The Levels or Grades of Murmurs.
Originally Posted by Mastifflove
I'm wondering if there is a connection between a heart murmur and limp.
I recently got a 7 week old French mastiff, a vet did a exam, and told me he has a heart murmur level one "well on it's way to level 4" then told me he has congenital bone diesease because of the limp, but he wasn't limping before the vet seen him....The vet said he doesn't have blood going to the left side of his body properly because of his heart.
The pup does seem to sleep quite a bit. But is up most of the night. He doesn't eat alot but is eating, is drinking, and is playing, I've had him for 2 days. He does seem to have an odd walk at times but not all the time.
Typically murmurs are graded 1-6. These levels are based on the how prominent the murmus can be heard on auscultation. While this can help lead us towards a diagnosis, it is not a diagnosis itself. Furthermore while typically the higher the level, the worse the disease. However this is not always the case. I have had grade 1 or 2 level murmurs that were life threatening and lead to serious complications. I have also had a dog with a grade 5 murmur that was determined to be completely stable by a cardiologist after ultrasound. That dog did great under anesthesia and was given a great prognosis for long term health. The upshot is - that while levels or grades of a murmur do give us information, it does not tell us what specific type of heart disease is present, nor does it give a reliable prognosis. A change in level or grading can be important as well as its overall existence. To better understand both the type of cardiac disease as well prognosis, an cardiac ultrasound with a veterinary cardiology specialist is needed.
Limping with cardiac disease
Is it possible? Yes. Common? No. Typically if there is such a degree of reduced blood flow that a limb has clear problems - there really should be other signs like fainting (syncope), weight loss, coughing, fluid in the chest or abdomen, etc...
"It is not uncommon for puppies to present with flow murmurs (physiological or innocent murmurs) which result from an increase in blood flow through the aorta or pulmonary artery. These are usually fairly quiet, although they tend to vary in intensity, often with a variation in heart rate, whereas pathological murmurs are usually of consistent loudness regardless of heart rate. Thus, examining the heart until the animal relaxes, and the heart rate slows, is important, since flow murmurs often disappear or become very quiet. Flow murmurs usually disappear by 6 months of age. Re-examination at that time to check if the murmur persists or not might be useful." - excerpt from British Small Animal Veterinary Congress 2008. Author: Mike Martin, MVB, DVC,MRCVS The Veterinary Cardiorespiratory Centre, Martin Referral Services Kenilworth, Warwickshire
Resting Respiratory Rate (RRR)
For left sided heart disease, the RRR can be one of the most sensitive indicators of developing pulmonary edema (fluid in the lungs). This is best done at home. How do you do it? when the pet is resting or sleeping - cound the number of breaths per minute. Normal should be in the high teens or low twenties. When RRR is equal to or greater than thirty then patients with underlying heart disease, this RRR is strongly suggestive of congestive heart failure. This should not be the only evaluation and does a lack of an elevated RRR does NOT replace a complete diagnostic workup. When a persistently elevated RRR is noted, then pet needs to see a veterinarian immediately.
I hope that this helps.