Heart murmur diagnosis and symptoms

[sanford]

I'll try to make this as brief as possible, so if I leave out any details, please bear with me. 

Last week, an echocardiogram revealed that Ruffy's mitral valve regurgitation has increased in the left atrium which is enlarged. The vet did not advise medication at this time. (Until we speak again, I am assuming it is stage I or II because medication is usually not prescribed until stage III or IV). The vet advised that Ruffy have a radiograph x-ray in 9-12 months to get a baseline reading and to see what the heart looks like. She said to bring him right in if he is "lethargic" or starts coughing.

Only after we hung up and I started to process the info, did I realize that In the past number of months I noticed a change in Ruffy's behavior that I even reported here, on this forum: 1) He has become somewhat indifferent to pursuing squirrels with the same interest and mania as in the past. 2) He also became indifferent to chasing the ball, and to playing with other dogs in the run. For 2 hours or more at the run, he used to be active and now he spends the entire time just sitting/lying under the bench. I attributed his change of behavior to possibly be a sign of maturity; he was approaching 9 years old. But still, I was somewhat puzzled and even a bit uneasy at the change.

We will be seeing the vet again on Jan 2nd when I'll be able to address this with her. Until then I'm puzzled with the terminology. My question is: How does one differentiate between "lethargy", (the word the vet used), and "indifference", (the word I would use) to describe Ruffy's change in behavior? Although I wouldn't describe Ruffy's behavior as lethargic, am I missing something here?

  Our Jan 2nd appointment is coming up soon, so at least I won't have to wait long for following up. But until then, I would appreciate a response from any members whose cairns have experienced a heart murmur. I have no context for evaluating the change in Ruffy's behavior, or if it's related to his diagnosis, so anything one can offer would be helpful and very much appreciated!

P.S. He has not been coughing at all.

[LindaMC]

I'm so sorry to hear that Ruffy is not feeling well.  I don't know anything about heart murmurs or mitral valve regurgitation.   I have always thought that lethargy means tired, weak, lack of enthusiasm.  Indifference, which I've always thought to mean a lack of interest.  I guess they are pretty close in meaning, however; II would be more concerned if Ruffy was lethargic.  I wish I had something more to offer you, however, I can offer you a huge hug and hope and pray that Ruffy bounces back to his old self soon and that your appointment of Jan. 2nd turns out to have a better news for you.

 

Edited December 18, 2016 by LindaMC

[Hillscreek]

Goodness me Sanford. What Ruffy has is what I have - exactly the same. Quite common in old humans I understand. I do not need medication at this time either. However whether the reasons Ruffy's behavior has changed are the same as mine of course I cannot say. But for what it's worth I am not as active as I was. I get tired more easily. I have to take more rests on our walks. I walk slowly, and am very glad I can go where Angus can be off leash. Only treatment I receive is doc listening to my heart when I go which is rarely. I have not had an x-ray.

I don't know as I would use the word lethargic. To me that means sort of lazy, apathetic, indifferent. I don't feel that way - tired yes but not indifferent. In cairn terms I might say I want to chase the squirrel but it is just too hard. I my human terms I might say I want to stride out faster like I used but It is just too difficult to do that now. Heart can't work that hard any more.

It has been difficult for me to accept this but your body forces you. And perhaps Ruffy's body is suggesting to him that he slow down and take things easy.

Good luck to both of you

[Account Deleted]

I too do not have any experience with any of my pets having MR, but have a ton of experience with humans who have MR from vegetation...I would agree with LindaMC...from a human med point of view lethargy would be more of a concern than lack of  interest.  I would think Ruffy could be a risk for Congestive heart failure, as his little heart may not be pulling out as much blood with each heart beat causing him to be more tired...he may even pant a little morethsn usual. 

I am encouraged the vet did not feel he was serious enough for Medications....He or she must not have heard any congestion (fluid)  in his lungs.  I would ask the Vet about exercise and diet advice...Sodium, protein intake...to maintain heart and kidney health.  A sort of cardiac rehab to help return him to an energetic bundle of joy

Edited December 19, 2016 by moggie

[Sam I Am]

Sanford,  was this just a regular check up when they discovered an issue with  Ruffys heart? Was there any blood work done beyond the echocardiogram? Liver, kidney values ok? 

My mare a few years ago was diagnosed with a heart mummer, and of course  I was concerned,  but interestingly enough, next time a check up was done and we have had several of them since, there was no sign of a mummer.   So for sure a baseline is so important.

I agree that lethargy vs lack of interest does not make sense to me.  Dogs, especially terriers are so hard wired to play etc, even when ill. Even my little Jock who had cancer, played with Rosie. They are so darn stoic. If the mummer is  at stage I, why the lack of interest? I think I would want more testing done. 

[hheldorfer]

I'm sorry to hear of Ruffy's heart issues.  Also sorry that I have no experience-based advice to offer.  

In dog terms, I would define "lethargic" as appearing to be terribly tired; for example, not wanting to go on walks, losing interest in food, etc..  I understand what you mean by "indifferent" - at least I think I do.  A dog that doesn't seem to have the strength to lift his head up when you return home or suddenly shows no interest in going for walks - that's "lethargic";  A dog that ignores your request to play fetch and instead walks away to find his half-eaten rawhide chew - that's "indifferent".  At least that's my take on it.

I'll be waiting to hear what the vet says on the 2nd.  Keeping fingers, toes and paws crossed for good news.

