Anyone who has a dog with a heart murmur-need input!

[Sue and Kids]

Hello. I'm Sue and usually over at the Cat Board as my cats outnumber my dog 3 to 1.

Anyway, Sparky was diagnosed with a heart murmur about 6 months ago, and was given Enalapril. He was fine for awhile, but lately his appetite had tapered off and he was lethargic (certainly not himself - he fits his name!) My vet said some dogs couldn't handle that med - that it gave them stomach problems. So now she has prescribed 2 meds to take its place - Lotensin (5mg once a day) and Spironolactone (25mg twice a day).

I talked to a very knowledgeable friend and asked her if the diuretic is necessary all the time or was just a one-time dose. She told me that dogs on lotensin had to be on a diuretic.

My question is... Is it necessary for Sparky (a 25-lb. terrier) to take 50mg of diuretic a day? By coincidence, I also take the exact same diuretic and the exact same dose! I weigh considerably more than my dog. If any of you have a dog on these meds, do you use this high a dose for the diuretic?

I'm going to call the vet's office tomorrow, but I'd like any input I can get from anyone here...

Thanks a lot!

Sue and Kids
Nikki, Buster and Shadow kitties and Sparky doggy

[lmd]

I have a 2 1/2 year old 70 pound male(neutered) that has a grade 1 heart murmer. I give him no meds, and he is fine running the hills with the other dogs. He did a bit of dog sledding this winter. I think that the age of the dog and the type of heart murmer will define what amount of meds may be needed.

[k9Karen]

I don't know dosing, but the need for medication would depend on the severity of the murmur and it's exact cause. Most humans with mild murmurs aren't on any daily meds, but do need to take antibiotics before any dental procedure due to the elevated risk of heart infection (bacterial endocarditis) that can be caused by bacteria from the mouth that 'leaks' into the blood stream during the dental procedures.

If you aren't satisfied with your vet's treatment or his answer to this problem, it would probably be wise to get a second opinion, preferably from a specialist.

[Traci]

Does your vet suspect or, is attempting to prevent congestive heart failure or fluid accumulation? If so, the dose is only slightly higher than normally prescribed (for a 25 lb dog, total dose would be around 45 mg a day (divided into two doses). However, the grade of the heart murmur must be taken into account, and if your vet feels he may be predisposed to CHF. (the higher the grade, the higher the risk for heart disease)

Sparky's electrolytes and renal function should be tested regularly while on these meds....around every 3 months, and see about total heart workup if necessary (ECG, etc).

[Sue and Kids]

First of all, I tried to contact my vet, but she is out of town until Tuesday. I will call her then.

I’m sorry… I should have given more information on my original post. Life was pretty crazy from the end of April to the middle of May. I took Sparky in to see my vet on April 30th and again on May 12th. On May 2nd, I had an emergency stay in the hospital (bad staph infection in my left leg). So things were in an upheaval for awhile.

I’m well now and tonight I dug around in a big pile of medical paperwork (mine and Sparky’s) and I can now give the details about Spark.

On April 30th, we took Sparky into the vet. At that time she did an X-Ray, which showed that Sparky’s heart was slightly enlarged but Dr. Sharon said that it was not bad. She also ran a BUN test and a Creatinine Test. The results were: BUN: 35.6 and Creatinine: 1.10. She wrote on the sheet “Grade III-IV/II systolic murmur. Lungs clear.” She also wrote in all capital letters and underlined: PLAN – STOP ENACARD. Down below she had written: “ Start Lotensin - .5mg once daily, Spironolactone - .25mg twice daily.” The last thing she wrote was “Rev BUN in 10-14 days”.

We took Sparky in again on May 15th . He again had the BUN and Creatinine tests done. The test results this time were: BUN: 19.7mg/dl and Creatinine: 0.642mg/dl. She noted his heart rate this time, and it was at 120. Below that she wrote “Grade IV/VI systolic”. She then just noted again the medications he is taking.

I don’t suppose this will mean anything to anyone but Traci, so I hope you do read this.

Thank you for any information you can give me.

Sue and kids
Nikki, Buster, and Shadow the kitties and Sparky the doggie

[Traci]

I don't want to alarm you, but I would ask her if she would do an ECG on Sparky. While the xray may not have looked significant at this point, an ECG might be helpful. Does Dr Sharon have a consulting small animal cardiologist you can get referred to, or that makes rounds to her clinic?

There was quite a leap in the grade in about 2 week's time...an ECG might be more helpful here. Both grades reported are high (IV-VI is in a risky range) but this doesn't always mean that heart failure will occur, it depends on other factors: general health status, any secondary health issues, left-sided vs right-sided enlargement etc and progression if any. The current meds may actually help, but I think I would prefer to get an opinion from the cardiologist if possible.

[Sue and Kids]

I appreciate the information, Traci. I will call Dr. Sharon on Tuesday, but I know there are no cardiologists that come up here to the "sticks". The only thing I've heard is that people with good financial funds go to Fort Collins Veterinary College in Colorado. I'm afraid that, after all my medical bills from my hospital stay, we are not in good financial shape.

I looked up what information I could understand on the Internet. I did find one article, describing the meaning of the different stage numbers of systolic murmurs. It sounds like Sparky's outlook is very bleak.

Is there anything that can be done for Sparky, besides the meds, that will prolong his normal life as long as possible? Any special diet, etc.?

I am just heartbroken. That little dog has given us so much happiness!

I just can't think of life without him.

Sue and kids
Nikki, Buster, Shadow kitties and Sparky doggy

[Traci]

You have to talk to your vet in more detail, she's the only one who has examined him, and viewed xrays, prescribed the meds, etc. Ask her what her suspicions are, ask her who she consults for heart patients. Ask her what other testing may be necessary in order to keep the condition under control. (i.e., the ECG)

[Sue and Kids]

To anyone who's interested, I talked to my vet yesterday.

She asked me how Sparky was doing with his present medications or if he had taken a "turn for the worse". I told her he seemed to be feeling and doing quite well, but I was concerned about what I thought was a very large dose of spironolactone (the diuretic). Dr. Sharon was good enough to explain to me that people and animals do not metabolize medication the same. So the amount of medication was figured by her based on his general health and the murmur. She told me that dogs (and cats) can live a number of years with a heart murmur if they get the proper medicine.

She told me the best thing now would be for us to keep an eye on Sparky. If he starts to act differently or unwell, we should bring him back. She would then do a new X-Ray. Dr. Sharon could also do an ECG. What she would do would be to hook Sparky up to the machine, and record his "T waves". Dr. Sharon then faxes all the test material to a cardiovascular specialist vet at the University of Florida, who then faxes back his/her assessment of the test and recommendations for any medication changes.

So, now that I understand the medicine, John and I will just keep a watch on Sparky. He is as energetic as a dog can be when it's hot! Otherwise, he is eating and appears to feel good. Hopefully, this will continue. If not, I'll take Spark back for the X-Ray and ECG.

I am glad to gain some more knowledge about all this.

Sue and Kids
Nikki, Buster, Shadow the kitties and Sparky the dog