The Recommended Approach to the Coughing Dog with a Murmur - Brought to you by Boehringer Ingelheim

What’s the latest evidence on diagnosing, treating, and monitoring a canine patient with a heart murmur and cough? While many veterinarians instantly associate heart murmurs and coughs with pulmonary edema, differentiating a true “cardiac cough” from other causes of heart and respiratory diseases is essential for successful clinical outcomes.
Dr. Ernie Ward, VerticalVet’s Chief Veterinary Officer, is joined by Colorado State University cardiologist, Dr. Lance Visser, to discuss the latest research and findings about left-sided heart enlargement, myxomatous mitral valve disease (MMVD), and “cardiac cough” in dogs.
Vetmedin (pimobendan) usage with or without diuretics (e.g., furosemide), performing a vertebral heart score (VHS), and vertebral left atrial score (VLAS) are also reviewed.
Some of the topics covered include:
What is a "cardiac cough,” & what causes the cough?
Are there characteristics from the history or physical exam that are specific to a "cardiac cough"?
What are the common causes of chronic cough in dogs, and what's the recommended approach in dogs with murmurs?
When should cardiac medications (e.g., pimobendan, furosemide trial) be started in coughing dogs with a murmur?
What are some key clinical features that help differentiate left-sided congestive heart failure secondary to MMVD from MMVD+airway disease?
About Our Guest:
Lance Visser, DVM, MS, DACVIM (Cardiology) Associate Professor of Cardiology
Dr. Visser is from Grand Rapids, Michigan. He obtained a combined DVM/MS in 2010 from Michigan State University. He then completed a small animal rotating internship at NC State University in 2011, followed by a combined residency/MS program in cardiology at The Ohio State University in 2014. Dr. Visser is currently an Associate Professor of Cardiology in the Department of Clinical Sciences at Colorado State University. Dr. Visser is an award-winning educator and has a passion for helping veterinarians with the clinical management of patients with heart disease.

[@Gilly-gx8rt]

This was so informative. Thank you. My dog was wrongly diagnosed with heart failure 2 years ago. I wasn’t convinced & asked for a cardiology referral- Her heart was not enlarged. Heart worm etc was ruled out. Steroids were the only thing that helped stop the cough. Now 2 years later the vet is pushing vetmedin again. Her resting breathing rate is 20 breaths per min. Time for another cardiology referral & an X-ray.

[@dennismalone6303]

This was a great conversation to see as I am dealing with my 17-year-old Chihuahua with coughing and a heart murmur diagnosed through an echocardiogram. His breathing rate recently went up to about 33 breaths per minute, but after a few days of medication and a lot of rest it’s down to 20.

[@Roswell33]

Ok but what do we do about lung/tracheal cough? Everytime I go to my vet they talked me into Gabapentin for my dog and I kept trying to say it's making him ill but they don't listen, he was having syncope daily on it, I took him off Gabapentin and it went away but a mild version of the cough stayed and last night it was BAD I don't even trust my vet to help.. Now I don't know what to do as they generally say or do something I don't agree with but I'm not medically trained

[@franceslynch8815]

It can take a while for side effects to wear off. But you know your pet best and it's hard to see them uncomfortable/sick after they react to a new medicine. You could ask your vet for a different cough reliever or even a short term one, if possible, when it gets bad. Then You can always try another vet and explain everything you went through and how sick your pet was on the previous medication, if no help from your own vet. My own pet is on cardisure and was given a new heart meds that made her sick. When I rang saying I'd to stop it, I was told "but she's only on a very small dose". How this response addressed my pet being sick and my report of it had me bewildered. As if the small dose could not have made her sick. The 2½mg of Fortekor put her in a heavy sleep with odd limb spasms, twitching, panting, nightmares, vocal dreams and disorientation after waking and lethargic for rest of the day. I couldn't do this to her anymore after 3 days. I really hope you get your pet relief for their cough. Side effects are uncommon (my pets never has reactions until this one). And medications can make their lives comfortable and more bearable living with sicknessl so I really hope your beloved pet finds relief soon.

[@vha3742171]

My dog died from chf. He had a 4 heart murmur than started to cough.