View Full Version : Tips/advice for first cardiologist visit
13th February 2012, 05:50 PM
After much pressure, I have finally managed to get a referral for Darcy from my vet to a well known vet cardiologist in Dublin. Darcy is 6 and the vet felt her murmur was mild, perhaps a grade 2 but suggested she start on meds. I then requested a cardiologist referral as I didn't want to start meds without a proper assessment. I have not visited a vet cardiologist before so any tips or advice would be welcome on what sort of questions I need to ask, things I need to know etc.
13th February 2012, 06:20 PM
Hi Sue, sorry you have the need to bring Darcy to a cardiologist. Many dogs have grade 2 murmurs or higher and do not need medications until much later. The best way to find out is with a cardio workup and you are absolutely correct for insisting on this.
My Sydney had a grade 4 murmur for over a year, he was monitored by his cardiologist during that time before she determined it was time for him to go on meds. The first visit, for me, was scary as I had no idea what to expect and I hadn't found this fourm yet to ask just the question you're asking now.
Besides listening to his heart with a stethoscope, during the first visit, he had a chest x-ray, an echo cardiogram and a complete blood workup. It was felt that meds were not needed at first and a year later these tests were done again and the results determined what meds were needed.
Karlin has a great section in the health library that explains all the tests and it is a good read to get yourself started. Here's the link
Also, write down any questions you have. How often should Darcy be checked, activity level, special diet or supplements.
I'm sure some on the board can give you more detailed information, but hopefully this helps.
13th February 2012, 08:05 PM
Oh, he's really nice–you will learn a lot more than you are able to get from a vet, just in having him listening to Darcy's heart for 5 min. or so.
I can't imagine why a dog with only a grade 2 murmur would need to be put on medications. Maybe there is something quite unusual about the murmur, but generally the recommendation is that a dog shouldn't be put on medications until there are some symptoms of the disease, and these generally don't start to show up til a murmur gets to a fairly high grade. I mean, one of my rescue dogs that is living with a neighbor had a grade 5 murmur when she came in, and she didn't need medication for a year or so. Then my vet recommended putting her on meds, but after a while I took her off again because she just wasn't having any outward symptoms and I didn't see why she should be taking medications when there is no clear evidence for starting early, and there's good evidence that there's either no point, or that it might actually cause some damage. Gradually, symptoms began to show up and then I did put her back on to medications. She's lived for nearly 2 1/2 years now with a very high-grade murmur.
This just sounds like a very strange recommendation by the vet. If you have a vet who was baulking at giving you a recommendation to a cardiologist, yet was telling you that you had a dog that should go on medications–personally, I would change vets. I can't imagine why they would be reluctant to have the specialist have a look at the heart of a dog that they think needs medications...?
On a visit to the cardio, you will 1st wait while the cardiologist listens to her heart, which will take 5 or 10 min. But I would start by telling him why you are there–that you have a vet who says Darcy has a low-grade murmur and was recommending that she be put on medication, which didn't seem to be the advice that is generally given, and that you were concerned and wanted the opinion of a specialist.
Once he listens to her heart, he will tell you what the grade is, on what side of the heart it's located (sometimes you will have a murmur on both), and he will give you a sense of exactly what's going on–a lot of detail about what he hears and what that implies. If he recommends medications, I'd of course want to know why. I'd also want to know how he thinks things might progress. He may recommend that she have some additional tests. They can be a bit costly.
It is really good to go in at an early stage, as then you will have a good baseline for comparison if and as the murmur progresses.
Vets can be very poor at grading murmurs however. You may find that her murmur is actually milder then a 2, or greater than a 2. I think the experience most of us have had is that vets tend to think murmurs are less severe than they actually are, but not always, and some can be very good at giving grades. It is a skill after all, and some are better than others.
18th February 2012, 07:54 PM
:updte: what fantastic news we had today. Darcy has no heart murmur. b*n*n*. She does have a flow murmur that occurs when she becomes very excited and her hearbeat increases but no murmur. Her pulse is strong and blood is flowing to all the right places. No meds or supplements required and follow up only needed if something changes. The consultant was lovely, friendly and informative. He was totally amazed that Darcy`s heart was so good for 6 years old. He mentioned that she was the exception, not the norm & almost all cavaliers he sees have murmurs, even at young ages:(. He kept repeating how surprised he was that her heart was so good & gave us great encouragement that we are taking good care of her. I think she stole his heart a little, he was quite taken with her cuteness & temperment :l*v:. I am so, so glad I pushed for the referral & didn`t start her on meds. We feel such relief that her heart is good, today is a happy day :mexwav::w**h**::jmp::jmp:cl*p:jmp2:
18th February 2012, 09:37 PM
:rah:WAY TO GO DARCY!:rah:
You must be so relieved and happy.
18th February 2012, 10:07 PM
Oh that is fantastic news Sue!! so thrilled for you and Darcy.
I'm sure you will be on the 'phone to the vets 1st thing Monday anyway...they should be able to differentiate between a flow mumur and mitral valve disease.
18th February 2012, 11:49 PM
What happy news - thanks for sharing the update!
19th February 2012, 12:05 AM
Great news for you and Darcey.
19th February 2012, 02:45 AM
Yay!!!!! That is wonderful news! So happy for you and Darcy!!!!cl*p
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