# Koch has a murmur...



## Smith3

Well, took our puppy to the vet for her initial checkup and the vet detected a murmur. Now, I don't think it is all that serious since she really had to listen for it to confirm it is what she heard. She didn't recommend a specialist right away but in a few weeks, but I do have the number and reference form. 

The breeder has offered to make things right, but even though I have had her one 3 days now, I am quite a bit attached! She has even offered to work it out months from now if there are any issues (I mean there is the warranty on the dog so i am not concerned). 

I don't see any of the "bigger" issues that a mumur would cause in her, like tiredness, ect. It makes me love her even more because I had a murmur when young!

Should I head off to the specialist now for a ultra-sound or wait 4 weeks until her 2nd round of vaccines? see another vet for a 2nd opinion? The vet didn't seem all that overly concerned, saying to wait awhile to get it looked at, so I am taking that into consideration and not trying to worry that much lol

Other than that, a clean bill of health!


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## BlackGSD

I would wait. (Unless she starts showing signs that something is going on.) Often with baby puppies, they can have a slight murmur as babies, but it goes away on its own over time.


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## LisaT

My girl as an "old age" murmur, and in my research I keep running across these puppy murmurs that often "go away". With my old girl, I waited to have it looked at by a specialist until we started noticing changes in the murmur. If you are bringing your pup in on a regular basis, she should be able to tell if it's getting better.


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## Smith3

Thanks ladies! 

Of course the vet says "murmur" and my girlfriend and I think the worst, but after we sat on it, we will just have to wait and see. She will be getting regular vet visits (I am sure the vet will love that $$ lol), so we will keep it in check. 

Perhaps towards 12-16 weeks we will go see a specialist and see how she is doing and how bad it is (which it doesn't sound to be!)


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## Smith3

So I talked to the vet and she said she was concerned as it seemed a bit loud, so I scheduled an appointment for tomorrow with a specialist... $500 out the window... God am I impatient!

But, I'd rather know now what is wrong and how bad it is. I can't just have it in the back of my mind. I'd rather spend money know and know. Ugh. Everytime I pick her up i feel her little heart and I worry. 

Then the question becomes, do I send her back (God I couldn't)? Do I keep her? if so, how much money am I willing to spend on her? The breeder has offered up a new puppy if I want one or I can wait, she has given me so many options because she feels bad about it. 

I wish someone could make these decisions for me, because they aren't easy.


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## JeanKBBMMMAAN

Here is a good article on heart murmurs:
http://www.veterinarypartner.com/Content.plx?P=A&A=2488&S=1

Did she tell you what grade she heard? 

Info on PDA: http://www.upei.ca/~cidd/Diseases/cardiovascular%20diseases/PDA.htm

For more here is a list, just scroll down to cardiovascular:
http://www.upei.ca/~cidd/intro.htm

Again, though, it can just be a puppy murmur that she'll outgrow. 

Note the puppy in the picture: http://www.vet.cornell.edu/faculty/moise/ you can see all the publications she's done on GSDs and heart issues. Great resource if needed. 

Good luck!


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## GSD07

A friend of mine has a dog with heart murmur since he was a puppy. The dog is almost 4 years old now and doing well, but she spends about $2000-3000 a year on managing his condition.


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## Smith3

> Originally Posted By: JeanKBBMMMAANHere is a good article on heart murmurs:
> http://www.veterinarypartner.com/Content.plx?P=A&A=2488&S=1
> 
> Did she tell you what grade she heard?
> 
> Info on PDA: http://www.upei.ca/~cidd/Diseases/cardiovascular%20diseases/PDA.htm
> 
> For more here is a list, just scroll down to cardiovascular:
> http://www.upei.ca/~cidd/intro.htm
> 
> Again, though, it can just be a puppy murmur that she'll outgrow.
> 
> Note the puppy in the picture: http://www.vet.cornell.edu/faculty/moise/ you can see all the publications she's done on GSDs and heart issues. Great resource if needed.
> 
> Good luck!


