Page 33 - WSAVA2018
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Further investigation
Many factors may determine whether or not a dog will undergo further investigation.
Factors to consider include the following.
Your Singapore, the Tropical Garden City
 More likely to investigate.....
 Less likely to investigate if....
   Age of patient.
 Younger patient More likely to have definitive treatment and lengthy period of benefit
   Older patient
 Audibility of murmur
 Loud murmur ≥ III/VI
 Quiet murmur
 Timing of murmur
 Diastolic, continuous
 Presence or absence of clinical signs.
  Clinical signs are present
  Clinical signs are absent
   Intended use of dog
Dog used for breeding or as athlete
  Sedentary neutered dog
 Level of owner anxiety
  Owner anxious to know cause of murmur
  Owner happy to wait and see
   Anticipated cardiovascular stress
 Patient likely to be anaesthetised or receive fluids in near future
   Patient not expected to undergo any CV stress
   What is the best method of investigation?
Usually the initial preferred diagnostic test for investigation of the presence of a heart murmur is echocardiography including Doppler echocardiography. This is often sufficient for a diagnosis to be reached although other tests may be required to determine the severity and impact of the patient’s disease.

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