heart murmers in young puppies

My tri-color male, Oz, (now 11 months old) was diagnosed with a grade 1 heart murmer and intermittent 2nd degree heart block at 4 months of age. He had a stumbling episode in which he was oriented (so not a seizure), but kept falling down. He has since been diagnosed with a very mild case of syringomyelia (a 1 on a scale of 1-10, with one being the mildest). He is not on any meds for either condition. He did wear a holter monitor for 24 hours for his heart - based on those results the cardiologist just said to monitor his murmer and more testing if it gets louder or he becomes symptomatic. Does anyone have any experience with cavaliers who present with a murmer at such a youg age? He is really active and just a fun puppy. He was checked for SM because I just became aware of the condition when one of my older cavaliers (I have 4 total) had decompression surgery last week and Oz was scratching a bit more than the others and because of his stumbling episode. Any words of wisdom from anyone? Thanks.

I'm sorry you have this mix of things going on -- was he MRId? Why was no treatment suggested? Were syrinxes present? If he is scratching and stumbling due to SM, then personally I'd definitely be treating it as even scratching alone is a sign of damage to the dorsal horn area of the spine. Generally neurologists opt to give gabapentin or something to kill pain and halt the scratching, as it is a sign of pain and discomfort (at least according to Dr Clare Rusbridge). But different people have different approaches. I'd just definitely treat anything that is symptomatic.

The cardiologist then was saying this wasn't a puppy flow murmur? Usually that is what is seen in puppies that age but other kinds of murmurs can of course be there. Has he been retested since age 4 months?

Thanks for your reply. Oz did have an MRI - the neurologist said his malformation was mild with no syrinxes present. As his only stumbling episode was 5 months ago (with no signs of any weakness or unsteadiness since then, no head tilt, no balance issues - he runs and jumps really well) the thinking was to wait and maybe MRI him again in a year or if he becomes symptomatic. In retrospect, I think his scratching is most likely due to his new adult size collar which he just got and is still a little stiffer than his old one. I think I panicked about his scratching though because of what my other dog is going through, and it took years to get an accurate diagnosis for her. As for the murmer, the cardiologist thinks it's possible he may outgrow it - have to wait and see. He has not had another EKG since the original one at 4 months, but he's been listened to twice since then - particularly right before he had the MRI last week. I hope it's just a puppy flow murmer.

It sounds like the cardio thinks it is just a puppy murmur. Usually they disappear around 6-9 months. Fingers crossed that is all it is.

The scratching could definitely be a stiff collar! Keep in mind that almost every cavalier MRId has had the malformation so that alone wouldn't mean anything necessarily -- and isn't technically SM, as that indicates syrinxes, so I wouldn't overly worry about your fellow. Was the neurologist familiar with episodic falling syndrome in cavaliers? What you describe sounds a lot like it could be that, and sometimes there is only a single session or a few and then never any after. It also often shows around 4-6 months. There's info in the Library section on EFS.

Thanks - I will check out EFS. Haven't heard of it before.