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What are the different Heart Conditions in Dogs?

Heart disease is commonly diagnosed in both dogs and cats and the diagnosis can be disturbing and confusing for pet owners. The differences between heart disease and heart failure are important to recognize.

What is Heart Disease?

Heart disease in dogs and cats can take many different forms.

  • Heart disease can be the result of aging changes within the heart which cause the structures of the heart (such as the heart valves) to become malformed.
  • Heart disease can originate in the muscle of the heart.
  • Heart disease can be the result of a developmental abnormality which causes the structure of the heart or blood vessels to be abnormal at birth and remain abnormal.

Heart disease, depending on the type and the severity of the disease, may be asymptomatic, with the pet showing no symptoms of disease at all. However, heart disease can also cause severe symptoms which may fatal for your pet. Symptoms of heart disease can also fall in the middle range, where the dog or cat has symptoms of heart disease but is able to live with the symptoms.

What is Heart Failure?

Heart failure, also often referred to as congestive heart failure or CHF, is the end result of any type of heart disease. Dogs and cats that suffer from heart disease may eventually suffer from congestive heart failure if the disease within the heart results in an inability of the heart to function normally. When the heart is unable to pump blood effectively to other areas of the body, congestive heart failure results.

Dogs and cats can have heart disease without experiencing heart failure. However, when heart failure occurs, heart disease is present in one form or another.


Wendell O. Belfield, DVM
Author of How to Have a Healthier Dog

Jeffrey Feinman, DVM, BA, VMD, CVH
Jeffrey Feinman holds both molecular biology and veterinary degrees from the University of Pennsylvania. Dr. Jeff was the first dual degree recipient at Penn in the prestigious University Scholar program (which was designed to foster medical scientists).

Karen Becker, DVM
Diplomate American Veterinary Medical Association, American Holistic Veterinary Medical Association Academy of Veterinary Homeopathy

Stephen Tobin, DVM
Holistic veterinarian who provides treatment using homeopathy, herbs, and nutrition. He is a veterinary graduate of the Ludwig Maximillian Universitat in Munich, Germany.

Peter Dobias, DVM
Founder and CEO of Dr. Dobias Healing Solutions Inc. Advanced Professional Course in Veterinary Homeopathy. Homeopathic Master Clinician  (human homeopathy)

Steve Marsden, DVM ND MSOM LAc DiplCH AHG

Shawn Messonnier, DVM

Degenerative valvular disease is most common in small breed dogs but can affect large breed dogs as well. It is most common in middle-aged and senior dogs but can be seen less often in younger dogs also.

It is estimated that degenerative valve disease accounts for approximately 75% of all heart disease in dogs.

How the Normal Canine Heart Works

The heart of the dog is divided into four chambers. Unoxygenated blood flows into the right atrium and then through the tricuspid valve into the right ventricle. It then leaves the right ventricle through the pulmonic valve into the pulmonary artery to travel to the lungs. It returns to the left side of the heart after it has been oxygenated. It enters the left side of the heart through the left atrium. From the left atrium, the blood flows through the mitral valve into the left ventricle.

It leaves the ventricle through through the aortic valve to enter the aorta and then flows to the rest of the body.

The valves that are present in the heart are shaped like leaves that cover the openings which they guard. Their function is to open to let blood flow through the opening and then to close off the opening to prevent the blood from flowing backwards and re-entering the chamber which it has just left.

What Happens to Dogs with Valvular Heart Disease

In degenerative valvular heart disease, the valves of the heart become deformed and misshapen. Most often the affected valve becomes thicker than normal. It may start to look more like a knob than a leaf. When the valve becomes deformed, it no longer adequately closes the opening of the heart which it guards when it is closed. When this happens, blood can begin to flow backwards through the valve when the heart contracts instead of moving forward as it should. This is referred to as valvular regurgitation.

The most common valve involved is the mitral valve. Less often, the tricuspid valve is involved. Some dogs can have both mitral valve and tricuspid valve disease. Very infrequently, the pulmonic valve or the aortic valve becomes diseased.

Signs of Degenerative Heart Valve Disease in Dogs

The signs of degenerative valve disease are similar to those seen with many other forms of heart disease.

A heart murmur will be present in almost all dogs with mitral valve disease or tricuspid valve disease. This is often the first sign of a problem. The heart murmur is audible with a stethoscope and may be noticed by your veterinarian during a routine physical examination.

Many dogs with heart murmurs resulting from degenerative heart valve disease show no other signs of heart disease. These dogs may have disease that is progressive and they should be observed and monitored closely for signs of heart disease. However, many dogs with valvular heart disease develop only mild symptoms which do not affect their quality of life.

More specific signs of heart disease depend on which valve is diseased.

Signs of Mitral Valve Disease in Dogs

When the mitral valve is the diseased heart valve, left-sided heart failure will occur because of changes which occur in the left side of the heart.

Left-sided heart failure will cause fluid to build up in the lungs, causing coughing, shortness of breath and an increased respiratory rate as well as more general symptoms such as not eating well, tiring easily and acting depressed.

Signs of Tricuspid Valve Disease in Dogs

When the tricuspid valve becomes diseased, it is the right side of the heart that is affected, leading to right-sided heart failure. Right-sided-heart failure causes fluid to accumulate in the abdominal cavity, causing the belly to have a bloated appearance. It may also cause fluid to build up in the chest cavity outside of the lungs. Your pet’s legs may become swollen also.

When both mitral and tricuspid valve disease is present, you may see a combination of both left- and right-sided heart failure.


