# heart murmur grade 2



## sweetstrwbrry (May 26, 2014)

We took our pups to the vet for their annuals today. We found out our older maltese Gracie (10 years) has a grade 2 heart murmur. It was kind of a shock because this is a new thing - last year she didn't have it. He said there are 6 grades and the first one is barely audible if at all and once you can hear it, it is a grade 2. 

He explained to us that this is progressive and can lead to congestive heart failure - where the fluid backs up into the lungs. Specifically he said it was related to the mitral valve. She is not having any symptoms whatsoever - has been acting completely normal and no cough, weakness, etc. At this time he said no intervention was needed (meds, etc) but we could do an Xray to get more information. He is not starting her on any medications right now.

Has anyone had maltese with this issue and what was your experience? My father-in-law's maltese ended up passing away suddenly from CHF at 12 - I do not know if the pup had a mumur prior or not. The dog was however overweight and did not have much activity.

The vet said we did not need to change anything at this time - diets, exercise, etc. She loves to play and go on walks and is not showing any signs of exercise intolerance. We just would like to know realistically what to expect. I've researched it a bit and it seems anywhere from a few months and other dogs live years and years or a normal life with this condition.


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## mss (Mar 1, 2006)

It sounds to me like your vet has given you good advice. 

I've had several dogs with heart problems. Most of my dogs came to me as adults or middle aged, with a history of some degree of neglect. Some had very mild murmurs that progressed quickly; others progressed over 3 years or more. I had one dog who lived to age 17 with heart and other issues, on multiple medications and with less energy but in good spirits until the last week or so. 

I have one right now that I wish I had gotten on medication sooner, before he became symptomatic, because by then his heart was pretty enlarged. He has problems with both his mitral valve and his tricuspid valve (which is on the other side of the heart).

Did your vet recommend a schedule for a recheck? If it's possible, and you can afford it, it might be a good idea if his "number" goes up to consult a cardiologist who could do a cardiac ultrasound which would tell you more than an x-ray can. 

I wish you the best of luck with your dog and that you and he have a good long future together! {{{{}}}}


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## Luna&Me (Jul 23, 2016)

(((HUGS))) I know it is not easy to hear. My last dog was a cavalier and they almost all get heart murmurs at some point they can still have a nice life but do check more often and I really hope you have pet insurance or some savings as it can get quite expensive to care for them with this condition.


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## wkomorow (Aug 26, 2011)

i am sorry to hear that. There are a few on here who have dealt with CHF in dogs. Hopefully they will chime in. Michelle is going through it with one of her dogs right now. Michelle herself recently had surgery so she may not be posting much. My mother had CHF and was on several heart medications, one of the important ones was Furosemide (Lasix) which pulls the extra water out of the body and reduces the buid up in the lungs. Her Lasix's were in constant need of adjustment depending on how her heart was doing.


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## sweetstrwbrry (May 26, 2014)

Thank you all. We do have quite a bit of savings and are very aware of how expensive things can be. 3 years ago Gracie was diagnosed with a tumor on her pancreas and they said she had less than a year to go. We opted to do a 7K surgery to remove what was there so she could live up to 2 years. Turns out they opened her up AND NOTHING WAS THERE! So we have been through the wringer w/ her financially and emotional wise. From being told your dog is going to die to oh she is fine in a matter of months. 

The vet did give us a quote for Xray which is about $200. I think I'm going to take her back in 6 months and see where we are at. Her blood pressure was super elevated because she blew her vein when they were getting blood for heart worm. I would like to determine if the murmur is there permanently or not. He did say it could be physiologic meaning caused by something random and temporary. But given her age and breed it is likely a permanent condition. But we do have that sliver of hope seeing as what she has gone through in her life. 

I will continue to watch her diligently. We do that anyway because she also has immune mediated disease and has flare-ups. She was at the vet specialist for about 2 weeks once and almost lost her then due to this condition. Thankfully she has not had a flare-up in 2 years. She really is our miracle pup!


