# Grade III heart murmur - require medication



## ceelynn (Jan 25, 2013)

Hello there - 

I visited the vet with my 14 year old American Cocker Spaniel when there was a bit of blood in her stool about a month ago. She was diagnosed with colitis, treated and hasn't had any blood in stool since. However, the doc made a mention that her heart murmur (which she has had since about 5-6 years old) sounded a bit worse and suggested an ultrasound. She had the ultrasound two days ago, mitral valve disease/regurgitation was detected and she's been put on Vetmedin. The Vetmedin makes her heart beat VERY strong, which I understand is the desired effect, but as she does not have any fluid on her lungs, and is not coughing, is not lethargic (has no symptoms of the heart murmur) does she actually need medication at this point? 

Perhaps I should seek a second opinion? I'd really appreciate your thoughts. 

Carey


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## 912142 (Mar 28, 2011)

ceelynn said:


> Hello there -
> 
> I visited the vet with my 14 year old American Cocker Spaniel when there was a bit of blood in her stool about a month ago. She was diagnosed with colitis, treated and hasn't had any blood in stool since. However, the doc made a mention that her heart murmur (which she has had since about 5-6 years old) sounded a bit worse and suggested an ultrasound. She had the ultrasound two days ago, mitral valve disease/regurgitation was detected and she's been put on Vetmedin. The Vetmedin makes her heart beat VERY strong, which I understand is the desired effect, but as she does not have any fluid on her lungs, and is not coughing, is not lethargic (has no symptoms of the heart murmur) does she actually need medication at this point?
> 
> ...


I am sorry to hear about your girl - Vetmedin is talked about as the 'wonder drug' and increases the flow of the blood through the heart. Most owners notice a dramatic effect on their pet after even using it for a week!

My Dexter was diagnosed with a heart murmur and irregular heartbeat in November and like your girl showed no signs. The specialist said it is possible that because Dexter is otherwise a big healthy boy that we may not see signs. I'm not sure I truly believe that. However, the vet put him on Vetmedin at a cost of £150 per month all this appeared to do was to give him an upset stomach 5 days out of 7 and left him drained and pretty miserable. The vet then said he could give him something to conteract the upset stomach but I couldn't help but wonder if giving him another drug would eventually lead to another and my boy was looking and feeling very unhappy.

Dexter has a good life and enjoys being around people and going out and I didn't want him to feel as though he was an invalid in anyway, so after much thought I decided to stop the vetmedin and allow Dexter to continue living his life as normal and believe it or not Dexter is back to his happy playful self and long may it continue but whatever happens I will aways be there for him.

I guess you have to search your soul and do what you think is best for your girl.


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## rona (Aug 18, 2011)

Is there an option to reduce the dose?

You don't need a second opinion I don't think, your dog has a heart condition (fact) but your dog was showing no outward signs of the condition. It's really up to you to gather the facts and decide if you want to medicate or not.

Does this drug help the condition or just prevent the symptoms?


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## ceelynn (Jan 25, 2013)

Thank you for your replies. That's a very good point about the dosage - she is on 5mg (30lb dog) and there are lower doses available. I will enquire about this. 

As far as I can gather, the drug is intended to extend life by avoiding the blood from leaking to the lungs, but since she has had this heart murmur for such a long time and it has only progressed to a stage III in 7-8 years, I can't help but wonder if medicating her is necessary especially at her age. If she was a young dog with many years of life ahead of her, I probably wouldn't question it, but she'll be 15 in May and from my research it takes on average 3-5 years for mitral valve disease to progress to heart failure and if I'm very honest with myself, I know she is very unlikely to live 3-5 more years with or without a heart condition...


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## 912142 (Mar 28, 2011)

ceelynn said:


> Thank you for your replies. That's a very good point about the dosage - she is on 5mg (30lb dog) and there are lower doses available. I will enquire about this.
> 
> As far as I can gather, the drug is intended to extend life by avoiding the blood from leaking to the lungs, but since she has had this heart murmur for such a long time and it has only progressed to a stage III in 7-8 years, I can't help but wonder if medicating her is necessary especially at her age. If she was a young dog with many years of life ahead of her, I probably wouldn't question it, but she'll be 15 in May and from my research it takes on average 3-5 years for mitral valve disease to progress to heart failure and if I'm very honest with myself, I know she is very unlikely to live 3-5 more years with or without a heart condition...


You should have been given a report from the specialist that performed the ultrasound etc that should help you in your decision. Dexter was on 5mg and he is 75 kgs or thereabouts - his dosage was extremely low. When I discussed the issues with my vet 4 weeks on he advised me that Dexter had been put on medication as a trial.


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## ceelynn (Jan 25, 2013)

I've just found this on the US Vetmedin site. It looks like they don't even recommend use until clinical symptoms are present - and they're out to make money! VETMEDIN


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## 912142 (Mar 28, 2011)

ceelynn said:


> I've just found this on the US Vetmedin site. It looks like they don't even recommend use until clinical symptoms are present - and they're out to make money! VETMEDIN


Yes it's interesting and the difference between getting the drugs from the hospital and the vet turned out to be an additional £60 per month!


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## WeedySeaDragon (Oct 7, 2012)

Our eldest (now 14) has a heart murmur that he's had all his life.

It's been monitored and has steadily got worse over the years, it got to about a grade V before he started showing any clinical symptoms. In his case the only symptom he got was the coughing.

He wasn't medicated until the symptoms began and I understand that is the norm. Vetmedin is wonderful stuff if the dog is symptomatic, Arnie showed a dramatic difference within days. He's now in heart failure (he's been on medication for over a year) and is on a cocktail of Vetmedin, Frusemide and Fortekor, and is doing really well. 

Personally I think I'd be getting a second opinion as I'd find it quite surprising that a vet would be suggesting medication with a moderate murmur and no symptoms. It's always been stressed to us that regardless of the grade his murmur was at medication was unnecessary until he actually became symptomatic.


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