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Luke has a murmur

Lukesmom

Well-known member
Luke has a murmur. He'll be 5 on 2/7. I took him yesterday to a clinic to get looked at, and the vet said he has one. I'm going to take him soon to another clinic to get an echo. But damn. I don't know how long he's had it. The last time he was at a clinic was about a year and a half ago. He didn't have it at that point. My vet hasn't noted it, and he's been there within the last 6 months. They've always been looking at my vet because they know it's an issue for the breed. It was graded at 1-2 now. Hopefully it's not fast progressing. He'd be very upset to have to stop Flyball, but he's clearly been running with it fine for some time so he's not stopping now. He just got started in agility again, and I don't care if he never runs competitively. My friend handles him, so if all she does is works out kinks with him so the next one is better, I don't care.
A friend recommended a cardiologist locally who has cavaliers of her own, so I'll probably take him there after I get it confirmed via Doppler. The doctor who does the clinics is the other local cardiologist, but I can't imagine anyone better to treat a cavalier than someone who has cavaliers.
I've been looking at breeders for a bit for my next cavalier, because I do want to get one bred for sport. I lucked out on him being an athlete. I can't imagine not having one, but Luke also hates puppies. I don't think he'd like it much if I had one while he was still here.
My friends who have dogs with murmurs don't get this. Their dogs are twice his age. Their breeds don't have the likelihood of progressing quickly that cavaliers do. I hope he has a long time left, but I know he might not. It just sucks.
 
It is sad and frustrating that the breed as a whole has moved forward so little on this widespread issue. I have had dogs from two different lines known for good hearts and dogs from both all had murmurs. It takes a lot of research to find a good breeder who properly heart tests -- and follows heart protocols -- and of course even then there's a possibility of an early murmur but at least the chances are much reduced.

I am sure you will find a murmur that low not only won;t affect whether he can do flyball, but that a vet or cardiologist will strongly endorse him continuing to get the great exercise he gets with this activity. :)

You will want to start monitoring his heart of course. My cardio says much depends on the genes behind the dog (assuming he's already for and well cared for) -- I've got a cavalier who was graded at a 3 by my cardio four years ago last week, had only proceeded to a 4, with the murmur on the 'better' side of the heart that causes fewer issues. He is still on no meds with no heart symptoms at age 10. He was likely a 1 or 2 back around age 5. The right genetic mix means a much higher tolerance for a murmur and slower decline. Indeed your dog could go into old age without progressing much at all.

The difficulty for us all, is the not knowing -- which brings worry. Almost all of us will have cavaliers with murmurs, eventually. Most will have them years before they should even appear on the horizon. As owners and puppy buyers we can change this by refusing to buy puppies from breeders not verifiably following the heart protocol and cardio testing. It's a shame that the burden falls to the buyers and owners. I wish there were club- requirements internationally to control and mandate breeding and meaningful health testing with publicly-available results. Right now it still is a minefield.
 
Statistics have shown that over half of all cavaliers develop MVD murmurs before their 5th birthday. So, Luke's murmur is not surprising. The current protocol described by Dr. Mark Oyama, a cardiologist at the University of Pennsylvania's veterinary school, is to not bother with an echocardiograph examination unless and until the grade of the murmur approaches a 5 or 6, or unless the grade has been increasing rapidly.

Instead, he recommends that an x-ray of the chest be taken as soon as a murmur is detected, and to have his heart re-examined in 6 months, by stethoscope). The initial x-ray allows the vet and, in the future, the cardiologist, to compare it with x-rays taken later, to determine if and by how much the heart may have enlarged as the MVD progresses.

The current ACVIM Consensus Statement does not call for prescribing any medications to cavaliers with MVD until they reach the stage known as congestive heart failure (CHF).

So, if Luke was my cavalier, I would not rush him to a cardiologist at this point. But I would get that x-ray and have his heart listened to again in six months.
 
