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heart murmur in a dog
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heart murmur in a dog

i have an 11 yr old beagle shih tzu mix (male).  he is very active, loves going for walks, jumping on furniture, etc.   our veterinarian of 25 years just retired and a new vet took over the practice.  this was our first visit with the new vet.  she listened to my dog's heart and said he had a heart murmur.  she asked if he ever coughs, tires easily or gets winded and i replied no.  she said just to keep an eye out for symptoms and she will listen to his heart when he comes in for routine shots, etc.  as i said, my dog is very active and has absolutely no symptoms of a murmur.  here are my questions:  is a wait and see approach ok for something like this if he has no symptoms?  would he need heart medication if he has no symptoms?  are heart murmurs ever misdiagnosed by a veterinarian (saying he has one when he does not)?  my dog gets very nervous at the vet's office so i'm sure his heart was racing.  we are planning to take the dog to another vet for a second opinion.  i am very scared and worried about this!  
Type of Animal
:  
dog
Age of Animal
:  
11
Sex of Animal
:  
Male
Breed of Animal
:  
beagle - shih tzu mix
Last date your pet was examined by a vet?
:  
January 26, 2010
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Thanks for coming to MedHelp.org, I can tell you are very concerned.  It is not uncommon for older dogs to have heart murmur's and be as-symptomatic.  Especially smaller dogs.  A heart murmur is nothing more then an abnormal sound when you auscultate (listen to) the heart with a stethoscope.  The most common clinical signs that you see are the ones that your veterinarian described.  Coughing and tiring easily.  Their are 2 approaches one could take.  First would be the conservative approach.  That would be the watch and monitor approach that your veterinarian suggested.  Many dogs live their whole lives with heart murmurs and never have a problem.  The second approach would be to do some base line diagnostics.  In this approach I would recommend x-rays and an echocardiogram (an ultrasound of the heart).  I think in your case this would probably be a better approach.  This way you can know exactly what is causing the murmur and if you need to treat it.  I would probably start by having another discussion with your current veterinarian and letting them know you would feel more comfortable with more information.  Ask them if they are comfortable interpreting an echocardiogram.  Most veterinarians feel comfortable looking at chest x-rays but reading an echocardiogram may require a specialist.  If thats the case they may have a mobile Board Certified Radiologist that comes to their practice or they may want to refer you to a cardiologist.
So to answer your questions.
1) Yes a wait and see approach is acceptable but I would prefer more information like the chest xray and echocardiogram.  As a rule of thumb unless your dog has an erratic heart beat you probably don't need an EKG.
2) Different veterinarians have different opinions on weather to treat as-symptomatic dogs.  Some believe yes and some believe no.
3) Anything can be misdiagnosed but heart murmurs are usually not.  
Finally I would like to reemphasize not to panic.  This is a common problem in older dogs and many live with it just fine.
Hope this helps.
Let me know,
Thanks,
Dr Vicksman
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