Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - IMHA Dogs with Heart Murmurs

Hi Everyone - Murray was diagnosed with a heart murmur at his check-up with the internist who treated his IMHA. My question is - what do I do now? She said it was a level 1-2 and his heart rate and rhythm were fine. I know there are several dogs on the forum with cardiac issues. In your experience, would this warrant a follow-up with a cardiologist at this point? The internist was pretty much leaving it up to me since it isn't her field of specialty and I'm just always concerned with "how much is too much for an IMHA/AIHA dog?". Murray is becoming afraid to get in the car - it almost always ends with a vet visit for him. Thank you for any information you can share. Bonnie

Bonnie Chicago

I think it is pretty common for AIHA dogs to have heart murmurs. Madison had one while she was sick with AIHA but it went after she got better and the medication was reduced. Samantha

Samantha Perth

Dear Bonnie, My 11 year old Maltese Shihtzu X Millie was diagnosed with IMHA about 10 months ago. She also had a heart murmur, which was later diagnosed as early stage congestive heart disease following further testing. Millie is on 1.25mg Vetmedin twice daily, and is having no problems at all. Sounds like Murray's is only a minor murmur, and nothing to worry about, but if you are concerned I guess it can't hurt to see a cardiologist. No need to be alarmed by the sounds of it. Good luck, Samantha & Millie.

Samantha Geelong

Samantha - thank you, both of you, for your quick replies. It's great Madison and Millie are doing well and not having additional problems. I think I was typing too fast last night and my message was not clear - Murray's IMHA is in remission at this time. The heart murmur is something that just came up - he's a senior dog and the internist said it is likely due to aging. So, I was wondering if others had done further diagnostics that identified a condition that could be treated/slowed down without a lot of side effects for the dog. If not, then I'm hesitant to pursue additional diagnostics because of Murray's history, age, and other issues he's currently facing. Thank you again - Bonnie

Bonnie Chicago

Hi Bonnie, I also would not be alarmed. I know what you mean about getting them into the car. Wylie freaks now when she gets in the car so I try to minimize any vet visits. Wylie is 12 years old and in a year remission. Her visit last month showed a new heart murmer, level 2. The vet wasn't worried and said probably to old age and to just monitor and come back for a recheck in a few months. He said no meds until a level 3 or 4. Laurie

Laurie CA

Bonnie, I am sorry to hear about this diagnosis. Chance has a heart murmur also. These are relatively common in elderly dogs, more so usually in smaller dogs, less common in large dogs like Chance. It is a thickening of a valve in the left side of the heart, the side that sends the good oxygenated blood to the body. This valve is supposed to close when the heart pushes the fresh blood to the body. It gets a little sloppy and doesn't close all the way. So some blood goes backwards instead of out to the body. How much blood backs up is the critical question. If it's just a little, then it is a minor problem. In a human, they replace the valve with a pig's valve. Unfortunately, dogs don't get valve replacements. Moderating Murry's life style is important. Anything that increases the heart rate significantly, those things that require lots of extra blood to the body (extra oxygen), should be approached cautiously. Dogs are not aware there is anything wrong so they will not know to be careful! A workup with a cardiologist is your choice at this point, not a necessity. I would recommend routine heart x-rays, at your vet's leisure, to determine if there are any changes to the heart from the extra load. Most vets would probably recommend cutting back a bit on salty foods and maintaining a slim body weight. If you want, you can buy yourself an inexpensive stethoscope and learn to listen to his heart. Take it with you to the vets and compare what you hear with what the vet hears. This way you can check at home. my best patrice

Patrice NYS

Patrice, have you heard of supplementing to help? I read about L carnitine and taurrine can help. What are your thoughts on this. And you said about monitoring the heart rate. Wylie like to run around, but only for a few minutes. We only go for leisurely short walks. Laurie

Laurie CA

Dear Bonnie, Yes, likewise, Millie's heart murmur came up before her IMHA diagnosis. It was also diagnosed by our vet as a Grade 1 heart murmur, who told us not to worry about it as it was minor. Further testing during Millie's IMHA crisis revealed early stage congestive heart disease, and the vets prescribed the Vetmedin for Millie. Unfortunately this was most likely caused by the rotten teeth and infected mouth she had when we adopted her. We don't over exercise her, but she's still a bundle of energy who loves to run with her younger dog brother and sister - Mitsy and Harry (only 2!) and she can keep up with them! The vets have said the congestive heart disease may eventually kill her or she may be fine, as the Vetmedin isn't a cure, just assists in oxygenation of the blood (I think...!). I can tell you it's a very costly medication! Good luck, I hope Murray continues to live a healthy happy life through his twilight years. Samantha & Millie.

Samantha Geelong Australia

What I find strange with Wylie this is something that just doesn't happen overnight right? Because Wylie had her teeth cleaned not 2 months ago why wasn't this caught during this time. When I had her in 2 weeks ago is when he said she had the heart murmur.

Laurie CA

Many vets have visiting cardiologigsts with portable CAT xray machines. Able to show the level of the mitral valve prolapse, (blood that is flowing backwards) Sounds like a level 1-2 is minimum. But you may want to check again in a few months. Meds can be rxed like proponalol or enalipril (they are human drugs). Had a senior pet on both with a grade 3-4 HM. Prolonged his life for almost 2 years. Jan

Jan philly

Laurie, There are several causes of heart murmurs and one of them is bacterial infection (and thus scarring) of the heart valve. This might account for a worsening of the murmur to the point of it being more noticeable. There are many supplements that are of value to dogs (or humans) with heart disease. There are many different kinds of heart disease but in general the goal is to make the load on the heart easier, help strengthen the contractions and try to reduce any fluid buildup around the heart. The most important supplement, no surprise, is Omega 3 fatty acids. They have been shown to actually improve the heart condition and can even, in some cases, lessen or eliminate heart arrhythmias. Hands down, anyone with heart problems should be on this, unless there is unusual bleeding or the dog or person is on blood thinners already. It's always best to check with the vet or doctor first! For dogs, these are best given in the form of fish oil or in omega 3 eggs. Dogs are not able to process omega 3 fatty acids of vegetable origin well (flax seed, primrose, safflower etc) Other supplements seem to have beneficial effects but there are few conclusive studies that prove this beyond a doubt. Some dogs with a certain heart condition are known to have a deficiency of taurine, so thus this is often recommended. Taurine is in high quantities in liver so that is often recommended as the best form to give it. L-carnitine is an amino acid and has been anecdotally linked to improving some dog's heart conditions. I give this to Chance. Co-Q10 is another beneficial supplement, again, there is little research, only theory and anecdotal stories. I also use this for Chance. The best test to view a heart murmur is an echocardiogram. This is a live test, it looks similar to a live ultrasound, of the heart. The first view done is black and white and then color is added to view the amount of regurgitation (backflow) of blood back into the left atria (from the left ventricle). There is a bit of math that must be done by the vet to determine the quantity of blood and the size and shapes of the different chambers of the heart. However, this said, every vet and doctor has been trained to listen to the heart and can determine just from the sound just about what stage a murmur is at. A physical exam in this case is worth a million bucks. That's why I advise getting a stethoscope and learning to listen to the murmur yourself. my best patrice

Patrice NYS

This thread was discussed between 16/11/2009 and 20/11/2009

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