Phoebe, the siamese kitten, was the adored baby of my brother-in-law, David’s, family. When she was not riding shotgun on David’s shoulder she served as the family lap cat, passed shamelessly between David, his wife, Deborah, and their kids, Mia and Robin.
Phoebe accomplished more in her first few months than some humans achieve in a lifetime. Her youthful fearlessness so disarmed her older fur brother, Chili P., that an almost immediate armistice was signed. She was also a social media influencer; David’s extended family could barely get through the day without seeing her little clown-face splattered over a flurry of texts. In our COVID world, she was the coolant to everyone’s overheated jets.
Nestled less than two months into her family’s heart, Phoebe became listless and showed signs of respiratory distress. An exam revealed that she had a heart murmur. The cause was not immediately apparent. It was recommended that she be closely monitored.
A murmur is the sound of excessive blood flow turbulence in the heart. It is usually perceived with the use of a stethoscope. In severe cases, it may be palpated in various places across the thoracic region. Murmurs are “graded” by intensity, the time in which they occur in the heart cycle, duration, location and where they sound the loudest. These characteristics, in the setting of a pet’s specific symptoms, help to determine cause.
There are two types of heart murmurs. Physiologic (“innocent”) murmurs show no apparent evidence of heart disease. They are often softer-sounding and occur intermittently, possibly in conjunction with anemia and/or excitement. These kinds of murmurs are often seen in puppies (disappearing by 12-15 weeks old) or cats of any age. Pathologic murmurs are chronic and due to structural/disease process within the heart. Murmurs can be congenital (heart defects present since birth) or acquired (developed over the course of life).
Murmurs may be caused by heart valves not opening or closing properly or the presence of a hole in the heart between two chambers or two arteries that are not normally connected. Stenosis (narrowing) of a heart vessel or chamber and the vibration of cardiac structures as blood passes through them may also precipitate murmurs as could the afore-noted anemia and overexcitement.
In cats, murmurs usually occur during the systole phase of the heart cycle when the heart is contracting to pump blood out from the left ventricle through the aorta.
Most heart murmurs in dogs are due to a leaky mitral valve which connects the left atrium with the left ventricle. Murmur type in dogs can often be diagnosed by listening with a stethoscope, but not so with cats. Imaging such as x-rays or heart ultrasound may be indicated depending on the individual case.
Treatment usually involves the underlying cause — depending upon the type and severity of of the pet’s symptoms, and other circumstances (age, quality of life, cost of treatment and other factors). Treatment is diagnosis-based and may include specialized diets, medications, and/or supportive care.
Phoebe’s respiratory episodes increased in frequency and intensity such she was rushed to an ASPCA clinic. A veterinarian there told David and his family that her prospects for symptom management and quality of life were miniscule. Sadly, Phoebe was not able to return home.
The diagnosis of a murmur is not necessarily a death sentence, though it often means that a pet will need extra doses of TLC throughout the course of his/her life. