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Transcript
PET HEALTH BULLETIN Autumn 2012 1. Heart murmur At a routine vaccination visit, your vet mentions your dog or cat has a heart murmur. What does it mean for your beloved companion? In this issue of the news letter, we explain what a heart murmur is, and what steps you can take to manage your pet’s heart condition. What is a heart mur mur? A heart murmur is an abnormal heart sound that is heard through your vet’s stethoscope. The sound is produced by abnormal blood flow that is turbulent. In a normal heart, blood flows smoothly just as water would through a quiet river. But when there is narrowing of the stream, the water like blood in the heart produces sound that is much louder due to disruption in the otherwise smooth flow. Similarly, if there is impedance to the flow of blood through the heart, we hear the turbulence as a heart murmur. to the rest of the body. If this valve starts to leak, then we hear a heart murmur. In fact, up to 58% of dogs aged 9 and above have changes to their mitral valve. What does the “grade” of the heart murmur mean? Heart murmurs are graded on the scale of 1 to 6 according to the intensity and loudness of the murmur. • • • What are the different types of murmurs? There are generally two type of heart murmur; congenital and acquired. A congenital murmur is one that is present from birth and is due to heart defects. These could be due to a defect between the walls of the heart (Atrial and septal defects) , narrowing of certain major vessels of the heart (pulmonic and aortic stenosis) or because a closing between two vessels has failed to occur ( Patent Ductus Arteriosis). It is not uncommon for young puppies or kittens before 16 weeks to have a murmur. Murmurs that resolve with age are generally harmless. The latter, an acquired murmur, is one that your pet develops later in life and is usually due to heart or valvular disease. The most common acquired murmur is caused by a defect in the mitral valve. It is a valve that sits on the left side of the heart. It opens and closes as the heart contracts to pump blood • • • Grade 1 - Soft murmur that are very soft and is only audible via a stethoscope in quiet surroundings. Grade 2 – Soft murmur but easily heard by the stethoscope one side of the heart Grade 3 - Intermediate intensity heard by the stethoscope over both sides of the heart Grade 4 – Loud murmur heard by a stethoscope but no thrill Grade 5 – Loud murmur heard by a stethoscope and a palpable thrill (meaning you can feel the murmur by placing your hands over the heart) Grade 6 – Very loud, you can hear the murmur without the stethoscope Though grading of the heart murmur signifies the increasing intensity of the turbulent flow of the blood, it does not relate to prognosis (outcome) of the heart condition. What are the treatments for a heart murmur? Treatment only commences if your pet’s heart murmur progresses into heart failure. This is when your pet starts exhibiting signs such as collapse, coughing, difficulty breathing, exercise intolerance and lethargy. It is important to visit your veterinarian, at least once a year, to monitor the progress of the heart murmur and to report any symptoms if they occur. Your veterinarian might propose to do diagnostic imaging to work out the cause and severity of the heart murmur. An x ray will help evaluate the size of your pet’s heart and identify signs of heart failure (such as fluid in the lungs). An echocardiogram allows us to assess the structure of the heart which is not visible on x rays. It uses sound waves to create images of the heart in motion, similar to an ultrasound. Certain measurements are taken and these help us to tailor the best treatment protocol. The measurements can also be used to assess response to treatment at a subsequent echocardiogram. Recently, there is also a blood test available to determine if your pet’s heart has gone into failure. It measures a specific enzyme released by a failing heart. To date, there has been no evidence to suggest treating a heart murmur prior to development of clinical signs improves the outcome of the condition. Therefore, treatment for a heart murmur commences only when you notice signs of heart failure. The heart murmur itself is untreatable and is irreversible. However, the heart failure can be successfully managed with drugs. Regular blood tests and check ups are needed since medication changes after some time. This will help improve and maintain a quality of life your pet will enjoy with medication. What else can I do for my pet? In addition, to regular check up to monitor your pet’s heart. There are other steps you can take to help your pet’s heart. Maintaining a good weight limits the strain that is placed on the heart. Avoid food that is high in salt content such as processed food, chips, cheese and some canned food. Vitamin B supplementation can also be helpful since it replaces the loss as a consequence of heart failure. Supplementing their diet with Omega 3 fatty acid can also be beneficial. Lastly, avoid heat stress. Many pets with heart murmur continue to lead normal lives. Those that develop heart failure can be successfully managed to give them optimal quality of life. 2. Clinic News Dr Michael Banyard will be taking a 6 month leave of absence from April. He will be sorely missed by the staff at the Animal Medical Centre, as a colleague, a mentor and a friend. We hope he will return to do further work with us and we wish him the very best during his extended break. Rebecca Taylor, one of our lovely nurses, will also be leaving to pursue a career as a human nurse. Dr Amanda Craig, a well known Canberra vet with a special interest in dermatology and pharmacology will be joining us in mid April. Laura Palmer, a bright young vet nurse, has already started with us and we warmly welcome them both. We now have a new kennel and x ray facilities. We are continuing to improve our facilities to serve you better.