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## maggieh (Dec 16, 2007)

Samantha, my first Maltese, was diagnosed with a heart murmur at age 11. She did well on meds for several years and I lost her at 15+ from acute renal ur vet has given you some good advice - monitoring and adding meds when appropriate is the best course of action.


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## Snowball Pie's Mommi (Oct 16, 2008)

sweetstrwbrry said:


> We took our pups to the vet for their annuals today. We found out our older maltese Gracie (10 years) has a grade 2 heart murmur. It was kind of a shock because this is a new thing - last year she didn't have it. He said there are 6 grades and the first one is barely audible if at all and once you can hear it, it is a grade 2.
> 
> He explained to us that this is progressive and can lead to congestive heart failure - where the fluid backs up into the lungs. Specifically he said it was related to the mitral valve. She is not having any symptoms whatsoever - has been acting completely normal and no cough, weakness, etc. At this time he said no intervention was needed (meds, etc) but we could do an Xray to get more information. He is not starting her on any medications right now.
> 
> ...


Hi, Alison. My Snowball has been under cardiac care since March 4, 2016 ... at that time Snowball was admitted to the hospital for a congestive heart failure event secondary to chord tendinae rupture. 

The more detailed diagnosis was:

Advanced valvular disease
Severe mitral valve regurgitation causing heart murmur
Mild tricuspid valve regurgitation contributing to heart murmur
Flail tip of anterior mitral valve leaflet- ruptured chord tendineae
Only mild left atrial chamber dilation
Mild eccentric left ventricular dilation
Maintained left ventricular contractility
Left-sided congestive heart failure-secondary to ruptured chord tendinae and 
sudden severe mitral regurgitation

Alison, I would like to share with you that prior to Snowball's heart attack ... he had been diagnosed with a heart murmur. And at that time, there had only been one vet who happened to pick up a heart murmur. With that, and although I always felt Snowball, throughout the years, has received the best of care. However, it was only one vet who caught the murmur. And, with that, I made an appointment to be examined by a cardiologist. On July 30, 2014, Snowball had his first cardiology appointment. He was diagnosed with mild compensated degenerative valvular disease and there was no evidence of heart failure.

On April 8, 2015 ... Snowball was diagnosed with very stable mild compensated degenerative valvular disease. And, once again, there was no evidence of congestive heart failure. So, as with the initial exam ... no cardiac medications were recommended at that time.

And then a year later was when we ended up in the ER and he was admitted for his heart attack. SNowball's prognosis was for 18 months. It still bothers me to think about this. However, his last two cardiology exams have shown stable/improved advanced valvular disease ... which has been a good thing. From what I understand, scar tissue has helped close the ruptured mitral value somewhat. 

I shared all of this information because, if it were me, I would go ahead and make an appointment with a cardiologist. I feel it helped to already have a cardiologist checking Snowball out before he had a heart attack. I feel blessed that Snowball has been receiving the best of care with his medical team and cardiologist. Snowball had more than a heart attack ... a ruptured valve is even more serious than a heart attack itself. 

The good new is that with all Snowball went through with the heart issues ... and within a year of the attack ... he needed dental surgery for an impacted tooth (and, then unexpected tooth extractions) ... and, then surgery for oxalate stones. ll this seemed overwhelming ... but, with both surgeries, Snowball did extremely well. 

Snowball turned twelve years old on February 19th of this year. It is now eighteen months later. On his last cardiology exam (a few weeks ago), his prognosis is more hopeful. He has been doing extremely well...he loves his walks and has a great appetite. I hope and pray he lives much longer than his prognosis, which now has been improved somewhat. He has echo-cardiograms twice a year to monitor his heart. And, in between, I monitor his heart rate on a daily basis.

Gracie sounds as though she has a great vet. If you have any other questions about Snowball's diagnosis, please feel free to ask me. And, please give your sweet Gracie hugs from me.


