# any experiences with heart murmers?



## LisaT

I took Indy in to get some bloodwork today, and the vet found a heart murmer. She judged it as a grade two. It wasn't there when she had her mast cell tumor removed in September.

I suspect that it's caused from systemic inflammation? It's either from infection, or from her vaccine-related issues. We don't know which. I may know more when the bloodwork comes in.

Experiences anybody? I haven't yet done any research on it -- that will have to wait until tomorrow.


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## Maraccz

Yup my Cody (a non-gsd) had a heart murmer for a few years before her passed away (not related to the murmer)


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## Tula

Sorry, Lisa. I know nothing







But please keep us posted. I do know plenty of humans with heart murmurs yet don't have any issues. No clue if it's the same for dogs.


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## JeanKBBMMMAAN

M&J had a dog with one. I am not sure if it was like an adult onset or if he had it all along...

Is there such a thing as adult onset heart murmur? I guess there would be huh? I am sure they are different from the puppy murmurs. 

Anna had one but it was caused by an AV fistula and was that was probably caused by being shot.







I have an image of the fistula-it was huge. Hers was a 5 before her surgery and is a 1 now (can't really hear it but it's there). I cannot say enough good about her cardiologist. 

That must have been scary news-I'm sorry.


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## LisaT

thanks everyone.

Jean, I can imagine that being shot might induce some kind of trauma!?!?

The vet thought it was most likely due to degenerative changes from inflammation. What is inducing the inflammation is a entirely different story. I am worried about the suddent onset. She has not been well since that surgery









The vet thought we should monitor it and then see the cardiologist if it progresses. I think I am going to treat for infection first and see if that changes anything. I don't know yet what to do for valve disease -- most heart info I have is about the other aspects of the heart.

Yes Jean, it is scary news. I expected her some day to get cancer because of all her risk factors. Her heart wasn't something I would have ever expected. She has such a low heart rate too -- at the vet's it's probably about 68, and 52 at rest. They always have to set their monitors real low for her. When she was young, I used to think she wasn't breathing.....


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## M&J

Wow Jean, you have a good memory. Your Anna had the mack daddy of all heart murmurs and look how well she is doing!

Madison was dx with a grade 1 when he was around 4. It never interfered with his activity. When he was 14.5 it went up to a grade 3. Cardiologist said he would not die of anything heart related, and it was controlled with enalapril and a diuretic that began with an "L".
He ended up dying of kidney failure months later.
Hope the antibiotics work. If not, there are meds to help control it.
Good luck!


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## LisaT

Thanks Mary. Jean does remember all sorts of stuff, doesn't she? (hmmm, also assumed Jean is a she?)

I just recently read something about the heart and the kidneys.....hmmmmm.....

Indy doesn't tolerate drugs, so this will be a new path for us. For a grade 2 murmur, would you see a cardiologist? Or wait and monitor?

I too hope the abx work -- it's a long shot.


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## M&J

I am a hypochondriac so yes, I would see a cardiologist, just to be under their care.
I paid $400 for an ultrasound. Worth it for peace of mind, to me.
If I remember correctly, the cardiologist said they don't treat for a murmur until it reaches a grade 3. I guess it depends on what the ultrasound shows.
If the antibiotics work, I would just stick with my regular vet and monitor it.


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## LisaT

Thanks Mary. I think I will do just that -- see what happens with the antibiotics. The vet did say we'll monitor it closely and they do work with a cardiologist that she really likes. Max gets acupuncture about every 6 weeks, so I'll bring Indy in to get checked then.

Thanks.


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## M&J

Sounds like a plan, Lisa. Best of luck!

PS. My same dog had mast cell cancer when he was 7. He died at almost 15. The cancer never returned after his initial dx of MCC.


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## 3K9Mom

Grover had a murmur diagnosed about 3-4 years ago and graded by the cardiologist at a 2/6 with ultrasound. She had atrial enlargement. I think on the right side. 

September 2005, it was upgraded to a 3/6 after we went to the Emergency Clinic because she was having difficulty breathing. We did another ultrasound and put her on Furosemide (Lasix) and enalapril. I recall her being on a third medicine but I'm not sure what. I'll have to dig out her files. On those medicines, she did great -- I mean, absolutely great! 

December 2006, we did lose her due to massive congestive heart failure. She was 12 years old. She was doing great until Thanksgiving Day, when her tongue turned deep blue. After another ultrasound, the cardiologist ramped up the Lasix a lot, and it seemed that she turned the corner. We had bottled oxygen in the house just in case, but used it only a couple times. Then she was up and her regular self again. On December 5, she went into heart failure and died quickly. It was, quite honestly, a shock. 

