Medication for heart murmur

[Winnie]

It's been almost 7 years since I last posted here when my previous dog got paralysed. I have adopted another dog, Frappy, 6 years ago. He's about 8 or 9 years old (the owner who abandoned him did not microchip him so we do not know his exact age).

Anyway, took Frappy to the vet for his rabies shot and was told that he has heart murmur. An Xray was taken and the daignosis was Frappy is having an early stage of heart failure with a grade 2 heart murmur and an irregular arrhythmia. My dog is just his normal self, no coughing, no panting (he is not a playful dog though). My point is I would not have known that he has a heart problem but for the health check. As he is on home made diet (tailor made by his nutrientionist), I rejected the idea of prescription diet. The vet suggested that he takes Fortekor from now on. Anyone here knows the drug has any side effects ? Many thanks !!

[critters]

None of my monsters have ever taken meds for heart murmur, so I can't help you there. Welcome back, though!

[CarolC]

Hi Winnie,

Very good to see you again, hi!
Here is what it says in Plumb's Veterinary Drug Handbook, 7th edition (usual disclaimer, this is transcribed, not scanned, please check with your vet).

Benazepril HCL
Fortekor Lotensin

Contraindications/Precautions/Warnings

Benazepril is contraindicated in patients who have demonstrated hypersensitivity to the ACE inhibitors.
ACE inhibitors should be used with caution in patients with hyponatremia or sodium depletion, conronary or cerebrovascular insufficiency, preexisting hematologic abnormalities or a collagen vascular disease (eg., SLE). Patients with severe CHF should be monitored very closely upon initiation of theray.
Potentially, ACE inhibitors could worsen preexisting azotemia; using a lower dose and monitoring creatinine and BUN has been recommended (Bartges 2009).

Adverse Effects

Benazepril's adverse effect profile in dogs is not well described, but other ACE inhibitors effects in dogs usually center around GI distress (anorexia, vomiting, diarrhea). Potentially, hypotension, renal dysfunction and hyperkalemia could occur. Because it lacks a sulfhydryl group (unlike captopril), there is less likelihood that immune-mediated reactions will occur, but rashes, neutropenia and agranulocytosis have been reported in humans.
In healthy cats given mild overdoses (2 mg/kg PO once daily for 52 weeks, only increased food consumption and weight were noted.

[BendyMom]

Welcome back and congrats on your new pup.
i have had many cats with heart murmurs. what i usually do is have a chest echo done, this shows how the heart is functioning, if there is any ventricle enlargement or wall thickening. Depending on what the heart is doing, the critter (sorry critters) in question may or may not need meds. There are a lot of different meds for different heart conditions. If there isn't any enlargement, you don't need to worry about clots.
Jean Claude had a murmur when you listened to his heart, but ultrasound showed it was actually from an eddy in one of the arteries rather than a malfunctioning heart. I would say more information before medication!

[Winnie]

Dear Carol and Bendy Mom,

Thanks so much for the advice. Somehow I didn't receive any notification of your replies.

Anyway, I have been giving my dog supplements prescribed by my doggie's nutritionist : "VetriScience Cardio Strength" and also Hawthorn tinctures. The only sign that I can see is he is losing some weight. But I will take him to the vet early next month to see if his heart is any worsened.

Bendymom, the X ray showed that his heart has enlarged.

Thanks again!!
Winnie

[CarolC]

Hi Winnie,

Personally I'd go with the medication, or at least try it. The way it was explained to me by the vet, x-rays or even a cardiac ultrasound only shows the relative size of the two sides of the heart. You may see one side is bigger than the other, but you cannot see how much enlargement there is overall in comparison to the original size of the heart. If there is enlargement in both sides of the heart, the vet or radiologist will not necessarily be able to tell. There is something called cardiac cachexia which is weight loss associated with cardiac disease. This may or may not apply to your dog, weight loss could be caused by so many things. Here is an article that explains it. I do not know how authoritative it is but as far as I can tell (I am not trained in medicine) it is a good article.

http://www.dog-nutrition-advice.com/wha ... hexia.html

The sound of the murmur is also not enough to really diagnose how significant the heart disease is.

Do all murmurs sound the same?

No. The loudness of a murmur reflects the amount of turbulence that is present in the heart. However, the loudness of a heart murmur does not always correlate directly with the severity of disease

For what it's worth, I have an arrythmia and they put me on a very low dose beta blocker and it made a WORLD of difference. Before the medication I had to keep lying down and could not stand in line at the store or the bank without having to squat down, after the medication I was more normal. I also regained the weight I had lost.

[CarolC]

I have a really good article I'd like to give you. Need to give you a login to read it. Please PM me if you are interested.