Vet said it was 3/4 on a scale of 6... So somewhere in the middle. I should find out more tomorrow.


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## Smith3

> Originally Posted By: GSD07A friend of mine has a dog with heart murmur since he was a puppy. The dog is almost 4 years old now and doing well, but she spends about $2000-3000 a year on managing his condition.


Ugh, that is a chunk...


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## Lauri & The Gang

If it's a 3/4 of 6 then most likely it will not go away as she ages.


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## BlackGSD

> Originally Posted By: Smith3Then the question becomes, do I send her back (God I couldn't)? Do I keep her?


What would the breeder do with her if you took her back? Another question is, if you keep her, will you be able to stand constantly worrying about her for the next "however many" years?


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## 3K9Mom

I don't trust murmur ratings unless they come from a cardiologist. You can have three general practice vets listen to a dog and they'll give you three different ratings. 

Will the breeder pay for or split the cost of a cardiology consult with ultrasound? It's hard to know what you're looking at until you look at the heart. 

As Lauri said, if it's a (true) 3/6, this isn't a simple puppy murmur that she'll likely grow out of. 

I understand the paralysis of not knowing what decision is the right one. In this case, I always feel like I need as much information as possible. That's why I personally would want a cardiology consult. It's going to set you back several hundred dollars. But that will help you make an INFORMED decision.

Tracy raises good points to consider as well. These questions need to be answered as well. 

Heart meds aren't incredibly expensive, if your pup needs them (Since they're human meds as well, they can be filled at places like Walmart or Costco which helps keep prices down.). But it's an additional financial cost to consider. After being diagnosed with a murmur, my dogs see the cardiologist once every 1-2 years. As seniors, they're a bit different, but it's not an overwhelming schedule. 

If you have a cardiology consult, you'll want to ask all these sorts of questions too. Look far into the future, and anticipate your pup as a 10 year old, and ask the specialist, "what will my pup's life look like at that point? What will I need to do to ensure she's happy and healthy? What will this cost me?" I think at that point, you'll be able to make a decision that's good for you and for your puppy. 

Good luck.


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## JeanKBBMMMAAN

Oh, they do surgery for heart murmurs in puppies. Anna's (at age 2) went from a 5/6 to a 1 with it (knock wood). Hers was not congenital, it was caused by an AV fistula, most likely caused when she was shot. They were going to coil it until they saw it was too big and did regular open heart surgery on her. That was 4 years (!!!) ago, making her like a person with a 20-30 year positive post op result. Dr. Moise was the cardiologist and I would see her if I had a heart problem! 

The specialist you are seeing is a cardiologist? Just asking-I am taking a senior dog in for a heart murmur today but am seeing a radiologist for the ultrasound first, just wanted to make sure which doctor you will be seeing. 

And I agree with the number-seeing a cardiologist gives you the most accurate grade.


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## Smith3

> Originally Posted By: JeanKBBMMMAANOh, they do surgery for heart murmurs in puppies. Anna's (at age 2) went from a 5/6 to a 1 with it (knock wood). Hers was not congenital, it was caused by an AV fistula, most likely caused when she was shot. They were going to coil it until they saw it was too big and did regular open heart surgery on her. That was 4 years (!!!) ago, making her like a person with a 20-30 year positive post op result. Dr. Moise was the cardiologist and I would see her if I had a heart problem!
> 
> The specialist you are seeing is a cardiologist? Just asking-I am taking a senior dog in for a heart murmur today but am seeing a radiologist for the ultrasound first, just wanted to make sure which doctor you will be seeing.
> 
> And I agree with the number-seeing a cardiologist gives you the most accurate grade.


Jean, thanks for the input.

I am going to see chesapeake veterinary cardiology associates, and seeing Dr. Sidley. From what my vet told me they are pretty good and I hope to hear some good results!

In a few hours we should have a better idea. It is just nerve racking! You want the best for your bundle of fur. 

Great about your puppy going from a 5/6 to a 1, that is astounding! 

I just hope my baby can still do Schutzhund, although I won't be crushed if she has to take it easy her life. I'll give her the best I can.


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## Smith3

> Originally Posted By: 3K9MomI don't trust murmur ratings unless they come from a cardiologist. You can have three general practice vets listen to a dog and they'll give you three different ratings.
> 
> Will the breeder pay for or split the cost of a cardiology consult with ultrasound? It's hard to know what you're looking at until you look at the heart.
> 
> As Lauri said, if it's a (true) 3/6, this isn't a simple puppy murmur that she'll likely grow out of.
> 
> I understand the paralysis of not knowing what decision is the right one. In this case, I always feel like I need as much information as possible. That's why I personally would want a cardiology consult. It's going to set you back several hundred dollars. But that will help you make an INFORMED decision.
> 
> Tracy raises good points to consider as well. These questions need to be answered as well.
> 
> Heart meds aren't incredibly expensive, if your pup needs them (Since they're human meds as well, they can be filled at places like Walmart or Costco which helps keep prices down.). But it's an additional financial cost to consider. After being diagnosed with a murmur, my dogs see the cardiologist once every 1-2 years. As seniors, they're a bit different, but it's not an overwhelming schedule.
> 
> If you have a cardiology consult, you'll want to ask all these sorts of questions too. Look far into the future, and anticipate your pup as a 10 year old, and ask the specialist, "what will my pup's life look like at that point? What will I need to do to ensure she's happy and healthy? What will this cost me?" I think at that point, you'll be able to make a decision that's good for you and for your puppy.
> 
> Good luck.


Yeah, the "life cost" of it I would like to know. I think I'd want to keep her no matter what, I can afford to take care of this kind of condition so maybe it was good she did come to me. I haven't started talking to the breeder about this "compensation wise" but it may be something to bring up. she has promised to make it right and several of us on the board have dogs from her and i trust it! It isn't the big concern now - half the rush to get it done this afternoon was to calm my nerves lol. But, the cardiologist we are seeing today should be able to give a good breakdown of what is going on I would hope.

Thanks for the input! It has helped calm some nerves lol. It is crazy how someone who came into your life just 4 days ago can have such an impact.


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## M&J

Chesapeake Veterinary Cardiologists are wonderful. Koch is in good hands. They took care of my dog who had heart disease. If anyone can do something to help your Koch, they can. 
Good luck and I hope they give you good news! I live ten minutes from there so please let me know if you need anything.


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## Wolfmother

I went through something similar to you. I had my female for less than 48 hours when my vet detected what she felt was a a grade 3 heart murmur. As someone else mentioned, my vet said that her experience had shown that a dog is less likely to outgrow a murmur at that grade. When we picked her up from the breeder, she was running around like a maniac non-stop for almost 2 hours. She showed absolutely no signs of lethargy or anything else you would associate with a heart problem. At this point, my vet discussed the possibility of returning her to the breeder with me, but I was completely attached to her and wanted to at least see what the problem was and make a decision from there. 

Within a few days, we had her to a cardiologist and had an echocardiogram done. It was confirmed that she had a heart condition called a PDA. Less than a week later, she had heart surgery. That was the best decision we ever made. The surgery was almost $3000 (including the price of the echo), but in our situation, it was the best thing we could have done. They say with a PDA, it is best to have the surgery done before too long. 

I can certianly see why others would suggest that you wait a while to see if it goes away and am just looking at this from my own experience and see it from a different angle. I am also impatient and paranoid so I HAD to know right away. 

Good luck to you-let us know how you make out.


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## Smith3

Well, just got back and she did well getting her ultrasound, for the most part she was pretty still! 

