[BLOG] Heart murmurs in puppies : what to think ?

I’ve been doing a lot of reading lately, this is kind of my routine now while preparing a webinar series ! While doing so, I fell upon an interesting 2016 article on cardiac disorders in veterinary pediatrics. To tell you the truth, I usually don’t read thoroughly cardiology papers. I fully understand the importance of this discipline but since I was student, this has never really been my thing. This time however, I took my courage in both hands and read it. Because of its title : heart murmurs in puppies.

 

« The veterinarian heard a heart murmur on my puppy : how big a problem is it ? » is one of the most common question I get. I can tell, it was definitely worth the read ! Here is a quick summary of the 11 points I think are worth sharing with our online dog breeder community !   

 

#1 Puppy heart murmurs are in fact often found in veterinary medicine, typically detected during routine primary vaccination appointments. However, it is important to know they vary greatly in their significance. 

 

#2 Some are cause by congenital cardiac malformations… and the list is pretty long, with complicated terms such as « pulmonic stenosis », « mitral valve dysplasia », « aortic stenosis », « patent ductus arteriosus », « Tetralogy of Fallot », ...

 

#3 Most common congenital heart disease is pulmonic stenosis. It accounts for 32% of all congenital cardiac heart problems.

 

#4 There is great variation when it comes to the severity of those cardiac diseases. Hard to give a clear prognosis just based on hearing the heart murmur. 

 

#5 My point is, hearing the heart murmur does not tell you what disease you might be dealing with. Even if the localisation of the murmur can help the veterinarian narrow down some potential causes, the paper put an emphasis on the importance of reaching a diagnosis of certitude in those cases.   

 

#6 I’ll quote the paper here : « Referral to a cardiologist is warranted with any cardiac murmur to allow for accurate diagnosis using echocardiography. » 

 

#7 This is definitely of utmost importance : indeed, early identification and management of many congenital cardiac abnormalities result in a better long-term outcome for the pediatric patient.

 

#8 Something also important to point out : a large proportion of puppies can present with an « innocent murmur ».

 

#9 «  Innocent murmurs »  are typically said to be low grade ( they are usually said to be below 3/6 when using the 6 point scale veterinarian refer to when grading those murmurs) .

 

#10 They are not related to structural heart diseases, and are thought to occur due to changes in blood viscosity.

 

#11 Essential : these murmurs should disappear over time, usually by approximately 20 weeks of age. 

 

Hope this will help you guys ! Don’t hesitate to share any experience you might have on this topic, that would be great ! 

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Comment by Bellbrooke Labradors on June 3, 2016 at 6:53pm

over 40+ years of breeding and raising pups , finding a   'heart murmur' at the vet exam for the puppy prior to it being placed is the one thing I absolutely hate.  In my personal experience not one case has ever been found to continue past the 'innocent' stage ,, and is usually not heard in the next exam.  But, what this does for the placement of the pup is in most cases either delays the pup leaving or causes the pup to be 'passed' over by the original placement.  From my experience I have been extremely fortunate that the murmurs found have all been 'innocent' and disappear, but, even knowing that it makes it so difficult to try to explain that 'hopeful' result to any prospective puppy owner.

Would I opt to take a pup with a murmer? or pass it over in preference to another without?  Guilty, I would opt to pass on the murmur too.  Or at the least, wait until a subsequent follow up exam that was clear.  So there you have it.

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