pup has heart murmur

[fostermom]

We finally picked up my son's puppy from the breeder. At Riley's first vet check-up (the next day) the vet heard a heart murmur. The pup is 8 weeks old. I purchased a pup from this breeder as she could produce multi-generational health clearances including SAS. She also claimed to study the health issues that frequented certain lines and only breed to lines that didn't carry consistent health issues (like cancer). So how concerned should we be and should we notify the breeder?? Is this something common in puppies and if so, do they normally outgrow it? Returning the pup is not an option...my son and his wife are in love with her.

[Ayoka]

I have no personal experience but looked up the page on aortic stenosis on the regional Vet College website may be helpful

I think the breeder would/should be concerned.

[Dimitri]

my boy has a murmur as well, now the so called white trash backyard breeder offered to give me another pup or dog, but how do you let your pooch go back? i love my dog even with all his little hickups hasn't differed my resolve to give him a loving, safe, healthy, and happy home.

[BostonRott]

Yes, you need to let the breeder know.

It could be an innocent flow murmur or it could be something more. The only way to determine this is to take the puppy to a board certified cardiologist and spend $200-300 to do the Doppler scan.

[rottcrazed]

Well, as far as I have been told, even by the vet who was doing my puppy checks last year, is that some murmurs do go away in young puppies, often within the first few months. You will need to take your puppy to a cardiologist to be able to correctly grade the murmur, from there you can move onto what to do.

BUT, I would at a minimum, notify the breeder as to your vet's findings. Did the puppy get a vet check before leaving the breeder?

Kristi

[Bucky's Mom]

Originally Posted by fostermom

Returning the pup is not an option...my son and his wife are in love with her.

While I understand this comment - (blunt reply please forgive me) - it makes no sense. You go to the trouble to find a breeder with health checks and guarantees then when a (potential) life threatening condition is diagnosed the day AFTER they are brought home - people say they already love the puppy too much to return it.

How much more will they love it when it drops dead in a year?

I would definitely let the breeder know and see if this problem has presented itself in any of the other puppies in this litter.

Problems can show up in ANY litter - no matter how careful the breeding - so I mean this as no criticism of this breeder. But I wouldn't want to keep a puppy if the murmer was severe.

[fostermom]

She had a health certificate dated shortly after birth but the breeder said that was incorrect as they had also been checked at six weeks when they got their first shots. (Her area was one of the hardest hit with the recent floods so she might have been unable to obtain the more current records...all the interstates to her house and many areas still had no travel warnings.) Would a cardiologist be able to tell definitively at this age or is it better to wait till the pup is a bit older?

[Bucky's Mom]

I found this article:

Subaortic Stenosis
by Anita R. Weidinger, D.V.M.

Subaortic stenosis (SAS) is a genetic and congenital heart condition of dogs, meaning that it is present at birth and it can be inherited. Several breeds can be affected including the Golden Retriever. The condition is usually detected during puppy vaccine visits to the veterinarian by hearing a heart murmur during physical examination. A heart murmur is the abnormal sound of blood rushing through one of the heart valves. Instead of just the heart beat, a whistle of blood flow through a narrowed opening is heard. The puppy will most likely appear normal in all other respects. There is a possibility that the murmur may come and go, or it may develop slowly; therefore, it is important to check a puppy's heart condition often during the first few months of age. This is a very frustrating condition to be identified in your pet because the future is bleak and the chance for long term survival is low. These dogs will either go into heart failure or they will die suddenly, essentially from a severe heart attack.

