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Heart Murmur - Spay?

12K views 36 replies 10 participants last post by  Cascade 
#1 ·
I am currently fostering a 7 year old female intact GSD that was recently diagnosed with a grade 4 heart murmur.

She is not being fostered through an organization. My friend (who works at a shelter) was given ownership of many animals when her friend passed away and I agreed to take on Lola, the GSD, as she was dog aggressive and needed to be moved out of her old home asap. I've been fostering her for just over a month or so and she was thought to be spayed.

I took her into the vet but there were no records of her being spayed. (only had her vet records up to 9 months there). They shaved her belly to check for a spay scar but didn't see anything. I went to get her bloodwork done about a week or so later so she could get spayed and a different vet diagnosed her with a grade 4 heart murmur.

So I am not sure what to do and haven't dealt with heart murmurs before. She gets tired easily and pants hard when stressed and even barely any exercise. I have been looking for the right home for her, but now am faced with not knowing if it's safe to have the surgery done. She also has pannus and will be starting daily eyedrops. With her dog aggression, I have struggled to find her a home but will keep her for however long it may take. We are working with a trainer with her aggression. I'm now obviously worried about getting her spayed but I also worry about her getting pyometra if she were to be kept intact. I've had mostly male dogs so I don't know how high the risk of pyometra is?

My friend was going to talk further with the vet about it so I am waiting to hear what they think. I feel like I've been getting conflicting opinions on what to have done and it's making it hard to figure out :/
 

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#2 ·
My golden dislocated his hip and had to have surgery. They found a murmur and it scared me. I don't think they should go under if there are any issues with the heart. His murmur did go away(they said it was due to the shock and pain) and he had surgery later that week.

In this case I would not put her under. It's gets tricky if something happens and she has to be spayed. I would not want to be in that position. You can talk to the vet and see what they say.
 
#3 ·
I have a 6 1/2 yr old male - Woolf - who was diagnosed with a stage 3 heart murmur. The disease (won't even try typing out the name) is one that mostly smaller dogs get and eventually leads to congestive heart failure. Interestingly enough, he is fear aggressive - severe DA and sometime HA.

Woolf just had his teeth cleaned last month, but before the vet would even consider it he had the full preop blood workup and had to have had his yearly xrays to monitor for heart enlargement. Then had a discussion with his cardiologist. That is just to list the steps we took for a teeth cleaning.

If the rescue is funded or has access to funds (the echo alone cost $750 for Woolf); it would be worth it to get a cardiologist involved to get a solid diagnosis of why there is a heart murmur; then you would be better equipped to make a decision for the spay.

Get in contact with gsdsar who works for a cardiologist as well.
 
#4 ·
Thanks. The vet did mention I could take her to a cardiologist but I think he said it would be down at the coast so that's a 6-7 hour drive for me. I have been paying for everything myself for Lola so it would probably be pretty costly. He didn't say anything about doing X-rays.

My friend spoke to the vet and they decided that we could book the spay and he would check her heart right before. But I am not sure because that is nothing what he told me when I took her in. He didn't even do her blood work. He isn't the vet I normally use, and everyone else has given me negative feedback on him so I would be more comfortable if it were my own vet giving me this advice. I am going to book another appointment with my own vet and see what he has to say about it.
 
#5 ·
One cheap step you can take is to have the vet run a heartworm test right away -- it's pretty unlikely in Canada, but not impossible. I see lots and lots of murmurs in dogs that have heartworm disease, and they correct after treatment. Those dogs all get spayed and neutered, and they come through fine.

In a HW-negative dog, I think I'd want to start with a chest xray, for the reasons Twyla explained.

Your regular vet can do a chest xray to be sure the heart isn't enlarged due to DCM....and, if needed, that image can probably be sent off to a caridiologist for review for another $50-$100. That's the low-cost way of staring this investigation into cause. As Twyla mentioned, the worry here is that enlargement is a sign of DCM, and DCM means congestive heart failure is on the way. DCM dogs have a shortened lifespan, so it's something any prospective adopter would want to know.

