Hi, my CKCS Lucy has just turned 7 years old. 2 years ago after getting x-rays, ECG and blood tests, I was told she had to get a heart scan because her heart wasn't beating properly. They said she had a leaking Tricupid valve. She isn't on any medication for her heart condition. At a recent check-up I was told her heart condition is getting worse. She's getting a blood test next week but do you think she may need another scan or other tests? I'm so worried about her. Many thanks.
Unfortunately Cavaliers almost always develop heart disease at some stage in their life. Mitral valve disease is almost certainly what she has, although the Tricuspid valve can be affected too as the disease progresses. Below are some of the common questions owners have regarding the condition.
What is the mitral valve?
The heart has four chambers. The upper chambers are the atria (or auricles) and the lower the ventricles. The heart is also divided into right and left sides. Blood flows back from the tissues and organs of the body via the veins to the vena cava then the right atrium. Here it is stored briefly and then pumped into the right ventricle which, when it contracts, pumps the blood to the lungs where it is re-oxygenated. It flows from the lungs into the left atrium and then passes to the left ventricle which has the largest and strongest of the heart muscles. This muscle mass is necessary to generate sufficient pressure to pump the re-oxygenated blood to all parts of the body.
The auricle and ventricle on each side of the heart is separated by a valve which prevents the blood from going back into the atrium when the heart contracts. The mitral valve lies between the left atrium and the left ventricle. Due to the pressure this valve has to withstand throughout the dog’s life it often starts to leak with age, resulting in a ‘backflow’ of blood which can be detected with a stethoscope. This is called a mitral murmur.
How common is mitral valve disease?
Mitral valve disease is the most common cause of heart failure in small dogs. In large dogs dilated cardiomyopathy, (DCM), i.e. a weakness of the cardiac muscle, is usually the most common cause of heart failure.
How serious is a leaking mitral valve?
Many dogs of the smaller breeds have an audible mitral murmur from about 6 years of age. Often this is asymptomatic (it causes no obvious signs). With time the leak becomes more severe and as more blood leaks back into the atrium this results in reduced pumping efficiency. Eventually congestive heart failure occurs. This can sometimes be months or years from the time when the murmur was first detected.
When I took my little dog for his annual booster the vet told me he had a mitral murmur but said he was not going to treat it at this stage. Is this correct?
Many dogs have audible left side murmurs without showing any signs. Usually the first signs are exercise intolerance and/or a cough and often treatment is not commenced until these become apparent. However, if the dog is very energetic it is wise to reduce exercise and also to reduce weightif there is any obesity.
How will I know if heart failure is present?
When the heart is not pumping the blood properly and some is leaking back into the left auricle the blood moves more slowly through the lungs. This results in a collection of fluid in the lungs. The usual sign is that a cough develops as the dog attempts to get rid of this fluid. It is as though he is trying to clear the throat. Exercise tolerance is also reduced.
Does this mean that he will have a heart attack and die?
Not necessarily. Initially the body tries to compensate and apart from a cough you may not notice much difference except the dog will appear to be slowing down. Ultimately, however, without treatment congestive heart failure will develop. We have a separate information sheet on this condition.
How is the leaky valve assessed?
With any heart problem a similar collection of tests is carried out.
These include auscultation, which is listening with a stethoscope. This is the usual way the valve defect is first picked up.
Chest radiographs (x-rays) are then used to check the lungs and also the size and shape of the heart.
Blood and urine tests are performed to give an indication of any other disorders in the body, particularly those affecting the liver and kidneys which may have significance on heart function.
An electrocardiogram (ECG) will also be carried out. This assesses the electrical activity of the heart and allows accurate determination of both heart rate and rhythm. Any abnormal rhythms, (arrhythmias or dysrhythmias) can be detected and evaluated.
Using ultrasound the contractions of the heart can be evaluated in the conscious patient without any risk.
A combination of these tests will provide evaluation of heart function, but a full work-up of this nature is expensive. If your dog is not insured please feel free to discuss cost prior to any tests since these only lead to diagnosis. Additionally there is the cost of treatment which is often lifelong and depends on the medication required.
What does treatment usually involve?
There is a wide collection of drugs available which are effective to control the condition although cure is not possible. These include diuretics and also sophisticated drugs acting directly on the heart muscle, improving contraction and regulating rhythm. In addition, special drugs are used which dilate the arteries, sometimes also the veins, thus reducing load on the heart and so easing the pressure on the diseased valve.
Is this treatment costly and is it long term?
Unfortunately most dogs have to remain on treatment for the rest of their lives. However treatment is tailored according to each patient’s needs and sometimes relatively inexpensive drugs are effective.