A little review of normal heart function and circulation is in order to understand what SAS is and why it is so devastating. As you may remember from high school science, the heart has four chambers; the right atrium, the right ventricle, the left atrium, and the left ventricle. You can picture these as four circles together with two on the top and two on the bottom. The atria make up the top of the heart and receive blood from veins and the ventricles make up the bottom of the heart and pump blood into the arteries. Blood from most of the body is returned to the right atrium by veins, it passes down into the right ventricle, and is then pumped to the lungs where it receives oxygen. The veins of the lungs return blood to the left atrium and it passes into the left ventricle. There are valves or gates at each of these junctions throughout the heart and the aortic valve is between the left ventricle and the aorta, which is the main artery exiting the heart carrying oxygenated blood to the body. Subaortic stenosis is a narrowing of the left ventricular chamber just below the aortic valve. This creates problems for the heart because instead of just having a gate to open and close when blood is pumped out, there is a narrow canal almost like a funnel below the valve that makes the heart work harder to push the blood out of the left ventricle and into the aorta. When the heart has to work harder, the heart muscle responds by thickening. As the muscle wall thickens the chamber size can shrink in comparison decreasing the amount of blood that the left ventricle can handle. The thickened heart muscle also demands more oxygen to work. The blood vessels that supply the heart muscle with oxygen, the coronary arteries, are squeezed out by the thickness of the muscle and can't carry enough blood to the heart muscle. This can lead to muscle tissue of the heart dying as in a heart attack. The area of the left ventricle that is narrowed below the aortic valve also can develop scar tissue due to the force of blood through this area. The scar tissue narrows the canal more and decreases the flexibility of this area.

As mentioned before, the two potential outcomes of SAS are heart failure and sudden death. Changes take place in the heart because of the narrowed aortic canal. The heart works harder, the wall of the heart muscle thickens, the chamber size decreases, and the amount of blood the ventricle can handle decreases. Heart failure often occurs when the heart can not get enough blood in and out to keep up with demand. Blood backs up behind the left side of the heart in the lungs and causes congestion. The dog shows this congestion by coughing, weakness, tiring easily, and possibly fainting. Sudden death is just what it sounds like, the dog will die without giving us any clue that something is wrong. What probably happens to cause this sudden death is that a blood clot severely disrupts circulation to the heart muscle and it dies or the heart rhythm is changed dramatically and suddenly so the heart doesn't function and just stops.

What can you do if your puppy is diagnosed with a heart murmur consistent with SAS? First of all, contact your breeder if you can to let them know. They will not want to use this same set of parents to breed again. The puppies and dogs affected with SAS can be evaluated and classified as mild, moderate, or severe. Tests such as chest X-rays, echocardiography, and electro-cardiography can be performed to evaluate the severity of the situation. Unfortunately, not much can be done to treat the condition. A balloon catheter can be used in an attempt to dilate the narrowed aortic canal but the canal soon narrows again. If your dog with SAS develops heart failure, medications can be prescribed to alleviate the clinical signs it is experiencing. You can not prepare yourself for the sudden death of your pet. Even if you know that it is a possibility with SAS, it is still a shock when it occurs.

[Rhea's Mom]

This hit close to home for me (was in a similar situation when I got Rhea)... The vet heard a very faint (on his "10 point scale" with 5 being "moderate" he put it at just about "1") murmur at 9 weeks when we brought Rhea home. The vet said that it is faint enough not to have a major worry as it happens quite often throughout the growth stage. Since then Rhea's been seeng the same vet every month (now she's 5 months) and the murmur has gone down, if not almost disappeared. The vet can't even hear it when Rhea settles down and says it's barely (like a 0.5 on his "scale") noticeable even when she's excited and jumping around (Rhea loves our vet clinic)

1. I called the breeder from the vet's office when we found out - I suggest that you let your breeder know, especially since you say she's being diligent about screening her bloodlines for illnesses and such

2. I wouldn't jump the gun and get a replacement if the murmur is faint. I would monitor it and get a cardio at 6 months, a year, 2 and every couple of years after if the vet recommends it (this is what we'll be doing for Rhea).

3. By the same token (and I'm sorry if it sounds cold) - it's only been 1 day that the puppy's been in your son's home... I know that they love him/her, but there really hasn't been any true bonding... So, if potential health issues (and the potential is always there anyway) is not something your son wants to / can deal with, I'd give up the puppy right now so there is a better chance to rehome her.

