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Thread: Worrying news for Charlie

  1. #11
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    I have never heard that portosystemic liver shunt (also called portal caval shunt) could cause a heart murmur - I'll have to check that in my veterinary textbooks when I go home tonight. There are many symptoms for PSS - general failure to thrive, low weight, lethargy, seizures, GI problems, excessive drinking and urinating – but that doesn’t seem to fit your description of your puppy. I had a shih tzu with congenital PSS who had repair surgery when she was 1, and she lived to be 15 with no problems as a result of the PSS and subsequent surgery.

    http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

    This link is a veterinary paper which mentions that heart murmurs have been found is some cats with PSS:

    http://maxshouse.com/Portosystemic%20shunts.htm

    Ventricular septal defect (VSD, hole in the heart) is a birth defect; here is one of my favorite sites which describes it well:

    http://www.heartydog.co.uk/diseases/en/hole.shtml

    “Dogs can suffer from the classic 'hole in the heart' - otherwise known as a ventricular septal defect (VSD) - seen in babies. The term describes a malformation of the heart where there is a hole between the left and right ventricles. The effect is not dissimilar to that caused by patent ductus arteriosus: a short circuit leading to a loss in the heart's ability to pump blood.”

    Again, the symptoms don’t really seem to fit because your puppy is very active.

    “A dog with a 'hole in the heart', or VSD, may appear overly quiet and inactive. During any period of excitement, it may experience shortness of breath and or collapse, and its gums may appear tinged blue, due to a lack of oxygen. The symptoms of VSD will vary according to how large the defect is.”

    Actually, PDA is a congenital heart defect that is more common in Cavaliers than VSD.

    “Patent ductus arteriosus (PDA) occurs when a special blood vessel, used to bypass the pup's lungs in the womb, fails to seal after birth. This compromises the circulation of blood through the heart. PDA is the most commonly diagnosed congenital heart defect in dogs. It occurs in many breeds and is seen more often in females.” (From the above web site.)

    As far as MVD (acquired valvular disease) – a ten month old with a grade IV/V heart murmur (indicating advanced MVD) would be very unusual since this is an acquired disease (takes time to develop and progress) versus a congenital disease (present at birth). I was surprised by Bev’s Oz who was diagnosed so young with MVD, but he also had a heart block and only a grade 1 murmur. This would be even more shocking. At the 1998 heart symposium in Atlanta, Dr. Beardow stated that the youngest Cavaliers he had seen with early MVD and low grade murmurs were about a year old.

    Please keep us posted as you learn more, and I'm glad that you are able to see a specialist and have an ultrasound.

    Best wishes,

    Pat
    Pat B
    Atlanta, GA

  2. #12
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    thinking of you & Charlie, hope things are not to bad.

  3. #13
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    Hi Karen,

    Im sorry to hear it's worse than at first thought....you would never believe it to see the way the little chap was leaping about at the WHAM day last week!

    Anyway sending hugs and best wishes to you all.

    Mel

  4. #14
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    Karen - thinking of you and Charlie. You sure have a full plate with your dogs' health issues! Please be sure to let us know the minute you find out his diagnosis and prognosis.
    Bev
    Oliver (blenheim, born 3/2001), Riley (black & tan, born 8/2002,), Madison (ruby, born 9/2003), and Oz (tri-color, born 7/2007)

  5. #15
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    Quote Originally Posted by Pat View Post
    I have never heard that portosystemic liver shunt (also called portal caval shunt) could cause a heart murmur - I'll have to check that in my veterinary textbooks when I go home tonight. There are many symptoms for PSS - general failure to thrive, low weight, lethargy, seizures, GI problems, excessive drinking and urinating – but that doesn’t seem to fit your description of your puppy. I had a shih tzu with congenital PSS who had repair surgery when she was 1, and she lived to be 15 with no problems as a result of the PSS and subsequent surgery.

    http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

    This link is a veterinary paper which mentions that heart murmurs have been found is some cats with PSS:

    http://maxshouse.com/Portosystemic%20shunts.htm

    Ventricular septal defect (VSD, hole in the heart) is a birth defect; here is one of my favorite sites which describes it well:

    http://www.heartydog.co.uk/diseases/en/hole.shtml

    “Dogs can suffer from the classic 'hole in the heart' - otherwise known as a ventricular septal defect (VSD) - seen in babies. The term describes a malformation of the heart where there is a hole between the left and right ventricles. The effect is not dissimilar to that caused by patent ductus arteriosus: a short circuit leading to a loss in the heart's ability to pump blood.”

