Grade 6 heart murmur any thoughts?

[CathedralSpire]

i don’t really know why I’m posting but I suppose I wondered if anyone else has been here with their dog.

Cavalier, age 10, had a heart murmur diagnosed 5 years ago and it’s now at grade 6. Also recently a lot of stomach problems despite very careful management of her diet, and some vomiting.

Vet wants to do a heart scan. She had one last year. We know she has a bad heart, we know it’s worse. I’m not sure whether there is any point in doing this? What will it prove?

She is terrified of the vets, she hates taking tablets. She reacts very badly to general anaesthetics and the aftermath of this is awful for her and us. We are not going to put her through any surgery.

Any thoughts on where we go from here? Do we keep putting medicine into her or do we let her fade away and end things if we see she is starting to be in pain? She is not herself at the moment but she’s not on her last legs yet either. I wish they could tell us how much discomfort they are in

[CathedralSpire]

bump

[BiteyShark]

I think you need to have a very frank chat with your vet alone the lines of what would change if you went ahead with the scan.

Totally understand your reasoning for no surgery/anaesthetic so for me it would be a case of letting my vet know my thoughts and asking how not having a scan would alter things medically or not.

[villainousbroodmare]

Is she coughing? Lacking energy? Is her belly enlarged? What meds is she on?

[CathedralSpire]

Thank you for replying. I think she looks a bit bloated but the vet didn’t comment at the time (he wasn’t our usual one and he didn’t seem very engaged). She occasionally has faster breathing but not even all or much of the time. She coughs occasionally, I know that’s her heart. That’s a bit worse, it happens when she’s lying down now - again, occasionally. She’s not keen on a walk but she still has mad zoomies about once a week. She’s on Vetmedin for her heart and Gabapentin for her head. Both twice a day. One has to be taken on an empty stomach and the other with food.

[Hovverry]

Mitral valve disease is the curse of cavaliers and I believe the average life expectancy is only nine.
There’s no point in veterinary intervention which distresses your poor little dog. Kinder to just manage her symptoms and keep her happy for the time she has left.

[villainousbroodmare]

I'm speaking as a vet. A heart scan is reasonably swift and not invasive. There are potentially a couple of other meds that she could be on which might benefit her quality of life. The one thing that you can't really do is to let her "fade away" and wait until you think she is in pain before you act. Dying of congestive heart failure is akin to drowning - very distressing while not actually painful.

[OnTheEdgeOfTheNight]

My last few cavaliers have all had MVD. You really need to have a vet you trust. Everything else becomes easier. In my experience the medication can change several times - new drugs, different dosages etc. There is a lot that they can try and presumably the vet feels that more information would help at the moment. Do you have a particular person at the practice who knows your dog or do you see different people? Maybe you could have a telephone consultation to discuss things.

[Fujexa]

I'm a veterinary cardiologist. Heart scans are a fantastic test; non invasive and not scary at all for most dogs, and they can tell us so much. If your pet has a grade 6 murmur and respiratory symptoms (even subtle ones) then she almost certainly needs more meds than just vetmedin and gabapentin. The scan can confirm this. The right combo of meds could make her much safer and more comfortable. There's so much we can do to help. As mentioned above, find a vet you trust to discuss it with. Look up how to monitor Sleeping Respiratory Rate also - it's a simple at-home test which you can do to monitor her condition. If her SRR is above 30 then have her reassessed as soon as you can. Even if you don't wish to do the heart scan, your vets may be able to help her further. Letting her "fade away" (essentially drown) with CHF would be a horrible way to go when there's ways to keep her very happy. I understand it's scary but please do seek expert advice. Wishing you the best.

[CathedralSpire]

Thank you so much for the extra information. I totally get what you’re saying and will get her back to the vet ASAP (making sure we get to see the one we like and trust) to review her medicines.