She has 2 congenital defects:

- Small restrictive perimembranous ventricular septal defect
- Mild pulmoni stenosis

basically, a small hole between the two sides of her heart, because it is so small it makes it sound "louder" than it actually is and she has a (i think it is what it is) small exit artery from her heart, where the exit valve is a bit smaller. 

So, they shouldn't impact her lifespan and quality of life. Her ability to do Schutzhund is up in the air until we get her checked up in a year. It is a MASSIVE sigh of relief! The best $500 I have spent lol. So the stress of the last two days is behind us and the little girl can go on being a great puppy!

Thanks everyone for the kind words and assistance


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## Smith3

> Originally Posted By: M&JChesapeake Veterinary Cardiologists are wonderful. Koch is in good hands. They took care of my dog who had heart disease. If anyone can do something to help your Koch, they can.
> Good luck and I hope they give you good news! I live ten minutes from there so please let me know if you need anything.


they really were great. she was the hit of the office since they don't see many pups!

thanks for the offer of help! maybe we all can get a "DC Meet" going sometime soon!


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## Smith3

> Originally Posted By: WolfmotherI went through something similar to you. I had my female for less than 48 hours when my vet detected what she felt was a a grade 3 heart murmur. As someone else mentioned, my vet said that her experience had shown that a dog is less likely to outgrow a murmur at that grade. When we picked her up from the breeder, she was running around like a maniac non-stop for almost 2 hours. She showed absolutely no signs of lethargy or anything else you would associate with a heart problem. At this point, my vet discussed the possibility of returning her to the breeder with me, but I was completely attached to her and wanted to at least see what the problem was and make a decision from there.
> 
> Within a few days, we had her to a cardiologist and had an echocardiogram done. It was confirmed that she had a heart condition called a PDA. Less than a week later, she had heart surgery. That was the best decision we ever made. The surgery was almost $3000 (including the price of the echo), but in our situation, it was the best thing we could have done. They say with a PDA, it is best to have the surgery done before too long.
> 
> I can certianly see why others would suggest that you wait a while to see if it goes away and am just looking at this from my own experience and see it from a different angle. I am also impatient and paranoid so I HAD to know right away.
> 
> Good luck to you-let us know how you make out.


haha, i am glad to know my impatience is shared! that was the half of it, i HAD to know what was wrong!

and i don't know how anyone could return their pup. She might have been with us for a few days, but she is OURS now and thats that! even if it was surgery she needed, I think i would have to. 

glad to hear everything went well on your end!


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## Wolfmother

I don't understand how anyone could return the pup either. Both my vet and husband didn't want to see me have a broken heart later if it was something that couldn't be fixed and she didn't live a full life. I think I would have kept her regardless. I know I was in love with her the moment we decided that we were going to bring her home with us.

I am glad to hear that you got good news. Good luck with everything!


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## M&J

Glad it turned out so well. I came very close to going down with a bag of treats and coffee for you.

Will they put her on any medication, or is this hole going to close? Glad the prognosis is so postive. Whew. Agreed, I'd rather pay the money for peace of mind over obsessing about what could be going on. 
Koch is so lucky to have you.


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## Smith3

> Originally Posted By: WolfmotherI don't understand how anyone could return the pup either. Both my vet and husband didn't want to see me have a broken heart later if it was something that couldn't be fixed and she didn't live a full life. I think I would have kept her regardless. I know I was in love with her the moment we decided that we were going to bring her home with us.
> 
> I am glad to hear that you got good news. Good luck with everything!


haha, i don't get it at all! my g/f and i are so glad to have her in our life, she is a joy!


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## Smith3

> Originally Posted By: M&JGlad it turned out so well. I came very close to going down with a bag of treats and coffee for you.
> 
> Will they put her on any medication, or is this hole going to close? Glad the prognosis is so postive. Whew. Agreed, I'd rather pay the money for peace of mind over obsessing about what could be going on.
> Koch is so lucky to have you.


haha, thanks! 

the dr said no medication at all. the hole may or may not close up, that we will wait and see. that we don't need to come back for a year for a checkup since it didn't look that bad at all. So, that sounds like a good sign to me! I am just glad she is going to live a normal life of a spoiled dog!

she graded it at a "level 4" murmur, but overall no big risks to consider.