Best of luck. I hope you get to enjoy that puppy breath for a while!

[BostonRott]

A health check performed shortly after birth will tell you nothing other than if the puppy has an open anus and a closed upper palate. They should have been checked right before they left. I understand they had flooding, but still, YOUR puppy should have been individually checked before it left, if she couldn't get the litter in as a whole.

I believe innocent flow murmurs are supposed to disappear by age 12 weeks. I would wait until that time and then have the puppy re-checked by your vet and then consider the cardiologist consult.

[hcelsa]

There ARE non-SAS murmurs as well, so just having a murmur is not a guarantee that your puppy has something fatal. You really must notify the breeder (even if it turns out to be something harmless she should want to know for future decisions), any breeder worth their salt will want to know right away if anything unexpected comes up. She can also tell you if she's experienced puppy murmurs in the past and should be able to give you advice on where (and when) to go for a cardiologist opinion.

One of my B-pups has what the cardiologist calls a "musical" murmur. She was echo'ed after she turned a year old, and has an passing OFA number and it is not SAS or other heart defect related (can't remember the actual "note", but I think it might be G?). It's there, and different than the average heart sounds, but will not affect her life-span or ability to work in any way :).

[Anton]

Originally Posted by hcelsa

There ARE non-SAS murmurs as well, so just having a murmur is not a guarantee that your puppy has something fatal. You really must notify the breeder (even if it turns out to be something harmless she should want to know for future decisions), any breeder worth their salt will want to know right away if anything unexpected comes up. She can also tell you if she's experienced puppy murmurs in the past and should be able to give you advice on where (and when) to go for a cardiologist opinion.

One of my B-pups has what the cardiologist calls a "musical" murmur. She was echo'ed after she turned a year old, and has an passing OFA number and it is not SAS or other heart defect related (can't remember the actual "note", but I think it might be G?). It's there, and different than the average heart sounds, but will not affect her life-span or ability to work in any way :).

You're absolutely right Becky. One of my dogs was diagnosed with a heart murmur at a young age (his murmur was about a 4). We had him seen by a cardiologist, who did an echo on him, and gave him a CLEAR for SAS, and he got his OFA cardiac number.

This dog grew to be a big, powerful dog (about 125 lbs), and just turned 11 yrs old in April and is still doing great.

Now that he's older, we have him checked yearly to see if there are any issues, and if any medication is needed. So far my vet has said he's good to go.

None of the other puppies in his litter were diagnosed with any heart issues, and neither were the half siblings that came along afterwards.

[moondog]

Yep....my Luna had a murmur at 8 weeks that also cleared up. She never had a problem with her heart for her entire life, just shy of 10 years. At the time the vet detected it, he advised to wait and see if it resolved in the next few weeks, before taking any potential ramifications any further. I waited, and it did resolve, never to cause her a moment of grief.

Those murmurs are not all created equal, and not all of them are a death sentence.

[fostermom]

Thanks for all the replys. Whether the pup goes back to the breeder is my son's decision and he's already said Riley is staying with them. I do know that with past dogs (and cats), from time to time, a vet would comment on hearing a murmur although subsequent vets wouldn't hear anything and recently my then one year old rotti was at Cornell for uveitis when the vet "found" a heart murmur which she felt was significant and needed to be checked....$600 later the cardiologist there told me it was nothing to be concerned about so I guess we'll have to see if this turn out to be pathologic or not. My son did say he would let the breeder know.
I'll pass all info along to my son so he will be aware of what needs to be monitored and possible outcomes. Thanks again.

[BostonRott]

I will tell you this. I do not trust practitioners to hear or accurately grade murmurs. I've had regular vets hear the dog's breathing sounds and call it a Grade III/VI murmur. I've had regular vets miss murmurs.

Hopefully it's just an innocent flow murmur, but if you want a REAL answer, you NEED to see a cardiologist (and I know they're not cheap.....Doppler at Tufts will run you $350. That's why I'm driving 3hrs to southern CT to get Xcel's heart clearance done for $175).