Heart murmur... I'm worried. Advice?

Hey everyone. It's been a long time! I wish I was posting again for better reasons...

So Miss Pia has just been diagnosed with a Grade 3 heart murmur. She's 4 and a half, and I've never been told she had a murmur before. And I'm kinda freaking out.

She was scared at the vet, but then, she always is. I didn't feel like she was necessarily more freaked out than normal. Her immigration exam was certainly far more intense, and there were a lot more other animals in the building at that one. So, if anything, this visit was relatively easy for her.

The vet told me she should get more testing, and I've been given the options of a blood test or a heart scan. I'm leaning towards the heart scan right now.

I don't know what kind of stuff I'm looking at, with such a young cat with no prior history. Pearl had a mild acquired murmur when she got to be 13 or 14, but that's really just a thing that happens with a lot of old cats. They pretty much just told me make sure it gets checked during her senior exams and don't worry too much unless it gets bad.

I didn't expect my healthy young moggie with no history to suddenly have such a pronounced murmur.

Anyone with any experience, or any advice on the possibilities given the sudden severity of the murmur, thanks so much.

Go with the heart scan, it will tell you more.  It could be heart disease, or it could be heartworm.  Yes, cats can get heartworm, but it's rare. It is carried by mosquitoes, and they pick it up from infected animals themselves.

Red Top Rescue said:

 
Go with the heart scan, it will tell you more.  It could be heart disease, or it could be heartworm.  Yes, cats can get heartworm, but it's rare. It is carried by mosquitoes, and they pick it up from infected animals themselves.

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Thanks so much. I've been looking up the most common candidates for young cats, and I think I will get the scan. Seems like most of them require a good look at the heart structure to diagnose.

I doubt it's heartworm. She's fully indoor. In a way, that's making me more scared. Some kind of heart problem is all that's on the table, and the ones affecting most younger cats just don't sound good...

I'm hoping maybe it's something stable and congenital that I can just work around, but yeah, freaking out...

Lilin, I am a human doctor, not a cat one. Don't freak out because a heart murmur has been diagnosed in your young, healthy cat. Miss Pia may have absolutely nothing wrong with her as a murmur is NOT a disease.

All mammalian hearts are similar in construction so cats hearts are similar to humans.  A heart murmur is the name given to the sound made by vibration in a heart valve and is best heard through a stethoscope.  Heart murmurs can be due to many causes, the loudness of a murmur not necessarily being an indication of the severity of any illness. 

There are four chambers in the mammalian heart with four valves, each valve being able to cause murmurs depending on whether they are narrowed or leaking - sometimes there is even a murmur but with no evidence of thickening or leaking!   Indeed a slight thickening of a valve has been known to cause a loud murmur yet the owner may still be perfectly healthy.   A significantly leaking valve, on the other hand, could cause a faint murmur but the animal, human or cat, could be quite ill.   Therefore the diagnosis of a 'murmur' is NOT a disease!  It is the cat's symptoms that are an index of the severity of the illness. 

Assessment of the significance of a murmur in humans depends on a careful history as to whether there is any shortness of breath, loss of consciousness or fainting on exercise, however I am not sure how this translates to symptoms in cats.   Whatever, there are tests that can help assess the degree of damage, if any, that is present.

In my opinion, a blood test may not give you any information about the structural damage to the heart.

An electrocardiograph is a well known test, measuring the amount of electricity that the muscle contraction in the chamber produces.  It shows whether a chamber is producing more electricity and hence whether a heart chamber is enlarged. 

An echocardiograph will also demonstrate whether a chamber of the heart is damaged but it is more accurate then an electrocardiograph.  This is the test that is probably the one that you refer to as a "scan' and is likely to give your vet the most information of the significance of the murmur. In my opinion, this is the test that you should have.   It is perfectly harmless and consists of giving the cat a light anaesthetic and then checking each chamber and valve with ultrasound.  This measures the reflection of the thickness of the chambers and whether there is any damage to the valves. 

Remember, investigations may find very little pathology even though there is a loud murmur  - so don't freak out until you have to  - it may never happen!

With best wishes,

Geoffrey

When I adopted my guy, I found out he has a Grade IV heart murmur. I was so scared, but a bit understanding because I have a heart murmur myself. I was born with it. No big deal to me. It is just something I have...