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## Snuggle's Mom (Jan 3, 2008)

I can certainly sympathize with you and feel very sorry to have read your post. Our late Angel suffered for a short time with CHF and lived to be 14 1/2 years old. She also had kidney failure as well.


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## Orla (Jul 5, 2009)

My dog passed away 3 weeks ago from CHF. She was diagnosed with a slight murmur about 3 years ago(at the age of 11). She developed a cough around a year ago, but other than that she was still active and happy! She was on medication since soon after the cough developed. Everything went downhill very quickly just after she turned 15. In the space of 2 months she went from running on the beach to not being able to walk without falling down. She stayed eating but dropped so much weight. 

Despite the murmur, she had a great quality of life. Even in the last few weeks she had some good days!


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## wkomorow (Aug 26, 2011)

Orla -

I did not know that Milo had a sister. I am sorry for your loss.


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## Maglily (Feb 3, 2009)

My friend's Shih Tzu Benny had a grade 2 heart murmur (he is now 11 years) and today had a coughing episode which brought him to the ER, now they say he has grade 4 and is scheduled for an echocardiogram. He is back home now and settled but my friend is pretty upset.

I'm sorry I don't know much about heart murmurs first hand only what friends have experienced here (and my friend which is very little, since they were just aware of it but monitoring). I hope all goes as well as they can for your pup.


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## sweetstrwbrry (May 26, 2014)

Yeah I am not sure what to do :/ he didn't mention anything about seeing a cardiologist. Just to monitor her for cough, lethargy, etc.


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## Matilda's mommy (Jun 1, 2005)

Alison my precious Matilda passed over to Heavens Rainbow Bridge Jan 15th of this year., she was 11 1/2. When we rushed her to the emergency vet we were told she had 3 heart murmur's and had congestive heart failure. We had no idea, the vet at the emergency said our Matilda was in critical condition but thought she would be OK and would send her home with Lasix and heart meds. It happened so quickly, we lost the joy in our hearts that night, my Matilda. looking back there were signs that were over looked by her vet. We took her in months before for a cough, then again for her gaining weight even though she was eating the same as always, the vet thought she had Cushing, we bought the medication but both Lorin and I just felt in our souls that she didn't have Cushing and we got rid the the medication. Then it was time for her yearly senior panel, everything came back great, she then had a dental, again everything went well. But she would cough on occasion, so off to the vets where he checked her and told us she was wonderful. Matilda played, walked enjoyed everything. So we have been devastated since losing her. Marie has helped me to understand just how quickly things can change and how murmur' can be overlooked. Typing this has not been easy for me as tears are flowing down my face. I don't want you to go through what we are enduring. Please get the x-ray, take your sweet baby to a cardiologist, don't just listen to one opinion seek more. We thought we had a wonderful vet, we trusted him. Since we have changed vets. Maddie's vet said Matilda 's vet should have looked into why Matilda coughed, her weight gain which was actually swelling, and should have ran tests to determine why this was happening to her. I'll be praying for you and precious little Gracie, the picture below is of our Matilda a few weeks before she left us.


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## Maglily (Feb 3, 2009)

Matilda's mommy said:


> Alison my precious Matilda passed over to Heavens Rainbow Bridge Jan 15th of this year., she was 11 1/2. When we rushed her to the emergency vet we were told she had 3 heart murmur's and had congestive heart failure. We had no idea, the vet at the emergency said our Matilda was in critical condition but thought she would be OK and would send her home with Lasix and heart meds. It happened so quickly, we lost the joy in our hearts that night, my Matilda. looking back there were signs that were over looked by her vet. We took her in months before for a cough, then again for her gaining weight even though she was eating the same as always, the vet thought she had Cushing, we bought the medication but both Lorin and I just felt in our souls that she didn't have Cushing and we got rid the the medication. Then it was time for her yearly senior panel, everything came back great, she then had a dental, again everything went well. But she would cough on occasion, so off to the vets where he checked her and told us she was wonderful. Matilda played, walked enjoyed everything. So we have been devastated since losing her. Marie has helped me to understand just how quickly things can change and how murmur' can be overlooked. Typing this has not been easy for me as tears are flowing down my face. I don't want you to go through what we are enduring. Please get the x-ray, take your sweet baby to a cardiologist, don't just listen to one opinion seek more. We thought we had a wonderful vet, we trusted him. Since we have changed vets. Maddie's vet said Matilda 's vet should have looked into why Matilda coughed, her weight gain which was actually swelling, and should have ran tests to determine why this was happening to her. I'll be praying for you and precious little Gracie, the picture below is of our Matilda a few weeks before she left us.


