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Getting to the Heart of the Matter – Heart murmurs in dogs

February being the month of luurve I thought I would write about matters of the heart. The actual heart. Sorry if anyone got excited there! Whenever you take your dog to the vet, your vet will listen to their heart and chest. They are checking to make sure the heart beat is strong, regular and that there are no murmurs. A heart murmur occurs when the clear drum beat of the heart (often described as ‘lub dub’) has a swooshing sound. This is caused by the blood not being pushed cleanly through the different chambers of the heart, most often escaping through leaky valves back the way it came. It is one of the commonest signs of heart disease and I am going to concentrate on them in this article. The breed we see most often with heart murmurs is the gorgeous Cavalier King Charles Spaniel. They often develop them fairly early in life, between 4 and 6 years old is average, but don’t usually develop associated heart failure for at least a couple of years. However, they can occur in any dog and are occasionally heard in puppies (but most will grow out of them) Heart murmurs are graded from 1-6, with 1 being the quietest and 6 being so loud the normal beating of the heart is drowned out completely. In general the louder the murmur, the worse the leaking of the valves and as the disease progresses the murmurs will get louder. Every time your vet checks your dog they will record the degree of murmur, which allows them to track its progress. They will also be listening to the pattern of the murmur and whereabouts on the heart it is loudest. Often there are no outward signs of a problem, which is why regular veterinary check-ups are so important. It is very worrying when your dog is diagnosed with a heart murmur and you can feel quite helpless. However, although we cannot cure your pet’s problem there is a huge amount both we as vets, and you as an owner, can do to help them. The first thing to determine is whether they are in actual heart failure and this is a really important point. Just because a dog has a heart murmur it does NOT mean they are in heart failure! It does mean, however, that thire heart is inefficient and has to work harder than a normal organ to do the same job. This puts it under more pressure and essentially means it wears out more quickly. When a heart murmur is diagnosed, it can be helpful to perform some extra tests to determine how the heart is coping and what exactly is causing the sound. Techniques include ultrasound scanning (although some vets may need to refer you to a specialist for this), using x-rays to measure the size and shape of the heart and taking your dog’s blood pressure. It can be very useful to repeat these regularly (once or twice a year) to monitor the progress of the condition. There are also things you can do at home. I advise my clients to take their pets heart rate at least once a week when they are relaxed, so any increases (which can indicate a worsening of the disease) are be picked up quickly. I also advise regularly timing a short walk they do often. This allows them to pick up on the very subtle slowing down that will occur early in the disease. Believe it or not dogs are far more naturally athletic and fit than us humans (even fat little Cavies!) and although, like people, they will eventually become breathless & find exercise more challenging, they can hide these effects of heart failure for some time. Other symptoms can include a soft wet cough, collapsing or even going blue or pale at the gums. However, these usually occur only when the heart is in advanced failure and treatment will be more difficult. Before heart failure develops the best thing you can do for your pet is ensure they stay slim. Being over-weight makes it much harder for the heart to function well. However, once it occurs, the sooner treatment is started the better, which is why looking for the more subtle signs of the problem is so important. The good news is there are many different medications that can help your pet, which will very significantly increase their length and quality of life. So, if your vet finds a heart murmur in your dog, don’t panic! Keep them in tip top condition, be vigilant for the signs of heart failure and once they occur ensure they start on medication quickly. With this your best friend is likely to be with you for some time yet, which will keep both your hearts from breaking! Cat Henstridge BVSc MRCVS - Read more of her blogs at
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Hyperthyroidism in cats.

This is one of the most commonly diagnosed endocrine (hormonal) diseases in cats. Many older cats suffer from a variety of symptoms which might just be put down to ageing, or might previously have been attributed to kidney disease, but many of these will actually be in the early stages of hyperthyroidism. Over the last 20-30 years a great deal of research has been done on this disease, and treatment has improved as a result. The thyroid glands lie in the neck, one either side of the windpipe, with occasional extra smaller glands present in some cats. The glands produce thyroid hormones which are involved in regulating metabolism, so they have an effect on most systems of the body. The glands can become enlarged and overactive, producing too much thyroid hormone. This is usually because of a benign (non-cancerous) change in the thyroid gland, but more rarely it can be caused by a tumour called a thyroid carcinoma. Fluffy-BWThe typical cat with hyperthyroidism will be an older cat with some or all of the following symptoms:
  • loss of weight
  • increased appetite
  • increased thirst
  • increased heart rate
  • heart murmur
  • restlessness or hyperactivity
  • digestive upset
  • an unkempt coat
  • swelling of the thyroid glands in the neck
These sorts of symptoms will arouse suspicion that hyperthyroidism is the cause, but it can only be confirmed with a blood test to measure the levels of thyroid hormones. This would usually be combined with other tests to check kidney and liver function and to check for diabetes, as all these can have similar symptoms and of course there might sometimes be more than one problem going on. If hyperthyroidism is diagnosed, treatment usually begins with tablets. The drugs reduce the production of thyroid hormone. The dose and frequency will depend on which drug is used and on how high the thyroid hormone levels were on the blood test. After 2 or 3 weeks a second blood test will show whether the levels are becoming closer to normal, at which time the dosage may be changed. If this treatment suits the patient, it can be continued long term with regular monitoring by blood tests. However, some cats are harder to give tablets to than others, and a few will suffer from side effects. Another treatment option is surgical removal of the thyroid glands, which is usually very successful and offers a more permanent solution. The operation does involve some risks, particularly the risk of damaging other small structures next to the thyroids, like the parathyroid glands. (These are important in regulating the levels of calcium in the blood, and if damaged during surgery supplementation with calcium could be needed.) A cat with heart problems may be a poor risk for surgery, but often tablets can be used first to improve health so surgery is a better option, and additional drugs to control any heart problems may be given. In most cases, cats which have had their thyroids removed will not need to take tablets, but sometimes the problem can still return later, if for example the cat has some smaller gland tissue which was not removed with the main glands. This extra thyroid tissue, known as ectopic thyroid tissue, can be located anywhere in the neck or even within the chest. In some cats only one thyroid is affected at first so only one is removed, then some years later the same condition could occur on the other side. The other main treatment available is with radioactive iodine, which is a specialist treatment only available at some centres in the UK. Radioactive iodine is given to the cat by injection and it becomes concentrated in the thyroid gland, where the radioactivity destroys the damaged tissue. One of the disadvantages of this treatment is that the cat has to be hospitalised for several weeks because of safety issues surrounding the radioactive material used. It is not dangerous to the cat itself but has to be handled safely to protect people working with it. Decisions on which treatment would be best for an individual cat are best made in conjunction with the vet who knows all the details of the case. Where complicating factors like heart disease or kidney disease are present, these need to be treated as well. Once diagnosed, the outlook for a cat with hyperthyroidism is usually very good. Whichever treatment is used, it is likely to prolong life and improve the quality of life. If you are worried that your cat is showing any of the symptoms listed, talk to your vet or use our interactive Cat Symptom Guide to help you decide what to do next.