MVD Questions

[anniemac]

I think the more I read the more confused I get. I posted before about Elton's vet first discovering a murmur in the end of June. He was examined in May and no murmur but it was first detected when he went in for a sick visit. The vet recommended x-rays but I wanted to go see a cardiologist. Elton went back to the vet after he was well to see if the murmur was still there before I drive to NC State and have full exam.
My appointment is scheduled and I really just want them to check his heart, x-rays, give me information etc.

• I am not sure about an Echocardiogram when he has such a mild murmur. Wouldn't X-Ray's be enough to use as a baseline to monitor changes?

• From what I have read if a cardiologist still detects a murmur it is MVD. I am a little confused with this. I know that sometimes puppies can have a murmur that goes away. Elton being almost 7 and with MVD being a health issue with the breed, I am sure it is not something that is going away. Of course everything I read makes me freak out that says things like once diagnosed they can live 1-3 years. Is the progression like SM where some can progress faster than others? Can some continue for years with a low grade murmur?

• It was recently posted by a forum member that a dog does not necessarily have a cough to be in congestive heart failure (CHF). I am not asking about Elton but it seems that I have heard cardiologists say if they are not coughing somehow meaning that they are not in CHF. I am questioning this because I also read that if the dog has fluid in the lungs then they are in CHF? These are more complicated questions and maybe it is like other conditions where symptoms can vary?

[Kate H]

My Oliver was diagnosed with a Grade 1 murmur at the age of 6. He's now 12, the murmur has gone up to a grade 3 and he has no symptoms at all. The murmur usually needs to go up to a grade 5 before you are likely to see any symptoms (such as coughing and tiredness when exercising), and 6 is congestive heart failure. Dogs do seem to vary in the speed with which they get worse. One of my Cavaliers, Meg, was diagnosed with a grade 5 at the age of 5 but had very few (if any) symptoms, didn't cough and loved long walks. At about 7 she went into CHF but still lived happily and enjoyed life for another 18 months. My next Cavalier, on the other hand, didn't (according to our vet) have a heart murmur at all, then at the age of 10 jumped to a grade 5 and went on to medication and gentle exercise and died quite suddenly of CHF about 6 months later. Neither of my Cavaliers who died of CHF had large amounts of fluid in their abdomen, which with some Cavaliers can be a major problem requiring frequent drainage.

I think a lot of how the disease progresses is down to genetics - Oliver comes from a line of strong hearts; the one who spent 18 months in CHF came from a line where her mother and all the rest of the litter eventually died of MVD. And of course many dogs of all breeds die of MVD in old age - Cavaliers are different because they can get it so much younger. An echocardiogram will be able to tell you what is really happening in the heart, though all mine have simply been treated by our excellent vets and just get a quick stethescope check by a cardiologist once a year for free at the Cavalier Club championship show, which gives me an accurate grade for them. Oliver had his first Doppler test a couple of months ago as part of a heart research programme!

I hope the cardiologist will be able to sort out your queries and set your mind at rest. Let us know what he says!

Kate, Oliver and Aled

[anniemac]

Thanks Kate

One of the reasons I'm asking is because Elton is being considered as a control dog for a heart study at nc state veterinary college. http://www.cvm.ncsu.edu/docs/cprl/clients.html

According to their website, Elton would be too young and too small. They are looking for 21-32 lbs and Elton is 12 lbs. I had the appointment scheduled for reasons I said before and I didn't think he would be considered. I still don't know It seems like they are needing more control cavaliers. They have his records so I was wondering how he wouldn't be considered as having heart disease when that if a murmur is still detected by a cardiologist they have MVD.

I guess I will have more information at my appointment. Still I am not sure because my pet insurance does not cover clinical trials but does if he is referred to a specialist.

[Kate H]

I would have thought that if you are taking part in a clinical trial you would get all the tests done for free, so your insurers wouldn't be involved. Oliver took part in a clinical trial of SM medications two years ago and everything was free - one of the researchers paid for the drugs out of his own money! Are they looking for heavier Cavaliers because the obese are more likely to have heart murmurs?!

Kate, Oliver and Aled

[anniemac]

I would have thought that if you are taking part in a clinical trial you would get all the tests done for free, so your insurers wouldn't be involved. Oliver took part in a clinical trial of SM medications two years ago and everything was free - one of the researchers paid for the drugs out of his own money! Are they looking for heavier Cavaliers because the obese are more likely to have heart murmurs?!

Kate, Oliver and Aled

The study does pay for different things for dogs with heart failure and "control" dogs. They said if he does qualify the study will help with some of the charges.

The study says "We are comparing the activity level of dogs with subjectively asymptomatic mitral valve disease against age-, size, and AKC breed group-matched controls without heart disease to determine if early heart disease does in fact impact their mobility and daily activity."

Like I said before, I know nothing about MVD like you and others. I DO know that obese dogs and humans be bad for the heart in general. How that relates to progression of murmurs etc. I am sure Pat, Rod and others know. Elton does have a murmur and is not obese. I would imagine it being harder to control weight on a cavalier that is in the advanced stages of MVD or CHF because I am sure they are less active. However, I guess that is one of the aims of the study to look at how the heart plays a role in their activity.

The contact mentioned she asked if they would consider Elton (a significantly lighter) cavalier as a control dog for one already enrolled. I guess the ones with heart failure enrolled are larger. I will get to learn more at his appointment. Either way I feel it will be interesting to talk to some of the researchers. To me, Elton does not seem like a good control cavalier. He has more energy than any cavalier I have seen his age. He fits because I have no other dogs, children or stairs.