So after her diagnosis, Grovie had several really good years. She ran, hiked, camped, swam, played, beat up on Camper, and did everything that she always had done. She barely missed a beat, and when she did, tweaking her medicine did the trick. 

Her death was quick and relatively painless. We took her to the Critical Care Clinic. Once they told us that her heart was failing, we decided to end it early, and she died surrounded by those who loved her most. It was a dignified end. 

I wish I could tell you that a murmur doesn't mean anything. But for Grover, it did spell the end....but after several years. In the interim, it didn't keep her from living a full life, and her death was sweet and fast.



Good luck to you and Indy, Lisa. Indy will be in my heart.







Let us know what the cardiologist says.


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## Drakegsd

Lisa,
I PMed you


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## LisaT

3K9Mom, Thank you for sharing your experience with me. It really helps me to not take this lightly. Since it has come on recently for Indy, with the onset of other problems, I really need to be proactive to make sure that things don't start to spiral. I have to confess, it was tough reading about Grover -- dogs have such a great heart, and it just seems so wrong that the actual organ can be such a source of disease.

I know I keep saying it, but I never imagined it would be her heart.

DrakeGSD, got your p.m., and thank you









Mary, I did a quick search, and there are histamine receptors in the heart, and histamine is a cause of inflammation. I wondre if there is something there.


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## LisaT

Just doing a bit of research. While there are some murmurs that stay relatively stable, those that progress seem to progress to congestive heart failure. Does anyone know if that's always the case?


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## debbiebrown

Lisa,
the only only thing i have seen with heart murmers is sometimes they can outgrow it if they are young. i don't know how old Indy is, but i have only seen it in young dogs and alot of times it can straighten itself out. in older dogs i have had no experience with it.

debbie


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## LisaT

Thanks debbie, I heard about the younger dogs growing out of it too. Indy is 10 1/2 now and the murmur wasn't there or was not detectible about 3 months ago. I don't think she'll outgrow it









Last summer she was panting on some of our walks, which she has never done before, but I attributed that to her bone infection, and, in retrospect, maybe the mast cell cancer. Now I'm wondering if it was the heart too.

I think Indy's spreadsheet can rival any of Jeans any day


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## debbiebrown

poor Indy, i hope there is something they can do. if i know you Lisa you will leave no stone unturned! yeah, you and Jean are in close running! lol!

debbie


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## JeanKBBMMMAAN

I agree-I think Indy's spreadsheet is much more involved-there are things on there that I never would have picked up on!

I just keep thinking she is so much younger-she looks younger. 

Here we go to a radiologist for the ultrasound first. Then she reports to the regular vet and if necessary, the cardiologist. 

I don't want to add fuel to the scary fire, but with Anna's hers started a 3 and ended a 5 from August to December (still have a panic feeling when I think of that). But they can do AMAZING things in cardiology. While we've been at Cornell, I've seen dogs in those holter monitors, dogs getting such great care...enriching the quantity and quality of their lives. 

I like Mary's stoy better-the mast cell and the heart murmur part!


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## 3K9Mom

Lisa, is Indy taking Glucosamine? 

A few months after Grovie died, I was reading up on Glucosamine, and I read that it's counter-indicated for heart conditions due to the salt levels. Made sense to me. 

On one hand, we're giving a diuretic; on the other hand, we're giving Glucosamine, a salt? 

Now, this information was for humans, and I don't know that dogs process salt like humans do. But looking back, if I had known, I would have pulled Grover off of Glucosamine the day we put her on the Lasix, just to be cautious. 

Just something I thought I'd mention.


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## LisaT

debbie, thanks. I *will* leave *no* stoned unturned (drives my husband nuts!).

Jean, Indy thanks you on the compliment of her age







The vet says the same thing -- in fact the vet brags to her collegues when Indy comes in. I contribute it to the homecooked food and supplements the last 7 or 8 years. I keep thinking that for a 35 lb dog, her "innards" shouldn't be aging so rapidly, but she's had a very tough life









3K9Mom, yes, she is on glucosamine. I hadn't thought about the salt issue. Her bloodwork has always shown her on the verge of dehydration, so I'll have to think about this. I hate choosing the lesser of two evils -- hard to imagine her not a good supplement. Drat...


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## EastGSD

Lisa, just wanted to comment real quick...