I just had major surgery done on one in rescue with a Grade 4 murmur. The surgeon not only wanted bloodwork, but also a chest x-ray prior to surgery. He sent it to a specialist to review to make sure the heart wasn't enlarged. Only after the specialist confirmed it wasn't enlarged did he go forward with the surgery. This was a complex surgery lasting at least an hour, so the dog was going to be under for a while. However, the surgery was done at a specialty clinic with a state-of-the-art surgery suite, very experienced anesthesia staff, a team of boarded vet specialists AND an emergency ICU on-site...so about as safe a surgery experience as one can possibly set up. The dog came through fine.

An uncomplicated spay can be done fast so they're not under for long at all. HOWEVER, I would not take a dog with a serious murmur to a low-cost spay clinic because they tend to not do an IV-cath with fluids during anesthesia. Assuming the heart isn't enlarged and you are cleared to go forward with the surgery, I'd suggest doing this dog's spay at a full-service clinic that uses fluids during anesthesia. That may potentially factor into the discussion you have with your vet (and cost).
 
#6 ·
I agree with all of this. I'd also add, that while I don't know the exact percentage of chance with pyometra, I do know that I work in a single doctor practice and we still see 2 cases of pyo every 6 months or so at least. In the event that she did develop it, the surgery would be much more complicated and dangerous for her at that time than it is during a routine spay.
 
#7 · (Edited)
Our King Charles was spayed and she had a heart murmur but at the time the murmur was at very low grade level which does not pose much of a greater risk then normal and done by a extremely gifted vet. A grade level 4 is a very high grade level and when our bella was at this grade level she was at the age of 7. The following year was at grade level 5 and in congestive heart failure and lived an additional 1 more year that consisted removing fluid from her abdomen and heavy duty meds.

This question needs to be asked to a cardiologists and an answer to that is when all tests are done. I can imagine any surgery would pose a very serious risk At this grade 4 level the stress of it can speed up the damage. I urge to you see a cardiolgist. A cardiologist has do X-ray, ekg, sonogram and bloodwork to see what condition the heart is in. The care a cardiologists gives her now will give her the greatest chance of living as long as she can with this condition. She will not receive the proper care of a regular vet at this grade level she is in.
 
#8 ·
So it's not so cut and dry with murmurs. Loudness of murmur does not always indicate severity of disease. It's just a sound. It's subjective(ish).

If you cannot see a cardiologist to determine why the dog has a murmur, then I would recommend at least chest X-rays and an ekg(something's about structure can be determined on a tracing). There are adjustments that should be made to IV fluid rate and medications that should be avoided(ones that can decrease cardiac output.).

GSD and other large beeed dogs will have generally different types of cardiac disease than say a Cavalier. At a grade 4 murmur you need to weigh the risk/benefit of a spay and adoptibility before proceeding.
 
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#11 ·
Thank you and I agree. I originally thought she was tiring easily and panting because she was out of shape as she was kept in a kennel since her last owner was sick. But I have been exercising her and there has been no change. Even taking her on a car ride, which she apparently did a lot with her previous owner, has her panting like she just went for a long run. She has been stressed out but even then it seems very excessive. My friend used to visit her at her previous home and they would throw the ball for Lola and she said Lola would never seem to get tired and could go all day. But now I definitely notice her get tired right away, and she will stop bringing me the ball. It's been tough trying to decide what to do. I will definitely feel better after I find out more though
 
#12 ·
Why don't you test her blood for LH? That will tell you if she is spayed.
 
#13 ·
I didn't know that was possible :( and I'm not sure why the vet didn't mention that...I did take her in to get her bloodwork done after all. But after he discovered her heart murmur he didn't take her blood. Grr.
 
#19 ·
She went to the vet today to get a chest xray and he listened to her heart again. It was unfortunately a rather rushed meeting so I didn't get a chance to ask the things I wanted to do. He said her xrays looked good, but he didn't show them to me, so I also don't have copies of them. I'm going to see if I can get a copy of the xrays and maybe get a second opinion from my regular vet who is very thorough when going over things. Is it normal to not see the xrays? I guess I'd like to know the reason she has the heart murmur but I'm guessing the next step would be a cardiologist? I am also waiting to see if she will come into heat.
 
