Grade 4 heart murmur.

Dr. Marie replied:

Sorry to hear that your dog has been diagnosed with a heart murmur. There are many heart murmurs that I don't worry at all about. For example, if I see a puppy with a grade 1 or 2 heart murmur it is almost always nothing to worry about.

We tend to grade heart murmurs on a scale of 1-4, so this means that a grade 4 murmur is the most serious grade.

A grade 4 heart murmur is almost always something to be concerned about. The problem is that getting an accurate diagnosis of the actual cause of the murmur can be difficult. An xray can tell you whether there is heart enlargement and should be able to give you an idea as to whether there are serious issues like fluid around the heart or significant heart enlargement. It can help your vet to know what types of medications would be best to use to treat your dog.

In order to have a better idea as to what is going on, a heart ultrasound can often tell us more. However, an ultrasound is much more expensive than an xray and usually requires a visit to a specialist.

We don't really treat a heart murmur. But we do treat a dog for heart problems when there are significant clinical signs. The most common of these is coughing. If there is just the occasional cough then your vet likely would not start him on medication just yet but would have you monitor his symptoms.

One other thought that I have is to ask your vet whether heartworm is a possibility. If you live in an area that has a lot of heartworm then it is a good idea to have him tested. Treating for heartworm is a lot easier the sooner you get a diagnosis.

Hope things work out ok!

Dr. Marie.

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