A heart murmur in itself is not a disease, it is a sound that is a symptom of something going on. A number of things can cause the "sound" like disease, degeneration or congenital problems. Another quite overlooked cause is blood volume issues. Blood volume is of course effected by hydration and also by packed cell volume so a dog that is aniemic (sp?) or dehydrated can present with a heart murmur of a low grade. I would get with your vet and attempt to get more info about the murmur, such as it's location (this is a big clue to the issue, where it is heard in the chest) and get some blood work done etc to try and figure out what you are dealing with. With a grade 2 I would not be terribly worried myself.

Take care,
Cherri


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## LisaT

Cherri,

Thanks for the input. I don't know if you would know anything about this, but she does have some blood anomolies. She has blood that is slow and very thick when drawn. Platelets are always normal. While RBC and WBC are always within the normal range, her wbc is always at the low end of the range. Her total RBCs are in the middle of the absolute range, though the percentage ofr RBC to WBC then of course is at the higher range.

Her HCT (isn't that the one equivalent to the PCV) is always at the high end, as is the MCHC.

Some of these oddities are very consistent to what happens in sighthounds (which may be in her lines), so it's never clear if this is not right, or it is right for her.

I have an email into the vet, but being the holidays, I haven't heard back from her.

Thanks for the heads up Cherri, I will be looking into all this.


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## middleofnowhere

Here's a related one for you. The eldest (now approaching 13) has a heart murmer & a slightly enlarged right side. If I remember correctly, she's had a slight murmer for a long while (forever?) On the other hand, maybe that was another dog. Those of you with good luck with enalapril - how old were your dogs at the time you began treating with this drug? How do you think it helped?


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## LisaT

I'll be interested to hear about the enalapril. I wonder is it's always combined with Lasix?

I've been looking at the standard heart supplements. They've already both been on CoQ-10, but I just added some l-carnitine and also hawthorne berry. Has anyone tried these?


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## middleofnowhere

Evidently not always combined with Lasix because our vet mentioned it as a solo.


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## M&J

My dog was on enalapril. I am on the fence about it. It's supposed to be safe, and they closely monitor kidney function with its use. Madison's levels had to be checked before he went on, after two weeks, six weeks, and then two months. His levels were fine for the first three blood tests.
Before he got to his 2 month (I think these are the intervals), he went into kidney failure and died a week later.
I do, however, know of several dogs who live years on enalapril. I am not convinced the drug had anything to do with Mad's kidney failure. The vet said at that point, he was in multiple organ failure....so I'm thinking it was going to happen regardless. I am thankful that he was healthy up until that day, and the enalapril was a benefit to him for those few months.


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## LisaT

THis looks like a good overview:

http://www.marvistavet.com/html/body_enalapril.html


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## middleofnowhere

Thanks for the link. I had done a search. The vet sounded as though it were benign but what I read on line caused me to question that. I suppose what it may mean is that I am not adept at translating vet/drug talk.


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## LisaT

I've found that vets and doctors seem to downplay the side effects on most things. AND....they tend to think that anyone experiencing those side effects is an anomoly......drives me nuts.


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## LisaT

Indy Update:

I took Indy in so the vet could listen to her heart, and there is good news. It seems that that the murmur is very faint. The vet said that if she didn't go looking for it, she might not have heard it.

I'm keeping my fingers crossed that this isn't a normal fluctuation, but an actual improvement in her heart condition. When she was initially diagnosed, I did the following:

added n-acetyl-carnitine and hawthorn berry for the heart, put her back on doxycyline in case the murmur was caused by infection that might have been triggered by the prednisone, and also put her on licorice, since she has been looking a bit like an Addison's dog and seemed to need some adrenal support.

I guess we'll really know in several months if this stuff really helped. One thing i did learn, is that whippets are known for having late onset heart murmurs and problems, and we suspect Indy to have some whippet in her. She does have the slow heart rate, and sinus arrythimia that whippets are said to have. So it's good to know to get a jump on this now, before she gets older. I'm wondering if this heart problem really translates to a circulation problem and maybe why she has always had very slow, thick blood.

Anyway, the good news is that she's not progressing, and hopefully she is improving!

http://www.mothernature.com/Library/Bookshelf/Books/15/18.cfm


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## M&J




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## LisaT

> Originally Posted By: M&J


Thanks


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## EastGSD

Good to hear Lisa


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## LisaT

thanks Cherri. I hope that this isn't something that will keep haunting us, or force her on antibiotics forever. But I'm very relieved at the result


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