# Heart murmur (Not Angel)



## angel's mom (Feb 14, 2007)

I have an 11 year old terrier mix. At her annual exam in April, the vet said she had a heart murmur and prescribed enalapril 5mg. He said it should help with her cough. I've noticed that her coughing is getting worse, and tonight she's really coughing a lot. I'll call the vet tomorrow.

How does the heart murmur cause the cough? What is the connection?


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## Ladysmom (Oct 19, 2004)

I believe the cough is from fluid build up in the chest. Your vet may prescribe Lasix.

What grade heart murmur is it? 

I hate when our babies get old. :grouphug:


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## JoyandZoeysmom (Mar 18, 2007)

Lynne, This is what causes the cough" When the heart is not properly pumping blood, the blood moves more slowly through the lungs. This results in small amounts of fluid leaking out of the capillaries into the air passageways. This fluid collection produces the earliest signs of heart failure: gagging as if trying to clear the throat, a chronic, hacking cough, and lack of stamina" My Joy has a heart murmur and has just started the coughing at night. Joy is on Enalapril 2.5 MG, Quartered.

Robin, Joy and Zoey


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## JoyandZoeysmom (Mar 18, 2007)

Joy is will be 2 yrs in January, she was born with the heart murmur. Her parents , grandparents, great grandparents, etc, have no history of heart disease,

Robin, Joy and Zoey


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## k/c mom (Oct 9, 2004)

My first Malt, Rosebud (R.I.P) was diagnosed with a heart murmur at about 9-10 years old and she lived until 12-1/2. Yes, the coughing is so tough to live with but in the earlier stages there is medicine that can help. Rosebud was on at least 5 different meds every day. At night if she was having trouble sleeping due to the coughing I would give her benedryl and that would help. 

Rosebud had an echocardiogram to see how bad her heart was. After being on the meds, a follow-up echocardiogram showed that it actually got a little better for a while. I believe there are two types of murmurs. For her type her heart enlarged which I believe restricted her breathing and that is why she coughed. I am almost positive that she never did have fluid build up. My vet explained it to me and I believe that was the other type of murmur. 

I hope I have not confused you even more!!


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## MalteseJane (Nov 21, 2004)

Alex was 10 years old end of May. He is going to have tests done on Wednesday morning to find out what grade his heart murmur is and if it is time to put him on medication. For now, he does not have any symptoms. Vet said there is good medicine now to help with it.


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## MickeysMom (Jun 16, 2006)

A heart murmur is usually caused by a leaky or malfunctioning valve. This causes the blood in the heart to flow backwards after contraction because the valves fail to close. Blood and fluid can start to accumulate in and around the lungs, causing a cough. 

Enalapril is an ACE inhibitor, which basically causes the vessels to dilate, lowering blood pressure, which can improve heart function.

The lasix is prescribed to get rid of the fluid retained in the chest and lungs.

A diseased heart will most likely become enlarged.


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## jadey (Nov 2, 2006)

i hope she feels better :grouphug:


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## binniebee (Sep 27, 2007)

My last Malt, Casper, was diagnosed with a heart murmur pretty early on in his life, less than 6 years old, if I remember correctly. But he didn't show any symptoms until he was about 10+ (meaning coughing). His cough wasn't bad enough to put him on meds until he was about 12. Then he was put on one of the 'Anapril meds (have apparently wiped my memory clean of the exact name). When his coughing got worse he was put on Lasix and then later it was increased. Casper lived to be about 14 1/2 years old and only had about 1 week of feeling bad prior to passing. :smcry: 

Five days later I got Midis. :wub: 

BinnieBee


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## Maidto2Maltese (Oct 19, 2004)

