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Sudden murmur heard in 7 year old

My cavalier just turned 7 (his birthday was May 18). He has never had any health problems but was recently diagnosed with very early arthritis. I'm currently living in Boston for graduate school but we wanted to keep a consistent vet so we were taking him to our original vet in my hometown. It had never really created a problem because it's where my parents live. In December, he had started to limp on his one front leg so we took him while we were home for the holidays. This vet is very conservative and said that it was just mild arthritis and that we should monitor it but that he didn't recommend any medication. Then in February the limp seemed to get worse and I knew I wouldn't be home until at least May so I decided to find a vet in Boston. I took him there and she said the same thing but that we could get him started on supplements and a mild pain killer. So he got started on Gabapentin and Dasequin. There are some days where his limp is a little worse but that seemed to be working well.

He also gained a few pounds, likely due to the awful winter we had in Boston the previous year. So I decreased his food by 80% per her instructions and really pushed myself to take him on long walks as much as possible. In the morning, we walk about a half mile and then in the evenings we do between 2 and 3 miles about 3-4 days per week. His limp actually seemed to be better on the days that we did the longer walk. Just recently I noticed that he was slowing down but this was extremely intermittent. One minute he would sort of mosey along and then the next he would be fine. It definitely wasn't to the point that I was concerned so I chalked it up to the temperatures increasing and him being on the dramatic side all his life. He didn't seem uncomfortable in any way, just was moseying along. On Sunday we walked closer to 4 miles and he was energetic the entire time.

We're preparing to move back to Ohio on Saturday but we got a notice that he's due for his rabies on the 27th so we decided to squeeze him into an appointment just so that we wouldn't have to stress about it as soon as we moved. At this appointment, we learned that he has lost at least 2 pounds. He wouldn't hold still so it's difficult to say that it's reliable. The first weight said he has lost 4 pounds and the second one said he'd lost 2. Either way, this was extremely exciting since we've been working so hard on his weight loss. This time we saw a different vet than the last time, which was a little annoying since she was unfamiliar with Nicky. But then we went in for the exam and she asked if he's been intolerant of exercise at all. I said that he hasn't really been intolerant but then he's been a little slower here and there. But that I chalked it up to temperature and potentially his arthritis. Then she listened to his heart and said she heart a murmur, that she was grading at between a 2 and a 3. She advised us to go to a cardiologist so we called yesterday and made an appointment at Ohio State's vet clinic.

Given some of the horror stories, I'm definitely a little worried and I know I'll be totally stressing until his appointment on the 7th. I know that I've seen a lot of posts about vets missing early murmurs but it seems frustrating to me that two vets in the past 6 months would have missed a 2nd grade murmur. Unless it really would have gone from 0 to a 2 or 3 between February and May. I did see some stuff saying that the outlook is better if they are diagnosed after age 5. But then I question if he has had a grade 1 murmur since before 5 and that it went undetected. For some reason he was extremely anxious during this visit and my fiance and I even commented on this while we were waiting for the vet. Is it possible that he was so anxious that his heart mimicked a murmur? She really didn't give us much information, she just kept saying that if there is a murmur she's thinking it's MVD since it's so common in the breed. Then of course I went home and started researching and went into a slight panic.

Right now I'd just love to hear some real life stories about murmurs and some info on how fast the grades typically progress. There are some really helpful sites but some seem to be more pessimistic than others so it would be great to get some idea of how it progresses with actual stories.
 
Commenting to follow this thread. My 7 year old was just diagnosed with a murmur (no grade given, will get a work up done once we're back in the US). Currently Guinness is still very happy, and playing fetch, he does cough occasionally, and his breathing rate is mostly normal (he's sleeping and I just counted 12 breaths in 1 minute).

I think the progression varies quite a bit from dog to dog, so no one can really tell rapidly the MVD will progress.
 
How did you get on with the cardiologist? And how is Nicky? Please give us an update - we'd love to know how you and your Cavalier are doing!

