Heart murmur.

Dr. Marie replied:

Gosh, Max keeps finding ways to make us worry.

I have had several cases (mostly Golden Retriever for some reason) where I could not hear a heart murmur, but I could hear one when the dog was sedated. There are a few possible reasons for this. It's possible that the sedation causes a mild decrease in blood pressure that changes the dynamics of how the blood flows through the heart and makes a murmur more likely. It's also possible that the sedation caused the heart rate to decrease and some murmurs may be more evident at a slower heart rate.

There are some dogs that can have murmurs that come and go. I may only hear them every third or fourth exam.

We grade murmurs on a scale of 1-6. Usually a grade 2 murmur in a young dog is nothing to worry about.

The only way to know for sure what is causing the murmur and how much of a concern it is would be to have an ultrasound done of his heart. This usually has to be done by a specialist as heart ultrasounds are a little bit more technically challenging that an abdominal ultrasound.

I have LOTS of patients in my practice that have a low grade murmur like this and never ever have any problems with their heart. This will likely be the case for Max.

It's very unlikely to cause problems with any future sedation or anesthesia.

I would be surprised if it got worse. However, if this were my patient I would likely be requesting an exam every six months to listen to see if the murmur is getting louder. If it was getting louder, or if he was developing signs of heart disease such as coughing or fainting then I would definitely want to do a heart ultrasound.

To summarize, I'm not too concerned about the murmur.

Hope you get some answers on the vomiting soon though.

Dr. Marie.



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Dr. Marie replied:

It might. If a dog is excited then there are changes in blood pressure and heart rate and this can possibly cause a murmur that was previously undetectable to become noticeable.

Dr. Marie replied:

This is good news!

Dr. Marie replied:

Hmmm...frustrating. It really shouldn't be a food issue as medical gastro should not cause a dog to vomit.

An ulcer should cause tiny black flecks (looking like coffee grounds) in the vomit.

An obstruction probably should have shown up on the xrays. Did the vets do a barium series of xrays? If not, this may be the next step.

You may want to ask your vet about the possibility of a condition called helicobacter. This is a type of bacteria that can affect the stomach and cause intermittent vomiting. It can be hard to diagnose. Sometimes, if I suspect this I will do a trial treatment. It is usually a combination of metronidazole, famotidine and a penicillin type antibiotic at the same time (sometimes there are other medicines thrown into the mix.)

Dr. Marie replied:

The xrays are likely the next best step then. But, ultimately your vets have more information than I do and they will be the best ones to advise you on this.