As a result of all the treatment, how much longer will my dog live?
Unfortunately it is difficult to answer this question with any certainty. It depends on the severity of the condition and the initial response to treatment. The more rapid the response once treatment is instituted, the better the prognosis. Many dogs, once stabilised, will live for months, or even years with no reduction in quality of life.
Hope this helps to shead a little more light on Lucky's condition.
Thanks for your help. As far as I'm aware Lucy has a leaking Tricupid valve problem,not mitral problem. At last scan, Lucy Mitral valve was fine. Many thanks.
Vet answer
Hi Margaret,
Unfortunately Cavaliers almost always develop heart disease at some stage in their life. Mitral valve disease is almost certainly what she has, although the Tricuspid valve can be affected too as the disease progresses. Below are some of the common questions owners have regarding the condition.
What is the mitral valve?
The heart has four chambers. The upper chambers are the atria (or auricles) and the lower the ventricles. The heart is also divided into right and left sides. Blood flows back from the tissues and organs of the body via the veins to the vena cava then the right atrium. Here it is stored briefly and then pumped into the right ventricle which, when it contracts, pumps the blood to the lungs where it is re-oxygenated. It flows from the lungs into the left atrium and then passes to the left ventricle which has the largest and strongest of the heart muscles. This muscle mass is necessary to generate sufficient pressure to pump the re-oxygenated blood to all parts of the body.
The auricle and ventricle on each side of the heart is separated by a valve which prevents the blood from going back into the atrium when the heart contracts. The mitral valve lies between the left atrium and the left ventricle. Due to the pressure this valve has to withstand throughout the dog’s life it often starts to leak with age, resulting in a ‘backflow’ of blood which can be detected with a stethoscope. This is called a mitral murmur.
How common is mitral valve disease?
Mitral valve disease is the most common cause of heart failure in small dogs. In large dogs dilated cardiomyopathy, (DCM), i.e. a weakness of the cardiac muscle, is usually the most common cause of heart failure.
How serious is a leaking mitral valve?
Many dogs of the smaller breeds have an audible mitral murmur from about 6 years of age. Often this is asymptomatic (it causes no obvious signs). With time the leak becomes more severe and as more blood leaks back into the atrium this results in reduced pumping efficiency. Eventually congestive heart failure occurs. This can sometimes be months or years from the time when the murmur was first detected.
When I took my little dog for his annual booster the vet told me he had a mitral murmur but said he was not going to treat it at this stage. Is this correct?
Many dogs have audible left side murmurs without showing any signs. Usually the first signs are exercise intolerance and/or a cough and often treatment is not commenced until these become apparent. However, if the dog is very energetic it is wise to reduce exercise and also to reduce weightif there is any obesity.
How will I know if heart failure is present?
When the heart is not pumping the blood properly and some is leaking back into the left auricle the blood moves more slowly through the lungs. This results in a collection of fluid in the lungs. The usual sign is that a cough develops as the dog attempts to get rid of this fluid. It is as though he is trying to clear the throat. Exercise tolerance is also reduced.
Does this mean that he will have a heart attack and die?
How is the leaky valve assessed?
With any heart problem a similar collection of tests is carried out.
These include auscultation, which is listening with a stethoscope. This is the usual way the valve defect is first picked up.
Chest radiographs (x-rays) are then used to check the lungs and also the size and shape of the heart.
Blood and urine tests are performed to give an indication of any other disorders in the body, particularly those affecting the liver and kidneys which may have significance on heart function.
An electrocardiogram (ECG) will also be carried out. This assesses the electrical activity of the heart and allows accurate determination of both heart rate and rhythm. Any abnormal rhythms, (arrhythmias or dysrhythmias) can be detected and evaluated.
Using ultrasound the contractions of the heart can be evaluated in the conscious patient without any risk.
A combination of these tests will provide evaluation of heart function, but a full work-up of this nature is expensive. If your dog is not insured please feel free to discuss cost prior to any tests since these only lead to diagnosis. Additionally there is the cost of treatment which is often lifelong and depends on the medication required.
What does treatment usually involve?
Is this treatment costly and is it long term?
Unfortunately most dogs have to remain on treatment for the rest of their lives. However treatment is tailored according to each patient’s needs and sometimes relatively inexpensive drugs are effective.
As a result of all the treatment, how much longer will my dog live?
Unfortunately it is difficult to answer this question with any certainty. It depends on the severity of the condition and the initial response to treatment. The more rapid the response once treatment is instituted, the better the prognosis. Many dogs, once stabilised, will live for months, or even years with no reduction in quality of life.
Hope this helps to shead a little more light on Lucky's condition.
All the best,
Anna.