I immediately agreed to an echocardiogram because of Artie' s age, (8 yrs old). I wanted to know what I was getting myself into. 

Turns out, yes, he does have a Grade IV murmur, however it is a functional murmur; meaning that it is not causing any harm to his heart~~~ just like mine.. As Geoffrey has explained, it is just something you are born with and is common.

Mine is from a heart valve leaflet which just bows back into the above chamber---common in women...

Artie has something similar, but not exactly ~~ a bit different in cats. 

I just watch him, usually forget about him having it; and enjoy him.

Since he is now taking steroids, It was suggested that I get another echo. He has IBD. I guess steroids can cause some heart failure. I am on a limited income now, without him having insurance, so it is a matter of cost. 

I may break down and do it, but I am not sure..

If he was not on steroids, I would not even consider another echo. He is happy, as healthy as he can be, and not showing any signs of heart failure. He is now 12 years old. And he is my love....

hopefully this will help you feel a bit relieved..

Lilin said:

 
Hey everyone. It's been a long time! I wish I was posting again for better reasons...

So Miss Pia has just been diagnosed with a Grade 3 heart murmur. She's 4 and a half, and I've never been told she had a murmur before. And I'm kinda freaking out.

She was scared at the vet, but then, she always is. I didn't feel like she was necessarily more freaked out than normal. Her immigration exam was certainly far more intense, and there were a lot more other animals in the building at that one. So, if anything, this visit was relatively easy for her.

The vet told me she should get more testing, and I've been given the options of a blood test or a heart scan. I'm leaning towards the heart scan right now.

I don't know what kind of stuff I'm looking at, with such a young cat with no prior history. Pearl had a mild acquired murmur when she got to be 13 or 14, but that's really just a thing that happens with a lot of old cats. They pretty much just told me make sure it gets checked during her senior exams and don't worry too much unless it gets bad.

I didn't expect my healthy young moggie with no history to suddenly have such a pronounced murmur.

Anyone with any experience, or any advice on the possibilities given the sudden severity of the murmur, thanks so much.

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My mum has two cats with a murmur. One of them was diagnosed with it when he was still a kitten. He's never let it slow him down at all. I'm not sure what grade it is however.

One of our older cats, who is 15, has also just been diagnosed. His is a little more severe, and my mum has had all the necessary tests done. Now we just have to work out if there's something causing it.

I can understand the concern, but there are many cats that can live long happy lives with their little heart blips and never notice a thing.

Artiemom said:

 
Since he is now taking steroids, It was suggested that I get another echo. He has IBD. I guess steroids can cause some heart failure. I am on a limited income now, without him having insurance, so it is a matter of cost. 

I may break down and do it, but I am not sure..

If he was not on steroids, I would not even consider another echo. He is happy, as healthy as he can be, and not showing any signs of heart failure. He is now 12 years old. And he is my love....

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 Artiemom, from what you wrote, I doubt very much that steroids would make any difference to your cat's murmur and I can see absolutely no reason for another echocardiogram!

With regards,

Geoffrey

Geoffrey said:

 
 Artiemom, from what you wrote, I doubt very much that steroids would make any difference to your cat's murmur and I can see absolutely no reason for another echocardiogram!

With regards,

Geoffrey

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Thank you Geoffrey!! I really appreciate the advice. This is exactly what my Vet said, and how I felt. It was the Internal Medicine Vet who was insisting on the echo...

Thank you, everyone! I'm feeling a little better about it after reading your replies. I guess, since I was looking up the most common actual diseases in order to assess which test would be the most likely to identify them, I may have worried myself a bit too much.

Ok, question. My vet said the "scan" that he had in mind would actually be an ultrasound, and Pia would not be anaesthetised -- only given a calming drug if necessary. She does usually get quite still when she's scared, at least if I'm there, but I don't know if she's by herself with the vets.

Wondering what thoughts are on this and if I should ask for the echo instead?

ETA: Hm, ok, I just Googled it. So an echo IS an ultrasound, but that's just what they call it when it's on the heart?

