Class 2 puppy murmur - Page 1

I just wanted to get any experienced feedback from anyone who has had a pup diagnosed in the 8 week old range with a level 2 murmur. Did it go away or get worse. What are the percentages that this kind of murmur worsens or improves? So far, no clinical signs like weight loss, fatigue etc. are showing and the pup is very active. Cardiologist said to wait until 16 weeks to see if it has improved or do the echo now with no guarantee of diagnosis but a guarantee to pay$500 for the test. Thoughts?

I have been breeding shepherds for some time now and my knowledge and experience with heart murmurs have been as follows. The vets rank a murmurmur from a grade 1 through a grade 6. Two of my vets claim that few human ears could detect something as small as a one since most young puppies are so excited on their visits to the vets, they are wiggling and panting so hard, that it would be near impossible to detect. A grade 2 in my experience will go away. In the last 7 years I have had two returned at 8 weeks of age and both murmurs were gone by 5 months of age and even after 1 year had not returned. Grades 4-6 are usually deadly and if untreated, the dog will usually die before a year of age from a heart attack. I had one of those I kept myself till he was 9 months old when he suddenly died. Grade 3 is the toughest one to call because the person doing the "grading" is a veterinarian whose opinion is naturally colored on the side of the purchaser(his patients owner) and doesnt want to be sued for malpractice. So most vets would rather err on the side of caution and grade a 2 a 3 or even a 3 a 4. However, these are 50/50 in my personal experience. One is still living and the other died before a year. Point of interest, none of these pups had the same father or mother so additional commentors please don't try to second guess my breeding program and just answer the question with first hand knowledge as I have done. Veterinarians are not GOD, most talk like experts before the fact but when circumstances prove them wrong they are very quick to hide behind the fact that they are "medical practicioners" and cant be held accountable foer the vagaries of nature!

Trxshep, good commentary from experience. I understand that all puppies are born with a very slight but predictable murmur as the valves of their hearts are not yet mature. I of course do not have the trained ear that can discern this, and that is where the service of a highly-skilled veterinarian is a great asset. I know that most of us view advanced medicine as the use of highly-specialized machines and detection/interpretation systems, but it is of interest to note how much effort to train a human cardiologist just so they can discern the quality, type, and source of very faint sounds made by the human heart and circulation system. Of course I am talking about a medical specialist and not a general practitioner. I think most veterinarians fall into the category of general practitioners, just as do most MD's. Again, good commentary. Bob-O

Bob-O, heart murmurs in young animals (and humans) have nothing to do with the valves usually. In the unborn animal, there is a hole between the left and right sides of the heart, the foramen ovale. The fetal blood circulates through this hole. Once the animal is born, and begins to breathe, the hole usually closes within a few days of birth, keeping the oxygenated blood on the left side of the heart separate from the non-oxygenated blood on the right. In some cases, the foramen is larger than usual, or does not close right away, which is what causes the murmur. The severity of the condition depends on the size of the hole, and how much blood is getting shunted from one side to the other. (I am familiar with this conditon, because I have a very slight murmur, and have had it all my life. Interestingly enough, on my most recent echo exam, the doctor could no longer find the hole OR the murmur!!) So, yeah, I agree 100%, nature is unpredictable. Medicine, whether human or veterinary, is part art and part science. Tests are not always reliable. I remember a friend of mine telling me about her visit to the doctor. He said, "You know, this x-ray shows the value of ALWAYS talking to you patient. According to this x-ray, YOU SHOULDN'T BE ABLE TO WALK!" And, of course, my friend was walking just fine, although with some pain.

I am going to pass on a couple of web links I found about heart murmurs. Some of their findings concur with those I related to this group and I even learned a few new things myself. Thats the unfortunate problem with breeding dogs, we never stop learning and most of that which we do have to learn is always because of something bad that happens to our dogs. Of course, if something bad didnt happen, then there would be no reason for us to have to learn. http://www.backcsc.com/heart.html http://yandisa.com.hosting.domaindirect.com/id56.html Hope this helps.

bob-o, gp's need the ability to correctly send a patient for an echo; a murmur is not always needed to do that (some other conditions without murmurs require an echo). The same applies to a cardiologist; he needs to have the skill to determine when a certain test is indicated, to subsequently treat. a diagnosis of chf, endocarditis, aortic stenosis or most of other heart problems requires imaging for the clinician to write a diagnosis in the patient's chart. Valve problems usually occur in adult; these are very specific problems that are usually associated with other problems; i can't think of any congenital valvulopathy... class II murmurs need to be followed; class 4 and higher need an echo; class 3, in the middle, are somewhat subjective and need to be combined with symptomatology to assess the need for an imaging study n.

A grade 2 murmur is probably no big deal. I wouldn't spend $500.00 on an echo for an asyptomatic 8 wk old puppy..but that's me. I hope it is nothing in your little one. I really doubt it. I agree with the recommendations of the cardiologist-wait til 16 wks and go from there unless puppy becomes symptomatic. Sunsilver- Yes, heart murmurs can come from leaky valves and frequently do. They also can be caused by small or large holes in the septum keeping the oxygenated and unoxygenated blood somewhat mixed depending on severity. Nikos- unfortunately, valve problems do regularly occur in the young ones but the causes are generally different. If I had a nickel for every one I have seen I could retire. I hope this helps.

Thank you everyone for your valued wisdom!! Thanks Trexshep for the links, I had not come across those in my searches. Thanks again, you have all been a help.