Kate and Ruby
 
We were able to get him into one of the cardiologists at Ohio State, who confirmed the murmur and diagnosed him with MVD. His discharge summary says the final diagnosis is "Mitral Regurgitation; Myxomatous (degenerative) Valvular Disease (endocardiosis); Compensated Valvular Heart Disease (ACVIM Stage B)". When we spoke to the cardiologist he said his heart was very slightly enlarged by one measure and not enlarged at all according to another measure. But his actual discharge summary says "Cardiac chambers size – borderline to mild left atrial enlargement; equivocal left ventricular dilatation". I'm telling myself his heart isn't enlarged at all yet since obviously I'm praying that he doesn't progress for quite some time.


We found a vet according to the holistic listing on the Cavalier Health MVD page but she wasn't nearly as knowledgeable about supplements as I would have liked. She was willing to research for information but I'm feeling much more independent in figuring things out than I would like. I ordered a number of supplements for him so will be starting those as soon as I receive them:
- Vetri-Science Cardio-Strength Chews (L-Carnitine HCl, 250 mg; L-Taurine, 250 mg; Arginine, 150 mg; Hawthorn (Crataegus oxycantha) Berry Extrac, 100 mg; Magnesium (Mg Oxide, 60 mg; N,N-Dimethylglycine HCl (DMG), 50 mg; Berberine (Hydrastis Canadensis) HCl, 50 mg; Coenzyme Q10, 30 mg; Folic Acid, 0.9 mg; Potassium (K Citrate), 0.1 mg
- Grizzly Salmon Oil


Of course, after I ordered, I saw some on here saying that it's better to give supplements separately so now I'm questioning if it would be better to switch away from the Vetri-science chews. I'm also considering starting a probiotic since we're having serious issues with him itching. He's on an anti-histamine but he has to take it 3 times per day and he itches in between doses. He's already been taking Dasuquin (Glucosamine/MSM) chews since February for joint health. The vet said there wasn't as much research for vitamin supplementation but I know some do provide them so I may start Vitamin E and B complex. I've also read that I should add Vitamin D with the fish oil but the vet insisted that it wasn't necessary.


We broke down and took him back to the vet last Saturday for the itching and since it was a last minute appointment he had to see a different vet. She was very cautious which was good in some ways because she was afraid to prescribe a steroid due to the affect it could have on his fluids. But she also graded his murmur at 4, which scared the crap out of me. She did grade it right after cleaning his anal glands (he did not enjoy that) and he also had not peed yet that day. He drives me crazy because he senses when we're going somewhere in the car and refuses to walk around first to go to the bathroom. She mentioned that urinary health can make it sound different at a given time so that may have affected it? Since it's been a few months since the cardio appointment I didn't appreciate hearing a grade 4. She was very rushed and listened, graded him at a 4, and then talked for a minute and listened again and mentioned a 2. So I'm mostly trying to ignore her grade. It's been very stressful for me due to the vastly different rates that the disease can progress. I contacted his breeder and he told me that both of his parents are still clear and that his grandmother passed away last year at age 14. She did have a murmur but it wasn't the cause of her death (he didn't say what was). I'm looking at that as good news and am striving to be optimistic.

The cardiologist said to visit again and do another echo after a year to a year a half.
 
Just in case someone happens to see this and could answer: should I worry about giving Nick 5 mg of prednisone? We have been dealing with itching and I'm a little afraid about the stress on his heart. We tried an anti-histamine first and it just seemed to wear off way too quickly and made him very drowsy. So the vet prescribed a short round of prednisone, starting at 5mg and tapering it down after 3 days. My research seems to point towards fluid retention being more of a concern once his heart is more enlarged but I'm still a little apprehensive. Of course I go out of the vet at 5 and I can't call his cardiologist until Monday now.
 
What did the cardiologist say? My own feeling was that a short course of a steroid wouldn't do any harm - dogs with pain from syringomyelia as well as having a heart murmur can be given steroids, but for as short a time as possible as the side effects can be severe if used for a long time. I'd be interested to know a cardiologist's view.

All the best

Kate and Ruby
 
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