Heart Murmur getting worse, what to expect?

This forum is for dog lovers seeking everyday advice and suggestions on health-related issues. Remember, however, that advice on a public forum simply can't be a substitute for proper medical attention. Only your vet can say assuredly what is best for your dog.

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Angel Maddy

Forever Loved.- 12/20/00-02/05/1- 2
Barked: Mon Jul 28, '08 11:21am PST 
Maddy was diagnosed with a grade 2 (out of 6) heart murmur back in March. At that point it was just something we had to monitor.

She went in today for her Distemper vaccine, and this time I saw a different vet at the same office. She listened for almost a minute, and said she would say it was a grade 3-4 now. They did an x-ray, and it showed the heart was enlarged horizontally (front to back). Instead of taking up 2.5 rib spaces, her heart was taking up 3.5 rib spaces. It was also very close to the breastplate, if not touching it.

They recommended I start her on a total of 5mg of Enalapril (half tablet twice a day). She will probably be on this the rest of her life, adding more medicine as the heart disease progresses.

I knew it was getting worse because she hasn't been playing quite as hard as usual. She's taking quite a few breaks, but didn't seem to be in pain at all.

I've never dealt with this before...what can I expect from here?
Sadie Mae- Mae

the mazester
Barked: Mon Jul 28, '08 11:47am PST 
I don't know what to say about this condition but please know that
we have your little baby in our prayers.

Cosmo Enyce- Politan

Got your owner- LQQKin!
Barked: Mon Jul 28, '08 11:55am PST 
Hi Maddy & Mommy,
Try not to worry. Cosmo's heart murmur is a grade 3 bordering on a 4 and if he plays too hard, he kinda flops over until he catches his breath. If Maddy doesn't do this, and limits herself on her play, I wouldn't worry so much. Also, the medicine might be a great thing. None of the vets I have take Cosmo to have recommended putting him on meds, but maybe thats because he's young. Maybe you should see a second opinion.
Keep us updated, but I'm pretty sure Maddy will be just fine. hug


Did someone say- chicken?
Barked: Mon Jul 28, '08 11:56am PST 
I do not know what to say either...

But my thoughts and prayers are with you.


Some days you- just feel like a- Princess.
Barked: Mon Jul 28, '08 12:28pm PST 
Lucy Louise

Just call me- Grandma.
Barked: Mon Jul 28, '08 12:46pm PST 
First of all, you might want to begin limiting Maddy's exercise a bit. Kinda like when humans go to get a stress test done to determine just how much exercise they're allowed to do with heart trouble, heart disease introduces limitations on activity in dogs as well. You may even find that Maddy doesn't want to play quite as much. And that's ok as long as she's eating, drinking and moving around some. The Enalipril is a good idea if the murmur is getting worse, but make sure that Maddy's other systems (kidneys and liver in particular) are functioning up to par because basically it takes some of the pressure off the heart and moves it to other systems. Enalipril is a blood pressure medicine, so it lowers a dog's (or human's) blood pressure and lowers the heart rate. Also, you mentioned that Maddy's heart is quite close to her breastbone. This is important to get under wraps because the heart can enlarge to the point of pushing on the trachea exasperating breathing problems. One thing to be aware of is if she shows any symptoms aside from the murmur. What I mean by this is coughing a lot, getting out of breath easily, fainting, or edema that is swelling in the belly or extremities. These are all symptoms of congestive heart failure, that is fluid back up in the lungs. In the case of pulmonary edema, your vet will likely also prescribe diuretics to lessen the fluid. Also, you will want to filter your water if it has a lot of sodium softeners in it. Sodium aggravates edema and puts strain on the kidneys. If you can find a low-sodium food that's good, too. Here's what I will tell you though. Lucy came to me with a grade IV heart murmur with no visible symptoms of CHF at age 14. I decided to go ahead and put her on meds (Benazipril) since she's pretty old anyways and they're not too expensive. She will be on them for the rest of her life, but I'm so thrilled to say that her murmur has since gone down to a grade II. I have to filter her water and take blood levels to monitor her kidneys periodically, but if it extends her life a few more years, it's definitely worth it to me! Good luck! Hope some of this mumbo jumbo helped. way to go

Gimme a cookie - NOW!
Barked: Mon Jul 28, '08 1:13pm PST 
hug Maddy hug
A second opinion definitely wouldn't hurt. It's important that if you decide on the meds, to make sure you have her monitored frequently. I'm on thyroid medicine that I will be on for the rest of my life also, and mom takes me every 3 months for a blood test to make sure all my levels are ok. Us pups are pretty smart, and we will often limit our activity if we aren't feeling 100%. Mom and I will definitely be keeping my sweet girl in our prayers. Please keep us updated.
Sparky- Winker Bean

Baby Bean
Barked: Mon Jul 28, '08 1:21pm PST 
oh maddy hughug

Lickers to all- dogs big and- small!
Barked: Mon Jul 28, '08 1:59pm PST 
Oh Maddy! It sounds like pups have given you some great advice. I sure hope things improve for you little fluff ball. big grin You will be in our prayers. hughugwisheswishes
Winnie Lam

Squeaker- Killer...Qu'est-- ce que c'est!
Barked: Mon Jul 28, '08 2:05pm PST 
Lucy Louise provides good advice. But did the vet explain what was causing the heart murmur? A murmur itself is an abnormal noise during the heart beat, which can be due to a lot of things. I'm guessing it's due to valvular endocardiosis, or mitral valve endocardiosis (heart valve degeneration, which is pretty common in toy and small breeds as they get older).

As Lucy pointed out, medications will help to control the signs of congestive heart failure, but unlike in people, there are no cures to reverse the valvular degeneration (no valve replacement surgery for dogs), and degeneration will continue despite therapy. One of our ancestor dogs (Toby, not on Dogster...she died in 2000) was diagnosed with mitral valve endocardiosis when she was 10, when it was perceptible only as a II/VI heart murmur. No heart enlargement yet. She was well-controlled on enalapril (all these ~pril drugs are related ACE inhibitors and work similarly) for 4 years, then when into overt congestive failure (i.e. there was starting to be fluid in the lungs, or edema) at the age of 15. She was then put on furosemide (diuretic to get rid of the excess fluid). She survived for another 8 months. So, from the time of diagnosis to time she passed on, it was about 5-6 years. Toby was also on a restricted sodium diet.

You can have a pretty good life given the right medical advice, medications, and diet, as Toby did.

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