#20 ·
I always see the xrays done of my dogs. This is MY opinion, but I would be running from this vet. Go to your regular vet just to confirm there is a heart murmur, then to the cardio for diagnosis. If your regular vet can do full blood work up and a complete thoracic study that will save $$ at the cardiologist. At least it did for me.
 
#23 ·
I don't think they were digital, he was holding the xray when he came back in. I'm hoping they can transfer the xrays to my regular vet and I can get him to check her out and do bloodwork.
 
#25 ·
The dog has a lot of issues. I would not risk her life to try to prevent something that might happen. I would get a cardiologist on board, and make a plan for how to treat the whole dog.

I currently have 2 intact bitches that will be 12 in August, one that will be 11 in august, 2 that will be 9 in August. 1 that will be 8 in July, and Bear who just turned seven. So far no pyometra. My spayed bitch had a false pregnancy, and since she required c-sections and never spewed any fluid prior to the surgery, I went ahead and spayed.

My vet told me that ALL females will get pyo. It isn't necessarily so.
 
#26 ·
Xrays on film is very...old school. Is this maybe an older vet? I feel like some of the old school vets don't really know what to do with a younger generation of clients who come in with research, go over each line of the blood test, have the xray explained up on the screen, and talk about the differentials....like partners in care. We confound and frustrate them, sometimes.
 
#27 ·
Not really older but they have a smaller operation. Like the clinic is located at his home I think. I think they mostly did horses but opened up a small animal clinic though I'm not sure how long ago. I'm definitely used to my other vet that explains pretty much everything and very thoroughly
 
#28 ·
So they can't send me a copy of the xrays as they are not digital, I can only go back to the office and view them. I guess I am just going to forget about it and go back to my regular vet, and just get a full exam, bloodwork, and xrays again if needed..I'm not sure if they can transfer the xrays or what.
 
#29 ·
Did you ask about LH Level testing? To see if she intact?

Lots of vets still have film X-ray. Digital is super expensive. And while better, if you have clients constantly complaining about costs, justifying it is hard. If you go back to see them, you can take a picture.

Or ask for her VHS- vertebral heart score. Should tell you at least if her heart is enlarged.
 
#31 ·
Lola has gone into heat..I noticed her first bleeding on April 29th, and she is still bleeding. I haven't had a dog in heat before but I'm thinking almost a month of bleeding is unusual? She hasn't been acting any different the past month and the bleeding has remained the same (dark, no other discharge). I mentioned it to my vet yesterday as I had to take my other dog in, and he said it is unusual but we got sidetracked and I forgot to ask further about it. She hasn't been lethargic or anything.
 
#32 ·
Every bitch is different, but usually, they start spotting for a few days, then the blood is dark for about a week or so, then it turns lighter, and becomes almost non-existent after the third week, but they can still have some blood. I would be concerned if she is bleeding dark blood red for a month, with no slowing down. I am not sure what I would do though. If all other signs are normal, no lethargy, no fever, no behavioral changes, no loss of appetite, I might wait another week to see if it resolves itself, but I would keep a close eye on her vital statistics. It just depends. I might take her in and have them check her and do bloodwork. 7 is on the edge of what I consider a mature adult. Bitches can get cysts in their uterine horns, just like women do. It is possible that the cysts are causing the bleeding. I really don't know what they could do for her that is not invasive. I think you need a cardiologist involved if you spay. I don't know that they will be able to see anything with an ultrasound, but they may be able to see if she has an inordinate amount of fluid in her uterine horns.

Sorry, I really don't have much experience with problems in this area. Odie, the one I spayed was probably the most problematic. They did see with an ultrasound that she had no puppies in her, and that her uterine horns were full of fluid. False pregnancy or she aborted and resorbed the puppies, so I went ahead and spayed, as I was not going to breed her again.
 