  

[pkcrossley]

that probably seems like scary news to hear, but I wonder if it is best to consider it part of the normal aging process (of course it is always better to age without any heart issues, but it is more common to have them). strangely I don't recall any of my dogs being diagnosed with it, but I have experience with humans, horses and cats. "lethargy" said by vets usually means sleeping more than usual. being awake but being unwilling to play or eat is "depression." I'm sure the vet explained that the murmur and the heart enlargement are related --with the inefficient valve, the heart works harder, which causes it to enlarge, which unfortunately makes it more inefficient, and so on and so forth. as you say, stage 1 and 2 are essentially benign --horses at that stage can be given whole-body anesthesia for major operations. but time to intervene and slow progression as much as possible. your vet doesn't sound very excited about it; waiting 9 to 12 months to get a baseline is pretty casual. I bet when the specialist puts it all in perspective you will feel somewhat reassured. they can suggest a few things. one thing to remember is that the body (all bodies, any species) can adjust to things like lower heart and kidney function, and over time dogs (people/horses/cats) can often go back to their normal activities, after some conditioning (and often some weight loss). hope the vet can give you useful information on jan 2 and suggest a program for getting ruffy to feel good again. not sure he will feel as good as he looks, but who could?

Edited December 19, 2016 by pkcrossley

[sanford]

I deeply appreciate the responses and the reassurance offered has helped lower my concerns. 

I'll  definitely post a report here after I see the vet. She's very conscientious and I'm now starting to understand that she would have conveyed more seriousness if she felt it was warranted. I guess my concern was in not being able to evaluate the change in  Ruffy's behavior as a natural result of aging or symptomatic of disease, but I'll take this up with the vet.

Again, many thanks to all.

[_whits_]

I don't have any experience with this issue, in pets or humans. I'm sorry that you and Ruffy have to deal with this. Hopefully your vet's limited concern mean it's more something to keep an eye on than something that will impact his day-to-day life. I sure am glad you're getting in to see a specialist; sometimes the not knowing is the worst part. 

Please keep us updated as you can and send Ruffy cuddles from Addie and I. 

PS I understand lethargy to mean a lack of energy. Mild lethargy would look like a dog being more tired than usual, sleeping for longer. On the other end of the spectrum, lethargy would constitute an emergency if a dog had so little energy it couldn't get up to eat or drink or potty. 

[Malcolm's Dad]

Sorry you have something to worry about. I can't help with this like others I have no experience with it. Hope it is not something too serious.

[remltr]

Hi Sanford. I can only relate an experience with a previous dog that was with me for 13 years and was probably 16+ when she passed. She was a 50 lb mix. Her name was Ginger.

Took Ginger in for her annual check up when she was around six years old. The vet mentioned that he heard a heart murmur and suggested we keep an eye on it. Not something to get to worried about at the moment. On the next annual visit he didn't say anything about the murmur, so I asked if he heard the murmur. He said he didn't. And it was never heard again the rest of her life. Very anti-climatic, just the way I like it.

I can only hope that Ruffy has the same experience.

[sanford]

Here is the update I said I would post, once I got all the final test results from the vet re Ruffy's cardiogram, dental procedure, heart murmur, etc.

Happy to report good news. Ruffy needed no extractions, so at least the already -expensive teeth cleaning didn't end up costing even more $$$. Cardiologist report identified heart murmur as Stage 1 (normal) and Stage 2 (minimal), which was a great relief.

Due to other health concerns which I've written about here in the past, we ran blood tests to monitor Ruffy's pancreatic readings which had been alarmingly high in the past. (Double the normal range)! Thankfully, these counts have decreased over time to well into the normal range where they have remained for the past year now. Ditto for urinalysis: the gravel that consistently appeared in the past, is now gone. Whew!

I addressed the pancreatic issues and the urinary gravel by modifying Ruffy's diet and administering some alternative remedies from a local wholistic pet supply. I must admit to a healthy skepticism re these remedies, but I tried them anyway and stuck with the regimen for several years now. My purpose here is not to brag, but simply to offer this as information to anyone who might be dealing with these issues. (I would be happy to pass the information along in a PM to anyone who might need it, unless Brad would not approve or allow it).

Over the past months, there has been some sad news here, re the health of some of our pups, so I thought it would be good to share this positive outcome with you all.

Thanks to all  for your support and expressions of concern for Ruffy!?

 

 

[pkcrossley]

you're right it is always a delight to hear good news. way to go, both of you. doing it all right. 

[hheldorfer]

Excellent news!  I'm relieved to know that Ruffy is A-OK.  Hope you can relax now with that worry off your mind.

[Lynn in TN]

Great news. I am so glad to hear such happy news.

[_whits_]

Oh what wonderful news. Thank you for passing it on! Send Ruffy some congratulatory cuddles from us!

[Hillscreek]

Excellent news! Thanks for the detailed info.  Go get 'em Ruffy!

[LindaMC]

Wonderful news, keep up the good work!

[Kathryn]

So good to hear! 

[bradl]

Really appreciate the update.  

Quote

(I would be happy to pass the information along in a PM to anyone who might need it, unless Brad would not approve or allow it

Sharing resources and tools and other stuff we come across in our life with Cairns is fine. Resources posted in good faith by actual, contributing members of the community are seldom an issue. 

The main things I am vigilant against are spamming, self-dealing, and SEO weasels.

[gd4]

So happy to hear your positive news! I hope for continued good news from Ruffy!