Self-Reported Management of Incidentally Detected Heart Murmurs in Puppies: A Survey among Veterinarians

Abstract

Background: Heart murmurs in puppies can be innocent or pathologic; the latter is almost always related to a congenital heart disease. Differentiating between these murmurs can be challenging for practicing veterinarians, but this differentiation is essential to ensure the best prognosis for puppies having a congenital heart disease. Our study aimed to reveal how veterinarians manage puppies with a heart murmur.

Methods: A web-based questionnaire was sent to Dutch and Belgian veterinary practices.

Results: Data from 452 respondents were analyzed. Though 88% of the respondents find detecting a heart murmur easy, only 9% find differentiating innocent murmurs from pathologic murmurs in puppies easy. Of the respondents, only 80% recommend immediate additional examination when detecting a loud heart murmur during the first veterinary health check at 6 weeks of age. Most of the respondents are aware that normal growth and the absence of clinical signs do not exclude severe congenital heart disease. Of the respondents, 31% were uncertain whether early surgical intervention could lead to improved outcomes.

Conclusions: Veterinarians are aware of the importance of echocardiography for puppies with a loud heart murmur, and recognize their limitations when differentiating an innocent from a pathological heart murmur in a puppy.

Keywords: Amplatz; auscultation; balloon valvuloplasty; catheter intervention; congenital heart disease; dogs; echocardiography; innocent murmur; patent ductus arteriosus; pulmonic stenosis; screening.

Figure 1

This histogram shows the size of the practice where the responding veterinarians work. The size of veterinary practice is categorized depending on the number of veterinary practitioners employed. Respondents working in a practice with 3–5 veterinarians were the most common (37%).

Figure 2

This histogram shows the estimated self-reported number of litters the respondents screen annually at the first health check at 6 weeks of age. The most frequent response was 1 to 5 litters a year.

Figure 3

This histogram shows the estimated self-reported number of newly bought or adopted individual puppies annually that the respondents see in their practice for their second health check at around the age of 9 weeks or later. The most frequent response was 50 to 100 puppies a year.