My understanding is that both of these tests use ultrasound to see images of the heart structure and are noninvasive yet show great details.  The simple scan is what they use to see babies inside their moms. I think that the scanner they use in an echocardiogram has the added ability to use a kind of doppler ultrasound to measure the amount of blood going through the vessels etc,   I think it is just a more complex machine with more capabilities.  My feeling is that they can do a regular ultrasound in your vet's office but that for a more complete echocardiogram, it might require going to a specialist's office.  I could be wrong, however.  Maybe @Geoffrey can clarify that for you.

I am an ultrasound tech. The words 'scan' and "echo" are used interchangeably with most doctors/vets..

They are referring to a test which uses ultrasound. Generally, the world scan is for the belly and echo is for the heart. Some doctors or Vets use the words either way. It seems Ultrasound exam or Echocardiogram of the heart is too long for some..

A basic 'scan' can be done in the Vet's office. It is done for the belly (abdominal) organs. 

A "scan" or "Echo" ~~ shortened form of the work Echocardiogram, is an ultrasound of the heart. These are done by specialists. You do have to either take them into a hospital for it, or to an office where they specialize in ultrasound and radiology (X-rays).. 

An Echocardiogram is more likely done by a Cardiologist (heart doctor).

My guy was not sedated, nor anesthetized for his echo. He had to be held down because he is a wiggler, a wiggle worm..His chest was not shaved either. I was present for the exam. The Cardiologist explained it all for me. He got really good images. 

@Red Top Rescue, You are correct. The doppler part of the exam can tell velocities of the blood flow. The Color aspect of it is the doppler waveforms turned into color images. This can show velocities but is also easier to see any abnormal flow, turbulent flow, abnormal leaking, abnormal jets,  etc.. There are a lot of measurements taken during an Echocardiogram. 

I hope this helps explain things. I hope I was not too technical..

Artiemom said:

 
I am an ultrasound tech. The words 'scan' and "echo" are used interchangeably with most doctors/vets..

They are referring to a test which uses ultrasound. Generally, the world scan is for the belly and echo is for the heart. Some doctors or Vets use the words either way. It seems Ultrasound exam or Echocardiogram of the heart is too long for some..

A basic 'scan' can be done in the Vet's office. It is done for the belly (abdominal) organs. 

A "scan" or "Echo" ~~ shortened form of the work Echocardiogram, is an ultrasound of the heart. These are done by specialists. You do have to either take them into a hospital for it, or to an office where they specialize in ultrasound and radiology (X-rays).. 

An Echocardiogram is more likely done by a Cardiologist (heart doctor).

My guy was not sedated, nor anesthetized for his echo. He had to be held down because he is a wiggler, a wiggle worm..His chest was not shaved either. I was present for the exam. The Cardiologist explained it all for me. He got really good images. 

@Red Top Rescue, You are correct. The doppler part of the exam can tell velocities of the blood flow. The Color aspect of it is the doppler waveforms turned into color images. This can show velocities but is also easier to see any abnormal flow, turbulent flow, abnormal leaking, abnormal jets,  etc.. There are a lot of measurements taken during an Echocardiogram. 

I hope this helps explain things. I hope I was not too technical..

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Awesome, thanks so much. Ok, it sounds like he means an echo, because he did say she would need to go to the hospital. I will double-check to be sure when I call back to book it.

Red Top Rescue said:

 
My understanding is that both of these tests use ultrasound to see images of the heart structure and are noninvasive yet show great details.  The simple scan is what they use to see babies inside their moms. I think that the scanner they use in an echocardiogram has the added ability to use a kind of doppler ultrasound to measure the amount of blood going through the vessels etc,   I think it is just a more complex machine with more capabilities.  My feeling is that they can do a regular ultrasound in your vet's office but that for a more complete echocardiogram, it might require going to a specialist's office.  I could be wrong, however.  Maybe @Geoffrey can clarify that for you.

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An echocardiograph is very complex to take and read and is only interpreted by a specialist cardiologist.  This applies to humans and would also apply to veterinary work.    Even if the vet in general practice has had specialist training, it would not be economical for him/her to use an echocardiograph - nor indeed any other form of ultrasound - unless cases were referred to him/her by other veterinarians. 

