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Thread: My Cindy had a heart murmur and i would like some advice please

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    Unhappy My Cindy had a heart murmur and i would like some advice please

    I have girl cavalier called Cindy, she is a rescue dog so unsure of her age but would guess over 8 years. We took her to the vet for her booster who told us she had a grade 4 heart murmur. She is now on heart meds but have been told this will not stop the problem only slow it down but that it will kill her in the end Apparently grade 4 is very bad.
    Could anyone please give me advice on this. How bad is grade 4? What does it mean?

    She had 24 teeth removed yesturday due to infections in her gums and holes in her teeth (problems we are sorting which she has had since we got her like her weight)Shes very drowsy today bless her.

    I have been told im not allowed on another cavalier forum as Cindy is not a "show dog". I hope members on this forum will help me as shes still my baby wether shes a show dog or not

    Thanks in advance

    My cindy

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    Quote Originally Posted by lincolnsmommy View Post
    I have girl cavalier called Cindy, she is a rescue dog so unsure of her age but would guess over 8 years. We took her to the vet for her booster who told us she had a grade 4 heart murmur. She is now on heart meds but have been told this will not stop the problem only slow it down but that it will kill her in the end Apparently grade 4 is very bad.
    Could anyone please give me advice on this. How bad is grade 4? What does it mean?
    Dear Lincolnsmommy: Mitral valve disease (MVD) in cavaliers is progressive, meaning it gets worse as time goes by. For some dogs, that progression is a slow process, but for others, it can be rapid. The grading system is from 1 to 6, with grade 6 being the worst. A grade 4 is not "bad" in and of itself, but it indicates that Cindy's valve disorder has gotten worse.

    One thing to keep in mind is the many general practice vets have not been trained enough in measuring the grades of heart murmurs to accurately classify the grades. So, Cindy's vet could be wrong about the grade 4. Veterinary cardiologists and internal medicine specialists are trained to do a better job of grading murmurs.

    There is a webpage on this subject -- http://cavalierhealth.org/mitral_valve_disease.htm -- that discusses it all in much more detail. Here is a link directly to a discussion on grades of murmurs: http://cavalierhealth.org/mitral_val...ase.htm#Grades

    Could you tell us more about Cindy's medications? What they are and how much per day? Where do you live? In the US, UK, Canada, or where else? I ask that because in the US and Canada, I can tell you if there are any veterinary cardiologists nearby who could examine Cindy and make sure her heart diagnosis is correct.

    I am a little concerned about the fact she has been prescribed medications, if she really does have a grade 4 murmur. There is a set of guidelines, called a Consensus Statement, published by a panel of cardiologists who do not recommend prescribing medications to dogs with mitral valve disease unless they show symptoms of congestive heart failure and/or have significant enlaregement of their hearts. You may find the Consensus Statement here: http://cavalierhealth.org/images/acv...ccvhd_2009.pdf

    If I were in your position, I would take a copy to my vet and ask him if he already has read it or not, and if he has not, to question whether Cindy needs heart medication if all he knows is that she has a grade 4 murmur. My family got our first cavalier in 1969, so we've had the breed for over 40 years. All but three of our cavaliers have had murmurs as high as grade 4 (the highest is grade 6), and none of them were prescribed any heart medications until they reached grade 6.

    I have found that some general practice vets are a little to quick to prescribe heart medications, and they end up doing so too early in the progression of MVD. Some such medications may lose their effectiveness if prescibed too early in that process. That is why, although we now have a cavalier with a grade 4 murmur, he is not taking any medications. He is being given supplements (see http://cavalierhealth.org/mitral_val...--_supplements).
    Last edited by RodRussell; 25th August 2012 at 04:46 PM.
    Rod Russell

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    Thanks so much for that info. The vet didnt seem confident when grading. She said she will grade it a 4 but another vet may grade another so we will never know as everyon thinks differently. We have been given Cardisure 5mg x 14.0. give 0.5 tablet 2 times daily. We have not given them to her yet as they vet has said she doesnt know wether she needs them but we can have them to try. The vet said she will put her on something else after but not sure what medication that will be.

    We are very confused and overwelmed by it all. Thanks for all your help

    Forgot to mention im in the UK
    Last edited by lincolnsmommy; 25th August 2012 at 04:56 PM. Reason: UK

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    Cindy is a beautiful girl, thank you for rescuing. My rescue/rehomed boy is almost nine with a grade 3 murmur. He does not require meds yet so I haven't had to worry about that. I would think her murmur must be worrisome to the vet to prescribe meds. My old boy is just slow at most things but sometimes it is hard to know if it is his arthritis or his heart that is slowing him down. We also had to remove some of his teeth due to decay when he was rehomed to us. You will be surprised how quickly she will learn to eat without her teeth.

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    The vet didnt seem confident when grading. She said she will grade it a 4 but another vet may grade another so we will never know as everyon thinks differently.
    I think as a priority, you should arrange to see a board-certified cardiologist. They can give you a definite grade -- it isn't quite as subjective as your vet describes; grading accurately requires expertise most vets won't have so they are guessing to a degree.