My Missy had a low grade murmur for some time but when she had a sonogram for her bladder tumor the vet had the heart looked at at the same time as the murmur had become a bit more pronounced. the sonogram showed a bit of thickening of the heart wall so she was put on enalapril @ 1/2 a 2.5 mg tab 1 x day. She was 8 years old then.
She had many other health issues and when she was 10 she did go into congestive heart failure ( symptom was labored breathing) and we rushed her to the vet and she was given a shot of lasix and vet put some nitroglycerine on the inside of her earflap. X-Ray showed her heart was very enlarged and pressing on her airway. there was also the fluid around her heart area which the lasix helped to rid.
She said with any other of her patients she would have placed her in the 24 hour vet hospital but felt for Missy my treating her at home was a better option. ( She was also diabetic and bad disc problems in her back). 
I was given oral lasix and theophylline to open the airway. Lasix works very quickly after administration.
The vet was on call consults with me over the whole week-end guiding me as to how much to give.. She preferred to give the oral lasix in smaller doses but more often rather than 'purging' her with larger dose just 1 or 2 x day. It did do wonders for Missy and we got to where she mostly only needed the med 2 x day.


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## jmm (Nov 23, 2004)

A heart murmur can be caused by any variety of heart problems (degenerative valve disease, cardiomyopathy, heart-based tumors). Coughing can be due to fluid in the chest or even primary pulmonary disease. 

As to the ideal medications, you are guessing by treating with enalapril without an echocardiogram. A radiograph of the chest can tell whether there is fluid in it or not. If so, lasix usually helps. Kidney values should be monitored after before and after beginning enalapril and definitely need to be monitored with lasix use. 

The only way to tell really what is going on is to have an echocardiogram performed by a boarded cardiologist. Any vet school will have this service. There are also a great many in private practice. This would give you a more accurate idea of prognosis and treatments. 

If your dog seems distressed, is using her abdomen to breathe, or her tongue looks blue, she should see an emergency vet NOW.


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## angel's mom (Feb 14, 2007)

I really want to thank all of you who responded. I think I have a much better understanding now of the connection. She does seem to have quieted some, and I will call the vet in the morning. He didn't do any testing on her at all, just listened to her heart. I did watch her breathing for quite a while while before I posted and didn't feel a sense of urgency. I wonder if dogs swell like people if they are retaining fluid? I'll know more after speaking with the vet. Again, thank you all.


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## bigsmom (Sep 8, 2007)

> I really want to thank all of you who responded. I think I have a much better understanding now of the connection. She does seem to have quieted some, and I will call the vet in the morning. He didn't do any testing on her at all, just listened to her heart. I did watch her breathing for quite a while while before I posted and didn't feel a sense of urgency. I wonder if dogs swell like people if they are retaining fluid? I'll know more after speaking with the vet. Again, thank you all.[/B]



I am very sorry to hear about this but everything will be alright in the end :grouphug: we just recently found out our 12 yr old maltese back home has a heart murmur and she is on enalapril...so if you could post what you find out from your vet about fluid retention that would be so great. our Prissie's cough settled down quite a bit..but I did see a dramatic weight change (though her appetite has dramatically changed now that shes on meds)..........anywho...haha i just wanted to know what they tell ya because my parents and i have been wondering the same thing :blush: 

thanks a million .....wish the best for your fluff.:wub:


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## Gemma (Jan 19, 2006)

I'm sorry  it is hard to listen to them caughing. I hope the vet can give her something that works better :grouphug: :grouphug:


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## k/c mom (Oct 9, 2004)

> A heart murmur can be caused by any variety of heart problems (degenerative valve disease, cardiomyopathy, heart-based tumors). Coughing can be due to fluid in the chest or even primary pulmonary disease.
> 
> As to the ideal medications, you are guessing by treating with enalapril without an echocardiogram. A radiograph of the chest can tell whether there is fluid in it or not. If so, lasix usually helps. Kidney values should be monitored after before and after beginning enalapril and definitely need to be monitored with lasix use.
> 
> ...


Thanks for the info, Jackie. 

Lynn, in my town we have a traveling cardiologist who visits various vets and does echocardiograms. If there isn't a vet school near you, perhaps you would have this option. I don't know how far you are from Knoxville, but of course that would also be an option.


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## angel's mom (Feb 14, 2007)

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I think I've seen someone post about a vet school in Nashville? That's just a little over an hour away.


