggested putting Mac on medication for his grade 3-4 heart murmur. She said that he could be fine forever, but his heart could also be 'working too hard' and kind of become overworked, thick and inefficent. Medications she suggested would change his blood pressure, making it easier for his heart to pump and without it become 'overworked'.

This is my unscientific interpretation!

I'm looking for any past experiences or suggestions.

I will be getting a second opinion if we do decide to medicate (see if it's worthwhile). Our vet has suggested an x-ray to attempt to determine the exact cause of his murmur.

My main thing is that Mac has seen 5-6 different vets, and none have suggested this. They've all been happy for him to live drug-free considering he is symptom free.

So just looking for opinions or experiences.

[anniek]

I eould skip the x-ray and have an ultrasound.

[ozjen]

On a recent vet check, my vet suggested putting Mac on medication for his grade 3-4 heart murmur. She said that he could be fine forever, but his heart could also be 'working too hard' and kind of become overworked, thick and inefficent. Medications she suggested would change his blood pressure, making it easier for his heart to pump and without it become 'overworked'.

This is my unscientific interpretation!

I'm looking for any past experiences or suggestions.

I will be getting a second opinion if we do decide to medicate (see if it's worthwhile). Our vet has suggested an x-ray to attempt to determine the exact cause of his murmur.

My main thing is that Mac has seen 5-6 different vets, and none have suggested this. They've all been happy for him to live drug-free considering he is symptom free.

So just looking for opinions or experiences.

When I took my Papillon to be sterilized I mentioned to the vet that I had been told by another vet that he was Braticardic (sorry about spelling), that his heart was beating slow but the vet that had told me didn't appear too worried by it . This vet did an ECG before putting him under anastetic and when I picked him up I was told he had a hole in his heart, that it was actually beating much faster to compesate and that he would need medication for life or would be dead within a year.

In shock I took the medication and kept him on it for some time, during that time I also changed my dogs diets to raw feeding. Over time I decided that my lad's health was so much better that I was going to try to go it without medication as he use to get quiet distressed giving him the tablets. He has been off medication for more than 4 years and been kept on a raw diet and has never looked back. He is full of beans, no longer has episoides of depression or off days gives my other larger dog a run for her money and would chase a ball all day given the chance. During this time he has only been to the vet for a couple of vaccinations and once to be stitched up(under anastetic) after a dog attack . He is 13 next month and shows no signs that he is slowing down other than some stiffness on occassion where he was attacked.

It is hard sometimes to decide what is right especially when you get different information from different vets and you want to do what is best for your dog. Sometimes it comes down to using your own judgement in the end, I took a gamble with my lad when I took him of medication but that was weighed up against the fact that he was becoming afraid of me because of having to force the medication (couldn't hid it from him in food) and I figured I would give him a heart attack with the stress it caused him. I decided quality of life was more important than quantity and with his health improving so much on the raw feeding I decided it was worth a try without medication.

Good luck with Mac whichever way you decide to go, I'm not suggesting that medication is not the way to go just that its not always the only answer depending on the individual dog. If medication had not been such an issue for my boy I would probabaly have never considered trying to go without it.

[Staranais]

I agree with anneik, from what I understand ultrasound is better than radiograph for diagnosing the underlying cause of a heart murmurs, though your local vet may not have one which may be why he suggested the radiograph?

If it was my dog I'd prefer to have both an ultrasound and a 2nd opinion before starting him on drugs.

[puggy_puggy]

Poor baby. He's not that old either is he.

The xray would only show if the heart was inlarged wouldn't it? Unless they injected some dye into him which might so blockages or the likes. You would think that an ultrasound would be able to show you more and you most likely wouldn't have to give him a GA to perform one.

[Leema]

Okay, I will confirm that she did mean xray not ultrasound. I'm pretty sure she said xray but we had a long conversation that day so I'd best check!

Mac is 7 years old and was born with this murmur, seemingly (diagnosed with it at 12 weeks). He's only been under GA once to be desexed (he had an undescendent testicle too!).

I feed a raw diet. I think he's a happy and healthy dog, symptom free.

Thanks for the suggestions so far. I appreciate your responses.

[Rappie]

Both xrays and ultrasound are useful, it depends on what information you are trying to obtain.

Ultrasound will show up structural abnormalities, such a defects in the heart wall or thickened valves as well make it possible to get measurements of blood flow and fractional shortening of the muscles etc.

Thoracic radiographs are also important to get general information about the heart - is it enlarged? is there pulmonary oedema? are the airways affected?

Ideally, one would do both. If ultrasound is not available, then we will often base our decision on whether to treat or not on thoracic radiographs. Although the radiographs wont tell us what the problem is (mitral valve dysplasia vs other causes of murmurs), they can tell us whether the heart is compensating well enough or not.

Generally speaking, starting treatment prior to the onset of clinical signs associated with congestive heart failure does not alter the progression of the disease. The most common approach is monitor closely and treat once clinical signs of decompensation occur - such as coughing, reduced exercise tolerance etc. There is another school of thought that suggests treating early may delay on the onset of clinical signs, but there has been no agreement on whether this is the case. Obviously, this all depends on the individual dog - certainly to investigate the murmur itself and ultrasound would determine the cause and how it was affecting blood flow through the heart.

[Leema]

Thanks for the useful advice, Rappie!