Neuse River Golden Retiever Rescue
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Neuse River Golden Retiever Rescue

Lub Dub, Lub Dub

by User Not Found | Sep 07, 2014

Dogs, unlike humans do not have a regular rhythmic heartbeat, but they can develop cardiovascular problems.  Heart disease is the number one killer of humans. However in dogs, it is not nearly as prevalent, accounting for only about 10% of ALL dogs.

A basic anatomy lesson is about to happen so get ready.  Blood is pumped from the body to the heart, processed thru the lungs, returned to the heart and pumped out to the body.  Simple right?  Now let’s focus on the heart.  The blood is pumped thru four different chambers within the heart.  Between each of these chambers there are valves.  Valves are thin membranes that open and close to prevent backward flow of blood.  If the valve leaks a little bit and doesn’t seal properly a little bit of blood can leak creating a distinct sound that can be heard by the trained ear.  Instead of lub dub, lub dub, it sounds something like lub-whoosh-dub.

Heart murmurs are most commonly caused by congenital (inherited) defects.  But diseases like Heartworm, thyroid conditions and infection can cause them as well.  Murmurs are “graded” on a scale of 1 (softest) to 6 (loudest).  Grading refers to the intensity of the sound of the murmur.  In fact some grade 6 murmurs are so loud, they can actually vibrate the chest wall!  Many dogs have absolutely no symptoms and their murmurs are found only during a routine exam.  The good news is that most go on to live a happy, healthy life without any signs that a problem exists and only rarely do they require surgery to repair a defect.

If a heart murmur is present in a puppy, it is usually called a “flow murmur” and is NOT caused by underlying heart disease.  These are typically grade 2 or softer and may disappear by the time your dog is 4-5 months old.  If a puppy has a loud murmur, grade 3 or higher or if it is still heard past 4-5 months of age, it is more likely that the cause is an underlying congenital heart problem (heart disease).  This can be a bit extreme sounding especially with such a young dog, but not all types of congenital heart disease with affect your puppy’s life expectancy or quality of life.  In these cases, you’ll most likely need to see a specialist to find out exactly what the problem is and how to monitor and maintain your pup for his good quality of life.

In older dogs, murmurs can vary in severity, from a minor leak that only produces a murmur sound and no other problems to defects that can lead to congestive heart failure.  If the murmur is loud enough and/or suddenly detected and your dog needs to be put under anesthesia, he/she is at risk.  Your vet will want to do x-rays and bloodwork and an ECHO (more on that in a minute) to make sure their heart is healthy enough for anesthesia.  The drugs and gasses they use to send our dogs to snoozy town can affect the heart’s function.  For example, anesthetic gas lowers blood pressure and can cause “pooling” of blood in the extremities.  The heart’s normal response would be to increase the rate it pumps to push blood along, but if you have a weakened heart, you don’t want it to pump faster because that could make the heart fail.  Your dog’s vital signs will be monitored really closely during the procedure, fluids can be given and drugs that affect the heart during and after surgery will be avoided.  Can you do surgery without a full workup?  Yes, but you also assume all the risks including your dog’s heart failing during the procedure.  My own dog was diagnosed with a grade 2 heart murmur at age 5.  She is now 10 and it is still a grade 2.  She has had dental cleanings and bloodwork, but has not had an ECHO.   The balance between risk and benefit for anesthesia is always tricky, but you should have an open conversation with your vet about the best decision for your dog.  Just because your dog has a heart murmur doesn’t mean their heart isn’t healthy and functioning properly.   

Vets have a pretty good set of information when listening to the heart.  Based on the sound, the location and breed of dog, they can make a pretty good educated guess at what type of disease is causing the problem.  My suggestion is to get more than one vet’s opinion.  Vet offices typically have at least 2-3 vets working there, so make an appointment with another vet at another time and get their opinion.  Since it’s based on sounds that they are hearing, it’s a pretty subjective science, but it is also more brains (and ears) in on the problem and that can only mean one thing….more information!!! If the murmur is more severe (sometimes grade 3 but mostly grades 4-6), listening to the sounds of the heart isn’t enough to diagnose.  The key component of a cardiac workup, in this case, is the ECHOcardiogram.  I emphasize ECHO because I don’t want you to confuse it with EKG or ECG, which are not reliably read by even specialists!  An ECHOcardiogram is an ultrasound of the heart.  It gives us a moving picture of the heart allowing us to look at the size, determine where blood is flowing and evaluate the thickness of the walls of the heart.  It’s like a heart movie.  Unique tools, with this procedure, also allow you to estimate the pressure inside the heart and lungs.  A word of advice: if you are monitoring the heart murmur in your dog and it seems to be getting worse and warrants further testing, bite the bullet and see a specialist.  Some vet offices also have traveling ultrasonagraphers that come to your regular vet office to perform these procedures.  The ECHO may be pricey but can give you an enormous amount of information.  This information can only be obtained by someone who has specialized training.  The procedure can diagnose where the problem is, how severe the disease is and what types of risks will be encountered should you have to put your dog under anesthesia.  In most cases, it can also direct your veterinarian as to which type of medications and fluids to use during surgery that would be the safest for the type of heart disease your dog has.  So if it is needed, it makes sense to do it the right way.

But fear not!  There are conventional medications to treat issues that may result from heart problems.  Examples are diuretics, vasodilators, anti-arrhythmics, and ion channel blockers.  Vets can give you lots of information about those options but there are a number of alternatives that can be used along-side prescription medications for keeping your dog’s heart healthy!

  1.  Nutrition—DO NOT let your dog get overweight.  This causes more problems than I can list!  Proper exercise and good nutritious food and a well-balanced diet keep the heart muscle strong and fit.  Also watch dog food and treat labels for salt content.
  2. Medications—talk to your vet about medications your dog may be on that affect the heart and its function.
  3. Vitamins—Things like Iron, Zinc, potassium and B-vitamins (L-carnitine) are usually deficient in human patients.  Vitamin E and C have been shown to benefit heart muscle by maintaining heart walls and blood vessels.  Careful about supplementing your dog with extra vitamins.  If your dog is eating a high quality diet you can easily overdose and that can be dangerous.  You should only supplement with proper supervision from your vet. 
  4. EFA’s (essential fatty acids) and Co Q-10 are great supplements.  They are used in humans to treat and prevent heart disease by strengthening the heart muscles.  They are found in fish like mackerel, salmon and sardines and are also found in beef, peanuts and spinach.  The amount of Co Q-10 declines as the dog ages, so older dogs are prime candidates for supplementation.  EFA’s rebuild and produce new cells, benefit healthy skin and hair, reduce blood pressure, aid in the prevention of arthritis, lower cholesterol and reduce the risk of blood clot formation.  I recommend that every dog is on EFAs’ for life and I take them myself!  To read more about them click here.

Remember whatever avenue you pursue, you should work with your vet on a safe approach to managing your dog’s diet and health.  We’re learning more and more that the way to fight disease and illness is not just with medications, but on many levels.  Proper diet, alternative medicine, exercise, and mental health are focused on the entire dog and his/her quality of life, rather than just on the symptoms. 

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