Hi Paula, sorry if I am cutting in on the thread, I could not bring myself to mention to my friends how suddenly you lost Matilda today. Not after they brought their Benny to the vet - it was grade 3-4 and they are doing the echo and will follow up with tests. I don't think they got an xray though. Vet was not certain the cough was due to heart or bronchitsis etc, so prescribed antibiotics and a pill for the cough too, which is helping.


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## sweetstrwbrry (May 26, 2014)

Thank you all for sharing these stories with me.

I have made an appointment for October 14th for us to go back and have a check-up. If she still has the murmur we will ask about the Xray or if we should see a cardiologist. Does anyone have any experience that these murmurs can be caused by stress temporarily? That day was torture for her - they couldn't find a vein and stuck her with the needle 5 times to draw blood for the heart worm test. They said her blood pressure was through the roof because she would not stop bleeding afterwards. The vein literally blew the clot. He said it was more likely since she is 10 it would be a permanent murmur but it is possible it could be physiologic (temporary). As far as this dog goes, we don't underestimate her since she has gone from being told she has cancer and months to live via a blood test to not having cancer at all. So anything is possible with her.

Since she won't need all the poking and prodding next time we will check to see if the murmur is still there. The vet tech called me to tell me her UA was normal and I asked about it and she said the same - entirely possible it could be an innocent murmur. So we will see what goes on with the next visit. So far she is 100% normal.


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## Snowball Pie's Mommi (Oct 16, 2008)

sweetstrwbrry said:


> Thank you all for sharing these stories with me.
> 
> I have made an appointment for October 14th for us to go back and have a check-up. If she still has the murmur we will ask about the Xray or if we should see a cardiologist. Does anyone have any experience that these murmurs can be caused by stress temporarily? That day was torture for her - they couldn't find a vein and stuck her with the needle 5 times to draw blood for the heart worm test. They said her blood pressure was through the roof because she would not stop bleeding afterwards. The vein literally blew the clot. He said it was more likely since she is 10 it would be a permanent murmur but it is possible it could be physiologic (temporary). As far as this dog goes, we don't underestimate her since she has gone from being told she has cancer and months to live via a blood test to not having cancer at all. So anything is possible with her.
> 
> Since she won't need all the poking and prodding next time we will check to see if the murmur is still there. The vet tech called me to tell me her UA was normal and I asked about it and she said the same - entirely possible it could be an innocent murmur. So we will see what goes on with the next visit. So far she is 100% normal.


Alison, you are such a wonderful mommy to Gracie. 

I want you to know that when I shared what happened to my Snowball I didn't mean to frighten or upset you. And, I am glad that others have shared their stories with you.

I still think about all that happened within hours before Snowball ended up in the ER and ICU. 

I remember picking Snowball up earlier that day and telling him he looked gorgeous and so healthy. Yes ... healthy. 

That evening we had an appointment at 7PM with Snowball's regular vet. Snowball was there to have lab tests done right before a scheduled dental. However, we had to wait over an hour in the vet's office because they had an emergency. During the long hour wait, Snowball started to breathe more rapidly than I had ever seen. My husband told me it was just me worrying and that Snowball was just nervous. When the vet tech finally came in to take Snowball's vitals ... I told her about my concern. Again, my husband seemed to convince her it was just me worrying and the Snowball was just nervous. Then the doctor came in to take the blood tests on Snowball and said that he would probably calm down after we went home. That did not happen at all.

