Sunday, April 5, 2015

Heart Murmurs. What are they, what to do about them, and how much does treatment cost?

This is a great question! and one that I answer often! It is also one that is incredibly important to the health and longevity of your pup. My sister is on her second heart failure pup so I will give you the same exact advise that I gave her, (In fact I am also going to send her a little note to jump in and give her personal experience).

There is not a right or wrong answer here. But, here is what I think is the best answer. Heart failure in our dogs is most commonly associated with a heart murmur (I think that this is what you are referring to when you say 'level 3'?). We categorize a heart murmur on a scale of 1 to 6, six being the most severe. In may cases dogs have murmurs for years. Once identified they should be monitored closely with re-check exams at 3-6 month intervals, or sooner if there is any change in the clinical signs (like lethargy, coughing, increased water intake, reluctance to play or exercise, or weight loss, muscle wasting or anything else that seems different in attitude or behavior). If the murmur is progressing we monitor more closely or discuss further diagnostics or treatment options.

Ideally, I send every suspected heart failure pet to the cardiologist for an echocardiogram. These are incredibly helpful in understanding what the heart is doing and how it is affecting the patient. From the echo we discuss if, or when, it is time to start heart medications to help the heart work better. There are many helpful heart medications available to pets. Most are very affordable and have a very low complications or potential adverse side effects. An echo in my area of the Baltimore Washington area is about $600. Heart medications for my sisters dog is about $20 a month. Without an echo we are making an educated guess about what is going on in your dogs heart. This makes deciding a treatment option more difficult and potentially less beneficial.

Most of my heart patients do very well for years when on heart medications, monitored closely and kept on a good heart diet (ask your vet about these they are super beneficial) and kept on a calm, quiet, moderate exercise plan. My sisters first dog was initially diagnosed with a 5/6 murmur and lived 3 years after because she had the help of a cardiologist, medication, and a great prescription diet.

I am wholeheartedly in support of working up your pups case, getting as much information as you can gather from as many experts as possible and telling age to take a back seat. Proactive, diligent, and dedicated pet parents can lengthen the lives of their pets with both quality and quantity of good happy, healthy days.

Best of luck, and please let us know how your pups case goes. We are here to support you both!




  1. You just wrote about a subject near and dear to my heart (no pun intended) as the owner of Cavalier King Charles spaniels.

    Our breed club (as well as those of Rottweilers and Dobermans and other breeds) often hold heart clinics to help keep tabs on the hearts of murmur-prone breeds. It is a good way to get board-certified cardiology exams and Dopplers for a very discounted rate. These clinics are not generally one that will prescribe (or fill) medications, but are designed for information and monitoring of heart health.

    My pets are auscultated annually at these clinics and the old dog with a murmur gets his heart checked twice yearly and echoed well.


    1. Hello Julie,
      Thanks for reading and for including the information about the cardiology exams. I know quite a few breeders who utilize this service. Please keep reading and commenting. And please join us on where we share pet advice and real life experiences to help other pet people. Your knowledge would be soo welcomed!
      Take Care,

  2. I didn't realize there were different levels of heart murmurs. Do they always progress and get worse or can they be at a level 1 and stay there with little concern?

    1. Hello,
      In almost all cases the murmur worsens over time because the murmur is the audible result of a failing (or imperfect) heart valve. In some cases it gets worse very very slowly and may never need treatment or lead to the pets death. In others it can rapidly decline and cause the pets death. This is influenced by many things. I have seen some pets have a grade 1 or 2 murmur from birth to death at a very ripe old age. I have also seen dogs go from a grade 2 to 5 in months. I also witnessed my sisters dog be diagnosed with a 5/6 get treatment that managed her with a grade 2-3/6 and then die years later from complications associated with an unrelated cancer at a very old age.
      All heart murmurs should be categorized, ideally echoed and closely monitored. There are no set rules for these but there is lots clients can do to help slow the disease.
      Thanks for reading and the question,

  3. Danielle Scheepers ( 12044947 )April 12, 2015 at 6:14 AM

    Dear Krista,

    I am a veterinary technologist from South Africa as well as a proud pet owner, so I understand the stress that the pet experiences in these traumatic situations as well as the cost implications that can easily skyrocket.

    I wanted to find out from you if you perhaps considered a diagnostic screening such as the Canine proBNP (pro B-type Natriuretic Peptide) test that I think most IDEXX Laboratories offer?

    B-type Natriuretic Peptide is a cardiac hormone produced in response to stretch, hypoxia and the activity of other neuroendocrine.

    We perform a simple ELISA (Enzyme-Linked Immunosorbent Assay) test on blood plasma that screens for Cardiomyopathy, differentiates between respiratory disease and cardiac disease and can also be used to monitor cardiac disease, assess the stage that it's currently at and assess the response to therapy.

    Although it doesn't fully diagnose cardiac disease, it guides you on whether to perform additional diagnostic tests and which to choose (such as the regular Echocardiograph, Electrocardiogram and radiographs).

    It is also a lot less stressful and a cheaper screening than the other procedures that require anesthesia.

    I am also currently studying to become a Veterinarian and would like to hear your opinion on the proBNP test with regards to your patients and experiences that you have had.

    Danielle Scheepers

  4. People are sometimes unaware that heart conditions can occur in dogs too.

  5. This comment has been removed by a blog administrator.

  6. This comment has been removed by a blog administrator.

  7. Hi Krista, I was interested in buying a 4mth old pup who has a grade 1 mechanical heart murmur. Can a cardiologist diagnose with tests if this type of murmur will remain a grade 1 for the dogs life or if it will become a grade 3 in a matter or months? I was hesitant in getting the dog in case it became extremely ill in a by the time it turned 3. Thank you