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## angel's mom (Feb 14, 2007)

> I am very sorry to hear about this but everything will be alright in the end :grouphug: we just recently found out our 12 yr old maltese back home has a heart murmur and she is on enalapril...so if you could post what you find out from your vet about fluid retention that would be so great. our Prissie's cough settled down quite a bit..but I did see a dramatic weight change (though her appetite has dramatically changed now that shes on meds)..........anywho...haha i just wanted to know what they tell ya because my parents and i have been wondering the same thing :blush:
> 
> thanks a million .....wish the best for your fluff.:wub:[/B]


Before her appt back in April, I thought Speckles was approaching the end of her life. She didn't play, hardly ate, just layed around all the time. When I took her to the vet, I asked him about her teeth because she seemed to be having problems eating the kibbles. He told me that her teeth were pretty infected and she needed a cleaning. Once he did that and put her on antibiotic and the heart med, she's been like a different animal! As you said, it was a drastic change.

Here's a picture of her and my hubby:
[attachment=27823:IMG_2780___web.jpg]


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## MalteseJane (Nov 21, 2004)

Lynne I am going in with Alex tomorrow. My vet can do all the tests at his clinic. They told me it will take an hour. I will let you know what they did. Since everything will be detailed on the bill I will know better and remember. Wish me luck that MY heart will not give up when seeing the bill :HistericalSmiley:


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## jmm (Nov 23, 2004)

I don't know exactly where in TN you are. The vet school is in Knoxville and that's the only place I for sure know there are cardiologists in the state (that's the only listing from acvim). 

I'm assuming being in the Nashville vicinity, you're the same as us: about 3 hours from Knoxville and 5 hours from Purdue in Indiana...
I'm not that familiar with the area so you should ask your vet if there is anyone closer.


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## momtoboo (Jan 30, 2006)

I don't really have anything helpful to add Lynne. I just wanted to say I'm sorry about Speckles heart problems. My son just found out today that his 7 yr old Pomeranian has an enlarged heart. He's been coughing & gagging for a while now & didn't have the energy he once had. He's been put on 2 different meds, lasix is one of them. I have no idea what the life expectancy is for an enlarged heart condition. I'll be saying prayers for Speckles & Taz. rayer: rayer: rayer: rayer:


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## msmagnolia (Sep 8, 2004)

Lynne, I am also sorry to hear of the problems that your pup is having. I will hope for the best possible outcome. Having an older girl, I can sympathize with the trials and tribulations of aging doggies......


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## angel's mom (Feb 14, 2007)

I just got back from the vet with Speckles. He listened to her chest really good and did a chest x-ray. He thinks the increased coughing is seasonal allergies and gave her Temerial - P, twice a day for 10 days. He said that should stop the coughing and he's hoping it won't come back. 

I asked what grade the murmur is; he said a 4. He said that had more to do with the sound rather than the severity. He said that a bacteria induce murmur (?) could only be causing a small sound, thus a lesser grade # but it would definitely be more severe than a louder one without the bacteria. 

I also asked about fluid retention and how it shows in a dog. He said that it would swell in the abdominal cavity.

So, we'll see how she does after she finishes this new medicine.


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## MickeysMom (Jun 16, 2006)

> I just got back from the vet with Speckles. He listened to her chest really good and did a chest x-ray. He thinks the increased coughing is seasonal allergies and gave her Temerial - P, twice a day for 10 days. He said that should stop the coughing and he's hoping it won't come back.
> 
> I asked what grade the murmur is; he said a 4. He said that had more to do with the sound rather than the severity. He said that a bacteria induce murmur (?) could only be causing a small sound, thus a lesser grade # but it would definitely be more severe than a louder one without the bacteria.
> 
> ...



I have learned that the abdominal swelling occurs later in heart failure, and the fluid first accumulates around the heart and lungs. There is both left sided and right sided heart failure. Left sided is almost always first, and right sided occurs secondary to left. Right sided heart failure shows signs such as swelling in the abdomen, subcutaneous edema, and enlarged liver and spleen. 

The fluid retention is a compensatory mechanism which causes more blood volume because the heart is putting out less. ACE inhibitors are used for 1. dilation of vessels, and 2. help prevent fluid retention. 

Was her heart enlarged on xray? The only way to know which areas of the heart are effected is to do an echocardiogram. The only thing an xray would show is the size of the heart, and if there is excess fluid. I am curious to know if the vet saw either.

I hope Speckles feels better soon, and the cough is not cardiac related.


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