    IMHO, you really really do not want to work solely with a vet who is so unsure about giving medications and designing an adequate treatment plan for this common heart issue in the breed. Almost 100% of cavaliers will eventually have MVD and the treatment approach is pretty well understood. HOWEVER vets are not specialists and thus often misgrade murmurs and also far too often start treatment too early -- which can hasten an earlier death! I agree with Rod on this -- all vets I have encountered prescribe meds too early, if you read what cardiologists recommend.

    You really do need to know the grade -- which a cardiologist can tell you accurately in 5 minutes of listening to the heart -- plus they can give you all sorts of further detail and tell you definitely whether your lovely rescue girl needs to start now on medications or wait. A grade 4 is often too early for many cases of MVD.

    Someone may be able to have the link to hand for certified cardios in the UK or receommend someone in your region. Please note that if money is tight, you can at the very least simply get an auscultation (listening by stethoscope) by a cardio and this will be worth every penny and is not generally very costly (about the same as a vet visit). Further tests may be recommended but you can decide if and when to do them if the cost is problematical.

    There's another current thread on MVD resources in the MVD/SM forum but in general you can find tons of info at www.cavalierhealth.org. I see Rod (who runs the site) has given you a detailed reply already.

    It is a shame any forum would not give help to someone with an ill cavalier simply because they don't have a show dog.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    Just a PS -- in the UK & Ireland vets and cardiologists sometimes use a 5-grade scale for murmurs and not a 6 grade scale. So the worst is sometimes a grade 5.

    Here's a good explanatory page from a UK vets:

    http://www.southillvets.co.uk/svs/fa...t-murmurs.html
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    I agree 100% with what everyone has said so I won't repeat it. The best thing you can do, besides seeing a cardiologist, is readeverything you can about MVD and learn the signs of your dog when she may be in distress.

    Good luck and let us know how she's doing.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

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    Quote Originally Posted by lincolnsmommy View Post
    ... We have been given Cardisure 5mg x 14.0. give 0.5 tablet 2 times daily. We have not given them to her yet as they vet has said she doesnt know wether she needs them but we can have them to try. The vet said she will put her on something else after but not sure what medication that will be. ...
    I missed the Cardisure mention before, until after I read Pat Beman's post about it. Yes, Cardisure is the same as Vetmedin, both are pimobendan. I would never give pimo to my dog upon the prescription of a general vet who only auscultated my dog with a stethoscope. Her doing so borders on malpractice. At the early stage of a typical Grade 4, without any symptoms, pimo more than likely would do much more harm than any good at all.

    Pat's post about cardio exams deserves a special place on this list.

    Pimo should be given only if the dog is in congestive heart failure (CHF), and in some cases -- including one of my dogs -- pimo is not even appropriate at earlier stages of CHF, in fact, it can be deadly. The premature ingestion of pimo can accelerate some dogs' MVD, turning a slowly progressing disease into nearly instant death. That is why I am so opposed to the EPIC Trial going on right now. I believe it is irresponsible of any cardiologist to talk any owner into allowing his/her cavalier to be used as a lab rat for the dangerously premature giving of pimo to the owner's dog.

    Incidentally, the EPIC Trial is financially underwritten by the manufacturer of Vetmedin, so the cardiologists who are talking owners into using their cavaliers as guinea pigs are being paid by Vetmedin to do so. Their advice thereby suddenly becomes un-objective and a shameful conflict of interest.

    I repeat, Pat's post about cardio exams deserves a special place on this list.
    Rod Russell

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    Quote Originally Posted by lincolnsmommy View Post
    I have been told im not allowed on another cavalier forum as Cindy is not a "show dog". I hope members on this forum will help me as shes still my baby wether shes a show dog or not
    What a bunch of SNOBS There is a ton of great info and "experts" on cavalier health (you will be pointed in the right direction- a vet is the only true expert) and many many personal experiences from people who love cavaliers all cavaliers. Not only that you will receive support from people who love their dogs like children.

    I agree with the advice you have been given by others. I have nothing to add just want to add my support and I hope you get your little one straight quickly.
    Melissa
    "If you don't own a dog, at least one, there is not necessarily anything wrong with you, but there may be something wrong with your life."
    -Roger Caras

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    Quote Originally Posted by lincolnsmommy View Post
    I have girl cavalier called Cindy, she is a rescue dog so unsure of her age but would guess over 8 years. We took her to the vet for her booster who told us she had a grade 4 heart murmur. She is now on heart meds but have been told this will not stop the problem only slow it down but that it will kill her in the end Apparently grade 4 is very bad.
    Could anyone please give me advice on this. How bad is grade 4? What does it mean?

    She had 24 teeth removed yesturday due to infections in her gums and holes in her teeth (problems we are sorting which she has had since we got her like her weight)Shes very drowsy today bless her.

    I have been told im not allowed on another cavalier forum as Cindy is not a "show dog". I hope members on this forum will help me as shes still my baby wether shes a show dog or not

    Thanks in advance

    My cindy
    I can't imagine someone or some forum being unwilling to help you because she's not a show dog! How silly and frustrating! I think you've gotten lots of good info already. I'll just second the idea of seeing a cardiologist. If your dog is at stage 4, it's too early for meds. She has a very sweet face!

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