"I've re-read the information I have on MVD, and unless I misunderstood it,
it states that the dog should be put on medication (enepril?), even w/o
symptoms."
Kris,
You are in the same boat that many Cavalier owners are because when you
want to argue starting ace inhibitors (i.e. enalapril) for afterload
reduction prior to symptoms, there are studies that support this and studies
that support waiting until symptoms appear. It makes the decision very
difficult when different research negates the others and the opinion of your
vet or cardiologist frequently depends on what research he is emotionally
connected to or was involved with conducting in the past. Certainly for a
grade 1 or 2 murmur that is asymptomatic, I agree with Carol and I'm not
aware of any research that supports starting them at that low grade. There
are enough side effects of ace inhibitors, one being renal insufficiency
over long period usage that it doesn't really support starting a dog with
such a low grade murmur. Now if you had a grade 4 murmur, it makes the
decision a little more grey, but at the same time there is no way to
guarantee that the rate of progression will be rapid and could be delayed
with ace inhibitors. This is why it is so important to look at not only the
age of onset of a murmur but also the rate of progression - look at the
ancestors and see: Did they stay at grade 1 for 10 years and progress over
their last year? Did they go from 1 to 2 to 3 to 4 very slowly and once
they hit 4 progressed to end stage failure in a year?
This again certainly doesn't guarantee anything, but it helps you guess what
might happen. Someone I knew very well years ago had imported a bitch that
didn't get a murmur until she was 7 1/2 years old, but she was dead from
heart failure before she was 8. Meanwhile, Char neutered her old boy Basil
when he was 2 1/2 because he had a murmur and it progressed to a 4 when we
had to put him down for arthritis and his inability to move around 3 months
shy of 17. There are just no guarantees are there?
best of luck,
Lamont Yoder
Sunbury, Ohio
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