#33 ·
I am not sure what to do at the moment either, I was also thinking of waiting another week to see if the bleeding would stop or book a vet appt for next week. I was going to take her back to my regular vet to get bloodwork + second opinion on the murmur but I've been waiting for her heat to finish...and still waiting haha. I started wondering if the bleeding was something else as she has not changed her behavior at all during the month of bleeding, and my male has had zero interest in her. He is neutered, but normally anything different he would at least want to sniff or check out.

She has also had a bit of a cough, or some breathing issues when she exercises. I'm not sure if she picked up something at the kennel or something else going on. It was discussed with my vet, and for now I am monitoring her breathing until I bring her back in for more testing. I'm not too concerned about getting her spayed right now; just trying to get everything else sorted out now.
 
#34 ·
The caugh is also concerning, as it can be heart-related. I wouldn't wait for the heat cycle to finish to go to a cardiologist.

There may be nothing you can do for the heart, and just give her the best life you can until the end draws near. And it would be well to know what the signs and symptoms of that time is so that you can help make it easier for her.

There may be medicine that can give your dog the best chance of having a good life, for as long as she can have with you. If that is the case, than you want to start that medication now.

And there could be surgery that can help your dog. I really don't know whether it is possible or if it makes sense for a dog the age of yours. I do know that waiting can mean that changes (enlargement) happens with the heart and it can be that surgery may no longer be possible. Chances are that if that were the case, it probably already is beyond any deadlines, considering her age. But unless we meet with a cardiologist, we simply do not know. Nikki should not be 3 years old with a PDA, either. But she is, and she is still able to undergo surgery for it. Most dogs with a PDA have their heart enlarge and do not make it to 3 years without surgery. So waiting is something I would not advise when it comes to the heart.

When it comes to bleeding in a heat cycle, yeah maybe.

The caugh could be the heart. Prolonged bleeding from inside maybe is affecting blood pressure or something else. This is way outside of anything I have experience with, save only my mother's friend was bleeding in her colon and her usually high blood pressure went very low, and by the time the docs figured it out, she was too far gone to survive.

I just don't know. The cough concerns me. Dogs don't get colds like we do. There is kennel cough, and there is heart-related cough. I sure hope you can get this figured out soon.
 
#35 ·
I have been concerned about the cough too.. I'm not sure if it's actually a cough, but when she starts exercising she starts exhaling really hard. Sorta hard to explain. I showed my vet a video of it though. The first vet that took the xray said there was no congestion around her heart. But that was before the coughing/breathing issue started. I am going to make note of her resting breathing rate when just at rest, after exercise, waking up etc as advised by my vet.

I am not sure if/when I can get to a cardiologist as we don't have one around here and the nearest is about 6-7 hours away. I was thinking if it is her heart giving her these issues and she continues to decline as she is, I will just be keeping her in palliative care..I had hoped to find her a home as I was only fostering her when I originally took her in. She is already a highly stressed dog, so I will have to consider her options of treatment (if any). Anyway thank you for your input. I planned on getting her back to the vet for bloodwork/xrays and whatever else needed after her heat, but I will try to get her in sooner.
 
#36 ·
There's technology to allow a regular vet to do an EKG remotely for a cardiologist to review -- they run the software and the signal goes through the phone to the cardiologist's office, who is monitoring it in real time on the computer screen, just like it were in the cardiologist's own clinic. Then the cardiologist prepares a report. If your vet calls the cardiologist, I'm sure they could explain it. It's cool stuff!

They can also send xrays and other diagnostics after the fact to the cardiologist for review.
 
#37 ·
A bit of an update..took Lola back to my regular vet, who doesn't hear a heart murmur. He discovered a lump on her mammary gland though, and felt her spleen was a bit hard. She is going back in to get her lumps (and any others I may find before then) aspirated to get checked out.. She stopped bleeding from her heat after about 7 weeks (7 weeks of bleeding) but her vulva is still swollen (??).

Guess I'll know more after the next appt. She hasn't been doing the coughing anymore that I've noticed, though despite taking her running and hiking she does seem to tire easier and breathes harder for much longer than my other GSD. Not sure if she is just taking longer to get into shape or what. Worried that she might have cancer now though.
 
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