Before I retired, a good part of my practice was reading electrocardiographs for other doctors.  An electrocardiograph machine is relatively inexpensive but, even if the general practitioner had such a machine - and most did -  many would send difficult ECGs to a consultant like me.  This would have been because the readings were best interpreted by those who had not only special training but also considerable experience in reading them.   By the time that I had retired, I had been reading ECGs for some 57 years,   I started to read them long before echocardiograph machines were invented and I too would refer cases that needed echocardiography to other cardiologists .  My practice was such that it would not have been economical for me for me to buy a machine and learn the specialised training required.  Sufficient to the day is the evil thereof!!

I am sorry but Red Top Rescue is not correct about GP vets using ultrasound in their practice.  Ultrasound scans bounce ultrasound off the abdominal structures and they are indeed used for viewing unborn foetuses in the uterus and also for viewing other abdominal structures, such as the kidneys and the bladder.  However they are far from being simple.  An obstetrician would interpret the first and a radiologist the latter. (These scans can best be likened to shining a torch into a dark room, only they would use a beam of ultrasound instead of a beam of light. )

Specialised Doppler ultrasound machines are used to look at blood vessels and determine blood flows, but this again is quite different again from echocardiographs or ultrasound  - they are usually interpreted by radiologists.  

With all best wishes,

Geoffrey

My cat had an echo a couple of weeks ago, they told me to order another one next year to see how things were progressing. She loves to jump up and fling herself around after her "da bird" toy, I'd been worried that this would place too much strain on her heart but they told me she'd be fine. They should give you a list of symptoms to look out for just in case, if they don't, you should probably ask.   

Geoffrey said:

 
I am sorry but Red Top Rescue is not correct about GP vets using ultrasound in their practice.  Ultrasound scans bounce ultrasound off the abdominal structures and they are indeed used for viewing unborn foetuses in the uterus and also for viewing other abdominal structures, such as the kidneys and the bladder.  However they are far from being simple.  An obstetrician would interpret the first and a radiologist the latter. (These scans can best be likened to shining a torch into a dark room, only they would use a beam of ultrasound instead of a beam of light. )

Specialised Doppler ultrasound machines are used to look at blood vessels and determine blood flows, but this again is quite different again from echocardiographs or ultrasound  - they are usually interpreted by radiologists.  

With all best wishes,

Geoffrey

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Geoffrey, I hate to differ with you, but in the United States, ultrasound machines are quite common in GP VETs offices. 

A GP VET will use an ultrasound for a quick look at the bladder; to check for stones, and location for a urine specimen; 

a look at the number of fetuses; and an unofficial quick look at the belly; and as you have said, a look at the kidneys. 

I know my Vet volunteered time up at the hospital, learning how to do this. Some Vets just learn by not the job training. 

Yes, I would prefer to have a specialist perform a scan, but for a quick look, I see not reason why the GPVETS cannot use it. 

Look at the small, portable held-held units they have in Human Emergency Rooms. The ER doctors are the ones who use it. There is no difference between that and a GPVet using one.

Also, the doppler program and color doppler is standardized in all adult ultrasound machines. 

You can get an inexpensive one without it, but those are not used by people specifically trained in ultrasound.

I have been involved in ultrasound since 1979, radiography before then. I have seen gigantic changes in the field. 

(hugs)

Artiemom said:

 

Geoffrey said:

 
I am sorry but Red Top Rescue is not correct about GP vets using ultrasound in their practice.  Ultrasound scans bounce ultrasound off the abdominal structures and they are indeed used for viewing unborn foetuses in the uterus and also for viewing other abdominal structures, such as the kidneys and the bladder.  However they are far from being simple.  An obstetrician would interpret the first and a radiologist the latter. (These scans can best be likened to shining a torch into a dark room, only they would use a beam of ultrasound instead of a beam of light. )

Specialised Doppler ultrasound machines are used to look at blood vessels and determine blood flows, but this again is quite different again from echocardiographs or ultrasound  - they are usually interpreted by radiologists.  

With all best wishes,

Geoffrey

Click to expand...

Geoffrey, I hate to differ with you, but in the United States, ultrasound machines are quite common in GP VETs offices. 