    Again, the symptoms don’t really seem to fit because your puppy is very active.

    “A dog with a 'hole in the heart', or VSD, may appear overly quiet and inactive. During any period of excitement, it may experience shortness of breath and or collapse, and its gums may appear tinged blue, due to a lack of oxygen. The symptoms of VSD will vary according to how large the defect is.”

    Actually, PDA is a congenital heart defect that is more common in Cavaliers than VSD.

    “Patent ductus arteriosus (PDA) occurs when a special blood vessel, used to bypass the pup's lungs in the womb, fails to seal after birth. This compromises the circulation of blood through the heart. PDA is the most commonly diagnosed congenital heart defect in dogs. It occurs in many breeds and is seen more often in females.” (From the above web site.)

    As far as MVD (acquired valvular disease) – a ten month old with a grade IV/V heart murmur (indicating advanced MVD) would be very unusual since this is an acquired disease (takes time to develop and progress) versus a congenital disease (present at birth). I was surprised by Bev’s Oz who was diagnosed so young with MVD, but he also had a heart block and only a grade 1 murmur. This would be even more shocking. At the 1998 heart symposium in Atlanta, Dr. Beardow stated that the youngest Cavaliers he had seen with early MVD and low grade murmurs were about a year old.

    Please keep us posted as you learn more, and I'm glad that you are able to see a specialist and have an ultrasound.

    Best wishes,

    Pat

    Thanks Pat for taking the time out to post all that information. The vet did say something about PDA but he didnt think it was that. I am just worried about the cost of everything as he wont be insured for any heart problems as it is a pre existing condidtion. I am very lucky to have a cardiologist in the veterinary practice we attend with both dogs as it does make everything alot cheaper. I would go hungry to give my dogs everything (although I do work in a restaurant so get well fed for free!! he he)
    They will also do the scan while charlie is fully awake so as not to take the risk with sedation x They are going to do the Bile test at the same time to check for the 1st option. Ruby had this done also when we found out about her murmor also. He did say that the severity of the murmor doesnt necersarily dictact the severity of disease so I am holding on to that thought.

    On a brighter note, Ruby hasnt had one scratching/head rubbing episode since being on the Pregabalin so although expensive it is certainly worth it to see her soooo full of beans and energy. She is trying soooo hard to keep up with the little Chezza!!!

    Thanks to everyone for all your kind messages and support and I will post as soon as I know more.
    Thanks again to Pat for the info you have provided (you know what its like when given bad news- the brain switched off and I heard nothing but "its actually a grade 4/5"

    karen, ruby and charlie xxxx

  6. #16
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    They will also do the scan while charlie is fully awake so as not to take the risk with sedation x They are going to do the Bile test at the same time to check for the 1st option. Ruby had this done also when we found out about her murmor also. He did say that the severity of the murmor doesnt necersarily dictact the severity of disease so I am holding on to that thought.
    ------------------
    Hi Karen,

    Yes, they should never have to sedate to do an ultrasound or an echocardiogram (an ultrasound of the heart). And very good that they are doing bile acid test.

    And I absolutely agree that the murmur grade does not necessarily correlate with the severity of the disease, which is why I don't pay too much attention when someone says their dog has a particular grade murmur. I pay much more attention to the results of the echocardiogram and the chest x-rays as they will give you all the info you need to stage the disease and do treatment planning. A murmur is just a clue to me that I should run certain tests - and the murmur grade might tell me what particular tests I want to run - such as a baseline two-view chest x-ray versus x-ray and echocardiogram, etc. A cardiologist can tell a great deal about the underlying disease by the loudness, timing and PMI of a heart murmur - much more than a general practice vet. (PMI is point of maximal intensity.)

    Funny, but getting bad news for me always puts me in "hyper-focus" - I completely shut down my heart and go totally into my brain. (I always break down later but I'm cool, calm and focused when talking with the vets/drs who are delivering the bad news.)

    Keep us posted,

    Pat
    Pat B
    Atlanta, GA

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