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## Remo

If you ever want to bring her around a bunch of GSD freaks when you are socializing her, feel free to bring her to visit a VGSR adoption day! We love to gush all over puppies.

Dr. Bill Tyrell (spelling?) who is one of the vets at the cardiology practice used to be my regular vet when he first started practicing medicine. I always adored him - he was so kind to the dogs!

When we spayed a rescue dog that had a grade 3 murmur, we did it at the emergency place in Vienna. That way, if anything went wrong with her heart while she was under, the cardiologists were right in the same building. She came through it just fine and is happily living a normal doggie life in McLean! 

Best wishes with your puppy and I hope she gets all of her Schutzhund titles!


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## Smith3

> Originally Posted By: RemoIf you ever want to bring her around a bunch of GSD freaks when you are socializing her, feel free to bring her to visit a VGSR adoption day! We love to gush all over puppies.
> 
> Dr. Bill Tyrell (spelling?) who is one of the vets at the cardiology practice used to be my regular vet when he first started practicing medicine. I always adored him - he was so kind to the dogs!
> *
> When we spayed a rescue dog that had a grade 3 murmur, we did it at the emergency place in Vienna. That way, if anything went wrong with her heart while she was under, the cardiologists were right in the same building. She came through it just fine and is happily living a normal doggie life in McLean!
> *
> Best wishes with your puppy and I hope she gets all of her Schutzhund titles!


Great advice, didn't even cross my mind! The vet did say something about putting her under, we will defiantly consider that for when we take her to get done. 

I hope to bring her out to one of the rescue events once she gets her next set of shots! 

i am sad too, i planned to donate some cash before years end to the VA Rescue, but she sort of broke my budget lol


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## Remo

Well when bring her to an adoption day, be prepared to have crazy people fawning all over her. We go completely gooey over puppies!

We are going to be joining up at the Canine Country Club out in Leesburg next year so I hope to start scheduling quarterly GSD meet ups out there! I'll keep you posted on progress.


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## LisaT

Smith3,

If you don't already, I would get a cheap stethoscope from one of the online places, like here: http://tinyurl.com/oz9kzn and get used to how her heart should sound. That way you can monitor any changes at home.

Indy was just upgraded to a 3. I've been trying to put together a protocol for her, but I'm not at all sure how helpful it will be. This is what I've learned so far.

The general oxidants are important (C, E - mixed tocopherols and maybe gamme E), CoenzymeQ-10 for any heart issue, added taurine if it's not included in your dog food (many don't add it), omega-3 fatty acids (I feed fish and flaxseed). I think those are pretty general recommendations.

Hawthorn and L-Carnitine are good for the strength of the heart and proper contraction. If the blood is thick, or if the red blood cells are high, I wouldn't use the carnitine.

Magnesium is important for proper heart function. I don't know, in general, if kibbles are well-balanced for magnesium, or if they have too little. If you ever add this, you will definitely know if there is too much because the stools will get soft, and you can get some bad diarrhea (think _Milk of Magnesia_







).

Proper sodium balance is important - too much is bad, too little is bad. Same is true of selenium. Oddly enough, high cholesterol with high vitamin D is bad for the aortic valve (and I presume also the mitral valve), though each alone doesn't appear bad for the valves.

Proper thyroid function is important -- hypothyroidism is bad for the heart, and so is hyperthyroidism. At some point, I would test the thyroid.

Keeping the valve, primarily it's connective tissue and collagen, supple, is important. I would add glucosamin, chondroitin and hyaluronic acid for any dog with a heart murmur. 

Curcumin is supposed to help prevent heart enlargement and maintain systolic function.


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## Smith3

Lisa, thanks for the advice!


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