A GP VET will use an ultrasound for a quick look at the bladder; to check for stones, and location for a urine specimen; 

a look at the number of fetuses; and an unofficial quick look at the belly; and as you have said, a look at the kidneys. 

I know my Vet volunteered time up at the hospital, learning how to do this. Some Vets just learn by not the job training. 

Yes, I would prefer to have a specialist perform a scan, but for a quick look, I see not reason why the GPVETS cannot use it. 

Look at the small, portable held-held units they have in Human Emergency Rooms. The ER doctors are the ones who use it. There is no difference between that and a GPVet using one.

Also, the doppler program and color doppler is standardized in all adult ultrasound machines. 

You can get an inexpensive one without it, but those are not used by people specifically trained in ultrasound.

I have been involved in ultrasound since 1979, radiography before then. I have seen gigantic changes in the field. 

(hugs)

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I am not surprised, it only goes to show the difference between US and Australia.   In Sydney there are specialist Cat Veterinary Hospitals with Physicians, (one of whom initially arranged a blood transfusion on my greedy Siamese, Kerry, and took the blood from Kerry's brother, Rupert. ( Kerry had eaten a rat poison bait and eventually died of cerebral haemorrhage.)

These Hospitals are fully equipped with echocardiograms and all the specialist scan equipment, together with a Radiologist and X-Ray equipment and vets find it easier to refer to these.  It is obviously different in places where there is less competition and even single vet towns, but I cannot comment on these!.

You wrote: <Look at the small, portable held-held units they have in Human Emergency Rooms. The ER doctors are the ones who use it. There is no difference between that and a GPVet using one.>

These are probably used by vets in remote areas, it would make a lot of sense, but again, I have no specific knowledge. 

With Best wishes,

Geoffrey

@Geoffrey  They are specialized Veterinary hospitals in the United States; a lot of them. I am fortunate to live near Boston which has many large Human and Veterinary Hospitals. 

The Vet hospitals are just like human hospitals. They have specialists; and an emergency room. They also do water physical therapy for animals. I am amazed at that. 

My guy had an endoscopic biopsy, done by an Internal Medicine Vet, and and ultrasound, which was read by a radiologist. The biopsy was interpreted by a pathologist. They also have a pharmacy and a specialized compounding pharmacy.

Artie periodically sees an IM Vet as well as his GPVEt. This is trading an animal as if they were human. I have come to find out that a cat is very familiar to a human, as far as medicine goes. Not completely, but fairly. My limited knowledge of medicine has helped me a lot to understand what is happening to him. 

Yes, there are some Vet practices out here where there are only one or two Vets in a town or city. That is usually in rural locations.

The only way I can explain it is that we, as humans can have one physician for general practice, but for complicated issues we go to a specialist and go to a hospital for tests. For cats and other animals, it is the exact same thing. 

Really not much of a difference between Australia and the US. It is just that the technology is more wide spread. It is up to the physician as to what level of practice they want. 

As for you, with your chosen profession: I am in awe of anyone who can read and EKG!! I just think they are squiggly lines!!    As much as I have tried, I still cannot get the hang of it!!

I envy you!! I really do forget why your profession title is.. could you please tell me?

I found cardiology to be very difficult. I am trained in general ultrasound but specialized for almost 20 years in maternal-fetal-medicine. You have to know a lot about everything. I found the heart to be the most difficult to understand. and of course the brain!! 

Perhaps because some days I go around saying I do not have a brain!!

But this is really getting off topic    I guess we could discuss more, if you wish in a PM..



@Lilin ,   I apologize for confusing you..

I sincerely hope we did not get you more confused. You really needed some explanation and thought on a heart murmur. 

I am thinking we really confused you..

Please let us know what you have decided and the the outcome of your kitty...That is the prime reason you are here. 

Wishing you all the best with Miss Pia.--- cute name. 

(((hugs)))

Ha ha ha, it's ok, no problem" I think I followed all that fairly well, actually. I do ok for a layperson.

I'm now living in the UK actually, and I just haven't updated my location on the site yet.

I think it's reasonably similar to the US, but GP vets tend to have slightly fewer resources in their general offices. I think this is simply due to space -- I live in London, so buildings are much smaller.

As I said, I will double check that he meant an echo when I call in on Monday. I'm glad I got to check in here!