UPenn is actually local to me. 45-60 minutes without traffic, but the person with cavaliers is 15-20 minutes, and comes highly recommended, so I'd probably go to her. On site, the other dog with a murmur, not sure the breed, did get an echo. However, that person was a breeder. I think she had a breeding planned, so she did it because she was going to have to exclude him from breeding and get him neutered. I know the dog was also competitive in agility. If I wanted that breed, I'd have gotten her name, because she seems like one of the good breeders.
As for an X-ray, can my regular vet do that for now? It'd certainly be cheaper than at the hospital place if I could have them done at my vet and take them over if I take him to the cardiologist. My vet will provide me copies to take to the hospital, as I have had to do that before when transferring a dog in an emergency.
I'm not stopping him from any activities. He's not yet competitive in agility, and I don't care if he ever is. My friend handles him, so if all the results is he has a good time and she makes all her beginner mistakes with him, I don't care. If he competes, great. If not, when I get another one, she'll be better prepared to handle the dog. I hate agility, so she can do that. The agility trainer has a cavalier, so she is familiar with the issues as well, and I don't think she'd hesitate to say he needs to stop. He'll compete in Flyball until he can't anymore. If he has to run part time, or go to the veterans class once he's 7, I'll put him there. We do weight pulling, and if wanted to get a title on him, mostly for the humor of it, but I probably won't now. He'll definitely still do it for conditioning, but he doesn't love it anyway.
His food is already one of the lowest in sodium on the market. It's lower than any of the "cardiac" diets available through the vets. The only thing that is lower commercially is frozen raw chicken flavor from the same brand. I use his kibble to train though at home. We never work in the morning, so I maybe switch him to that or raw for his breakfast. He gets hotdogs in class, which are high sodium, but he gets such tiny amounts. Usually I get whatever is cheapest, but I bought him lower sodium ones to use from now on. They were actually the cheapest ones in the store anyway. As long as he likes them, I'll go with it. It probably won't make much difference, he gets like maybe half a cocktail weenie worth once or twice a week, but I'll feel better about it. Plus they're cheaper anyway. He won't work for a toy, so I can't get him off of food treats.
In another note, the eye doctor thought his cataract was trauma related, and unlikely to get worse. He also confirmed that it is not effecting his vision.
The murmur wasn't surprising given his age, but it's still upsetting. He was bred from a dam who was 5 and clear, and the sire was 3 and clear. They were clear at 5 and 8. The ones I could find from his lines were pretty good as well. But, who knows about the ones I couldn't find. They didn't belong to his breeder, so why they weren't listed, I'll never know. I did trace him back to Ann's Son just now for the hell of it. At least on one side from one name I could remember.
 
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This might be a silly question, but how do Cav owners typically know to get their Cavs checked out for possible murmurs? Are there specific symptoms that are red flags to look out for, or should they just be brought into the clinics/vets to check for it periodically even if they appear perfectly fine?

I did see the following write up on MVD, but thought I'd ask just in case there are other experiences/opinions here.

http://www.cavalierhealth.org/mitral_valve_disease.htm#Symptoms
 
This might be a silly question, but how do Cav owners typically know to get their Cavs checked out for possible murmurs? Are there specific symptoms that are red flags to look out for, or should they just be brought into the clinics/vets to check for it periodically even if they appear perfectly fine?

I did see the following write up on MVD, but thought I'd ask just in case there are other experiences/opinions here.

http://www.cavalierhealth.org/mitral_valve_disease.htm#Symptoms

Its very important to take your cav for a yearly routine check up at the vet even if you think your dog is perfectly health and to keep them up to date with their immunisation ;)
 
The important thing with a mild heart murmur is to let your dog lead a normal life. Symptoms won't normally appear until the murmur gets to a grade 5. which with an older dog may never happen. Oliver is 12 and is still only a grade 3, having been clear until he was 8. He comes from a line renowned for its good hearts, so there may be some connection between that and the fact that his murmur appeared late and has not got very much worse. MVD isn't just a Cavalier disease - the Cavalier dimension is that they can get it so early, but many older dogs of many breeds also get it as a symptom of ageing, which I reckon is what is happening with Oliver. My rescue Aled is a grade 4 at age 6, having first been diagnosed with a grade 1 at the age of 2, but he still has no symptoms and isn't noticeably getting any worse.

I get them checked over (for free) every year by a leading cardiologist at one of the heart clinics run by the Cavalier Club - they have them in the US as well, and this provides a basic check-up. Cardiologists are simply better than most local vets at 'reading' heart murmurs. If Aled is shown to have gone up to a grade 5 this year, for example, I would monitor him carefully for symptoms but still give him plenty of exercise if he's OK with it. The other thing to watch is hot weather - any Cavalier (any dog) should be walked early and late when temperatures soar, but it does put a lot of pressure on hearts - even though I kept her as cool as possible in the house and didn't walk her more than a few yards early in the morning, 10 days of very hot and stuffy weather tipped one of my Cavaliers from a grade 5 into congestive heart failure.

Every vet I've ever met automatically checks a Cavalier's heart every time they see one, which can be an early warning that you need to talk to a cardiologist. But it may be years before that happens.

Kate, Oliver and Aled
 
... On site, the other dog with a murmur, not sure the breed, did get an echo. However, that person was a breeder. I think she had a breeding planned, so she did it because she was going to have to exclude him from breeding and get him neutered.

Breeders are in a different situation. If one of the dogs they are running on, or already are breeding, and a murmur is detected, it is recommended that their dog get an echo to confirm the existence of MVD. Echos are the gold standard of diagnosing MVD, and if there is any chance that the "murmur" was a ghost or not related to the mitral valve, the breeder would want to know that.

... As for an X-ray, can my regular vet do that for now? It'd certainly be cheaper than at the hospital place if I could have them done at my vet and take them over if I take him to the cardiologist. My vet will provide me copies to take to the hospital, as I have had to do that before when transferring a dog in an emergency.

Many general practice vets have x-ray equipment. There is nothing special about the x-ray; it is just a chest x-ray. But some vets are better at x-raying than are others. You want a really good x-ray, and digital certainly is more convenient than an oversized sheet, if only just for handling purposes.