I was on the bed with Snowball and I will never forget Snowball turning around and looking up at me a few times. He looked as though he was smiling at me. He didn't look sick. But, his breathing became even more rapid. I decided to count his breathes within a minute ... it was 52 breathes per minute. I called the ER and was told to bring him in ASAP.

When we arrived at the ER he was checked out immediately. The doctor said he could be suffering from congestion ... but, they would take an x-ray to be sure. A short time later ... the cardiologists on duty (yes, CVCA has a cardiologist on duty 24/7) gave me the bad news that Snowball had not only had congestive heart value ... but, that a mitral valve had ruptured. So, he was immediately put on oxygen and was in ICU. I still cannot get over how fast things had changed for this happy and healthy looking fluff baby of mine.

I was blessed that I was able to bring him back home the following evening. But, immediately changes were made. He started on three cardiac medications ... Pimobendan (Vetamin), Enalapril, and Lasix. These are the same cardiac medications prescribed for humans with heart issues. 

It was such an adjustment ... because most who know me on Spoiled Maltese know how worried and seriously I took, and have to this day, taken it all. 

Several months ago after one of Snowball's echocardiograms ... I asked the cardiologist if Snowball's attack could have come on from too much stress while waiting for the vet appointment for his lab tests. He said yes that it could have been too much stress for him. What still upsets me when I think about it is that if I would not have made that phone call to the ER when I did ... I could have lost Snowball. 

I am blessed now to have his vet do all of Snowball's check-up's and lab work right here at home. The only time Snowball has to go into the doctor's office is for his echo-cardiograms. And, then they schedule him the first thing in the morning so that we don't have to wait. The nurse (they have vet nurses) comes out to the car so that we can all go in together to start his exam. Again, they know and see how stressed he can get ... so, they are on top of things as much as can be humanly possible.

With all of this, I still make sure Snowball gets his walks (which he loves) and gets out for a car ride, etc. He normally relaxes then because when he looks up at me he is assured we are going for a fun car ride and walkie. If we need to go to the vet ... its hard to not be truthful with him ... he just knows. 

If you do at some point see a cardiologist , they will take an echocardiogram. Like with humans, x-rays do not always show serious here issues. When Snowball has the echo-cardiogram, I am right there in the room with him ... petting him as he lies on the examining table. His cardiologist is continually reading to me what he is seeing on the echo ... everything. I like how that is done because it does calm Snowball quite a bit that I am there with him.

The most difficult thing for me is knowing that even though Snowball has been doing so well with a heart condition such as his ... it can change in an instant. What I have been taught to do though is be aware of certain changes in his behavior or breathing. 

Again, I personally feel that you are going in the right direction with Gracie. Please let us know how her appointment goes in October.


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## Snowbody (Jan 3, 2009)

Alison - I'm so sorry to hear about the diagnosis and taking you by surprise. I would definitely see a cardiologist. It's interesting but one of my friends recently went to a doctor for a skin condition she had. The doc listened to her heart and suddenly said, "Did you know you have a heart murmur?" She said she knew she has Mitral Valve Prolapse so yes. He said, "Well it's quite pronounced. I think you need it looked into." Well she and I see the same cardiologist (who is also our internist) and have for years. She's terrific and is very aware of heart issues which my dad and her father had. She went to her and told her what the doc said and she said,"Not all doctors know how to listen for a murmur." She told her that hers is only a 1 and meanwhile this other doctor was acting like it was severe. So I would go to a specialist. I'm with AMAR and we got a dog in who had a pretty advanced heart murmur but needed a spay, a dental and a tumor removed. We took him to the cardio before doing them and he felt he would do well. And he did! He made if fine through the surgeries and is living the life. :wub:


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