Abstract
BackgroundCardiac auscultation is an important screening test at the first health examination of puppies because most clinically relevant congenital cardiac anomalies cause a loud murmur from birth. This retrospective study aimed to investigate the age at which dogs with suspected congenital cardiac anomalies were referred to a veterinary cardiology specialist for murmur investigation. A secondary aim was to establish the time interval between the visit to the cardiologist and the first available murmur documentation. The digital archive of a veterinary teaching hospital was searched for dogs with congenital cardiac anomalies and puppies with innocent murmurs during a 5-year period. Dogs had to be referred because of a murmur, and they had to undergo physical examination and echocardiography by a veterinary cardiology specialist. The health certificate section of the pet passport, and the medical records from the referring veterinarian, were reviewed to identify the date when the murmur was first documented.ResultsOf the 271 included dogs, 94% had a congenital cardiac anomaly and 6% had an innocent murmur. The dogs’ median age was 190 days when they were examined by the cardiologist. Only 10% of the dogs were referred by the breeder’s veterinarian, while 90% of the dogs were referred by the new owner’s veterinarian. The median age of the first available murmur documentation by a first opinion veterinary practitioner was 95 days.ConclusionsOnly 10% of the puppies in the present study were referred to a veterinary cardiology specialist for murmur investigation before they were sold to a new owner. Referral prior to re-homing would have been feasible if the murmur had been detected and documented by the breeder’s veterinarian, if referral was offered by the breeder’s veterinarian and the referral was accepted by the breeder.
Highlights
Cardiac auscultation is an important screening test at the first health examination of puppies because most clinically relevant congenital cardiac anomalies cause a loud murmur from birth
The same holds true for severe congenital valvular pulmonic stenosis, where asymptomatic dogs have a better prognosis after a successful balloon valvuloplasty compared to dogs that already show cardiac-related clinical signs [7, 15, 18]
Exclusion criteria were: (1) dogs where the veterinary cardiology specialist diagnosed a congenital cardiac anomaly, but the dog was brought to the clinic for screening, without a referral by another veterinarian; and (2) dogs where the veterinary cardiology specialist diagnosed a congenital cardiac anomaly, but the reason for referral was not, or did not include, a previously recognized cardiac murmur
Summary
Cardiac auscultation is an important screening test at the first health examination of puppies because most clinically relevant congenital cardiac anomalies cause a loud murmur from birth. This retrospective study aimed to investigate the age at which dogs with suspected congenital cardiac anomalies were referred to a veterinary cardiology specialist for murmur investigation. Of the three most prevalent congenital cardiac anomalies in dogs (i.e., aortic stenosis, patent ductus arteriosus and pulmonic stenosis), both left-to-right shunting patent ductus arteriosus and severe pulmonic stenosis are effectively treatable conditions and they typically cause loud murmurs [2, 7, 9, 14,15,16,17,18]. Last but not least, selling a puppy with an unrevealed congenital cardiac anomaly can have remarkable emotional and financial consequences for the new owner and for the breeder, as well as legal sequelae for the breeder’s veterinarian who performed the first health screening [3]
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