... I'm not stopping him from any activities. He's not yet competitive in agility, and I don't care if he ever is. My friend handles him, so if all the results is he has a good time and she makes all her beginner mistakes with him, I don't care. If he competes, great. If not, when I get another one, she'll be better prepared to handle the dog. I hate agility, so she can do that. The agility trainer has a cavalier, so she is familiar with the issues as well, and I don't think she'd hesitate to say he needs to stop.

We've competed several MVD-affected cavaliers in agility, as long as they had only low grade murmurs and no symptoms and the dogs still enjoyed the sport. We would not "campaign" an MVD-cavalier in agility, with trials more than, say, once a month.

... He'll compete in Flyball until he can't anymore. If he has to run part time, or go to the veterans class once he's 7, I'll put him there. We do weight pulling, and if wanted to get a title on him, mostly for the humor of it, but I probably won't now. He'll definitely still do it for conditioning, but he doesn't love it anyway.

I have worked in flyball rings, but not in weight-pulling. But, knowing what I know about flyball and weight-pulling, I would not compete MVD-cavaliers in those sports, but that is just a personal preference.
 
This might be a silly question, but how do Cav owners typically know to get their Cavs checked out for possible murmurs? Are there specific symptoms that are red flags to look out for, or should they just be brought into the clinics/vets to check for it periodically even if they appear perfectly fine?

I did see the following write up on MVD, but thought I'd ask just in case there are other experiences/opinions here.

http://www.cavalierhealth.org/mitral_valve_disease.htm#Symptoms

I know of no external symptoms for the early stages of MVD. Usually, there are no such symptoms until the dog's murmur grade reaches a 5 or 6 and is on the cusp of congestive heart failure (CHF). Except that, you may find the dog having less energy as the MVD progresses, and sleeps more of the time, and walks instead of runs.

A "cardiac cough" is a classic symptom, but there can be any of several reasons for a dog to cough. One relatively new device that cardiologists are recommending is to count the dog's breaths at rest or while asleep. The details are here: http://cavalierhealth.org/mitral_valve_disease.htm#respiratory_rates What it means is that once the dog's average breaths per minute are over 30, the dog probably is in CHF.

One other suggestion, as raised by Kate H and meljoy is to get the check-ups, ideally by a board certified cardiologist. There is a list of upcoming heart examination clinics in the USA and Canada, where cardiologists check the heart for reduced fees, at http://cavalierhealth.org/health_clinics.htm
 
I know of no external symptoms for the early stages of MVD. Usually, there are no such symptoms until the dog's murmur grade reaches a 5 or 6 and is on the cusp of congestive heart failure (CHF). Except that, you may find the dog having less energy as the MVD progresses, and sleeps more of the time, and walks instead of runs.

A "cardiac cough" is a classic symptom, but there can be any of several reasons for a dog to cough. One relatively new device that cardiologists are recommending is to count the dog's breaths at rest or while asleep. The details are here: http://cavalierhealth.org/mitral_valve_disease.htm#respiratory_rates What it means is that once the dog's average breaths per minute are over 30, the dog probably is in CHF.

One other suggestion, as raised by Kate H and meljoy is to get the check-ups, ideally by a board certified cardiologist. There is a list of upcoming heart examination clinics in the USA and Canada, where cardiologists check the heart for reduced fees, at http://cavalierhealth.org/health_clinics.htm

Thanks Rod, I'll be sure to check out the check-up schedule for my area!
 
Darn it, I just typed out a post, and it didn't work.
I started taking him to clinics when I found out about it. He doesn't show any symptoms. He'd run and chase a ball for a half hour straight, and does sometimes. I counted his resting breaths per minute just now, and I got 12. He's out of agility right now because the class is too late at night to do in the winter given that it's 45 minutes away. He only competes in Flyball once a month at most. He's been running for some time with the murmur, so I'm not going to stop him yet. When he first started, he didn't have enough stamina to last the while day (but ran it anyway because there was no other height dog). He's conditioned to do it now and hasn't had a problem. He runs in class, the tries to steal balls after class to play more, and gets up ridiculously early the next morning. He used to go to a team practice on Sunday mornings, and he still gets up early even though he hasn't been in 6-7 months. He can be so lazy around the house, but he can drive me nuts wanting to get his ball too.
He's not going to go competitive in weight pulling. He hadn't yet, but I was going to because it would be humorous to have a cavalier compete. He required work though to get him to pull the real cart, and he worked on a skateboard instead until he could do the cart. He was only recently able to, but he'll just continue practicing with low weights for conditioning. He'll be happy, because it means he gets treats again. He won't work for me unless there's food. He was working with other people because he'll do it for them because he likes to go talk to new people. Since I no longer have to worry about fading out food, he may as well work for me.
My vet does do digital x-rays if I recall correctly. Last time I had them X-ray a dog, it was before Luke, so it was 5 years ago. I'll have them do it. He needs to go I because I forgot to do his paperwork to renew his TDI certification. Oops.
 
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