My puppy has a grade 4 heart murmur. Is it serious? What to do?

Thank you for submitting your question regarding your potential new puppy. Young puppies can occasionally have what is known as an innocent murmur. This is a heart murmur they will outgrow usually by 6 months of age and is not associated with any ongoing disease. Other murmurs are associated with congenital heart disease and go on to cause the puppy significant disease. I recommend having the puppy evaluated by a board certified veterinary cardiologist. A procedure known as an echocardiogram will likely be needed to assess for any structural heart disease. This will give you the longterm prognosis for the puppy. I hope this information helps!

Most puppies with grade 1 heart murmurs have these due to physiologic changes that they grow out of. However, there are some heart conditions that can start as a grade 1 murmur which can progressively worsen over time. Odds are in your favor that Nelson would grow out of this murmur and that it is insignificant. There is always that off chance that he has a more severe condition. Consider asking the breeder to include progression of heart disease (indicated by a worsening murmur) in the contract, in that if it does progress, you could return Nelson (unless you believe that you will get too attached). This is not an easy decision without a definitive right or wrong answer.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! A grade 4 heart murmur is loud for such a young dog. He should have a chest X-ray, heart worm test and an echocardiogram (ultrasound of the heart) with a cardiologist to diagnosis what is causing the heart murmur. Then you can be provided a prognosis and treatment plan. These tests can be expensive. X-rays cost over $100 and the echocardiogram costs around $4-500. Medications cost depends on what his diagnosis is as does life expectancy. I would see if the rescue can get these done for you prior to adoption. Good luck!

Old dogs often suffer from endocardiosis, a condition where the heart valves do not close properly any more and the heart needs to work much harder to pump oxygenated blood to all the regions of the body. When the valves do not close properly the swirling blood makes a noise and depending on the volume of the noise we assign it grades. A grade or level 4 heart murmur on a scale of 5 would be a serious heart murmur, on a scale of 6, not quite so serious. Here is some excellent information: http://www.vcahospitals.com/main/pet-health-information/article/animal-health/heart-murmurs-in-dogs/3912

Thank you for submitting your question regarding Finely. The murmur is concerning and should not have been affected by him have been painful. I recommend having him evaluated by a veterinary cardiologist. He should have an echocardiogram prior to you agreeing to purchase him. Some murmurs can be innocent in puppies, meaning that they will eventually grow it. However, most are associated with congenital heart defects. You will want this information prior to buying the puppy so that you can plan for ongoing medical expenses that he may have. I hope this information helps.

This is common and generally they do grow out of it. Norwich Terriers are not at high risk for heat disease. I don't know of any statistics on this. If the murmur persists a grade 1/6 is very mild and would not require treatment. Generally a grade 3 or higher may need medication to improve the heart function and reduce fluid in the lungs. Most dogs with heart murmurs live long lives with minimal issues. Personally I would adopt the puppy anyway as I would not expect it to progress or effect the dogs quality of life. To be safe you may want another veterinarian to examine the pup and listen also. It's always a good idea to get a second opinion. Thanks for using Petco Pet Education Center, formerly Petcoach to help you get answers to your veterinary questions.

At this age, as long as Kona is doing well, I would just monitor for now. Continue going in every 3 weeks for her vaccinations and the veterinarian will check the murmur with each visit. Innocent murmurs, which happen often, are harmless heart murmurs that typically show up around 6-8 weeks of age and can persist for several months. The murmur will typically resolve by 4-6 months of age. If the murmur is still there at the time it is recommended to spay, I would hold off on the spay procedure and have a cardiologist do an echocardiography on her to see what the cause of the murmur is. I would avoid making her exercise too hard but she can still play. I hope this helps guide you in the right direction!