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Hearing a heart murmur during a routine physical examination will often be the first hint to your veterinarian that your pet has heart disease. Hearing a murmur is only a hint that something may be wrong (a clinical sign), not a final diagnosis. However, some veterinarian might not recommend a echocardiography or an ultrasound and prescribe Fortekor and Frusemide immediately.

Hearing a murmur is THE reason to consider more discussion and tests to determine the cause of the murmur (the diagnosis). Your veterinarian needs to discuss with you further test after knowing the initial diagnosis. Always request for a EKG electrocardiogram if the veterinarian suspect your pet has heart murmur. Both heart murmur and Degenerative Mitral Valve Disease has very similar signs and symptoms.


In order to determine exactly what is causing the symptoms, your veterinarian must differentiate between a wide range of abnormal heart sounds — split sounds, ejection sounds, gallop rhythms, and clicks, for example. He or she also must differentiate between abnormal lung and heart sounds, and listen to see if timing of abnormal sound is correlated with respiration or heartbeat.

The location and radiation of the murmur, as well as the timing during cardiac cycle, is another way to determine the underlying cause. This can be accomplished by conducting a variety of tests, including chest X-rays, Doppler studies, and echocardiography. A complete blood count, meanwhile, is one of the preferred methods for confirming anemic murmurs. Unless heart failure is evident, your dog will be treated as an outpatient. The course of treatment will be determined based on the associated clinical signs. Puppies with low grade murmurs, for example, may require little or no treatment and the murmur may resolve itself within six months. Routine diagnostic imaging is recommended for dogs with murmurs.


In 2014, during a regular TCM acupuncture session, Dale was seen barking and coughing. The attending veterinarian diagnosed him with Heart Murmur Grade 4. When he returned home, Dale’s mum broke the bad news and there was a huge bag of medicine.

Over the years of helping with pets, we have heard of all sort of stories about how their dogs passed on with improper diagnosis. And something that was imprinted deeply in me is how a small CHH was wrongly diagnosis with heart condition and was prescribed with Fortekor and Frusemide. The story did not went well, and in the bag of medicine, there was Fortekor and Frusemide.

I did not understand how Dale was diagnosed with Heart Murmur Grade 4. We then decided to engage one of the top Ultrasoundgrapher in Singapore to perform a scan on him. God answered our prayers that day. Dale DO NOT have heart murmur grade 4 but his heart is getting old. He was 15 then.

Dale was placed on a special formula of heart supplements eversince. He is 18 in 2017 and we do hope that he stays with us for a couple of years more.

For dogs suspected of heart conditions or diseases, always get a ECG or Ultrasound done before giving your dog any form of medication.

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Coenzyme Q10, fat-soluble substance, which resembles a vitamin, is present in most eukaryotic cells, primarily in the mitochondria. It is a component of the electron transport chain and participates in aerobic cellular respiration, which generates energy in the form of ATP. Ninety-five percent of the human body’s energy is generated this way. Therefore, those organs with the highest energy requirements—such as the heart, liver, and kidney—have the highest CoQ10 concentrations.

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The three types of omega-3 fatty acids involved in human physiology are α-linolenic acid (ALA) (found in plant oils), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) (both commonly found in marine oils). Marine algae and phytoplankton are primary sources of omega-3 fatty acids. Common sources of plant oils containing the omega-3 ALA fatty acid include walnut, edible seeds, clary sage seed oil, algal oil, flaxseed oil, Sacha Inchi oil, Echium oil, and hemp oil, while sources of animal omega-3 EPA and DHA fatty acids include fish oils, egg oil, squid oils, and krill oil.

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A natural ingredient for building new ATP (adenosine triphosphate), D-ribose is an important component of a “cardiac rejuvenation” regimen. Animal studies show that it dramatically increases ATP levels in the critical reperfusion period after a heart attack (the time when blood flow is restored and cells use energy at extremely high levels to repair the damage).

L-Arginie heart conditions murmur disease dogs

L-Arginine is a conditionally essential amino acid found in the diet. It is a dietary supplement used mostly by athletic people because it is the amino acid that directly produces Nitric Oxide via the nitric oxide synthase enzymes. In the body, the amino acid arginine changes into nitric oxide (NO). Nitric oxide is a powerful neurotransmitter that helps blood vessels relax and also improves circulation.

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The U.S. National Library of Medicine considers milk thistle to be a powerful anti-inflammatory, stopping inflammation, which is one of the main causes of heart disease. Milk thistle benefits heart health and helps lower high cholesterol levels by lowering inflammation, cleaning the blood and preventing oxidative stress damage within the arteries.

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Vitamin E improves circulation and promotes normal blood clotting and is known to help the red blood cells to live longer. In the 1940s, Drs. Wilfrid and Evan Shute, who were brothers, began a 40-year study of the effects of vitamin E on the heart. Wilfrid Shute’s research involved dogs as well as humans, for he was a show judge and Doberman Pinscher breeder. Soon, thanks to his efforts, vitamin E improved the health of dogs around the world.

As Wendell O. Belfield, DVM, reports in his classic book How to Have a Healthier Dog, many of these cases were dramatic. In 1945, Dr. N. H. Lambert in Dublin, Ireland, learned of the Shute brothers’ work and began giving vitamin E to dogs, the first of which, a nine-year-old Griffon, was dying of heart disease complicated by an inflammatory uterine condition. Conventional treatment had been unsuccessful. “Placed on vitamin E, she made a spectacular recovery,” Dr. Belfield reports. “Lambert said she became quite rejuvenated and lived for another six years.

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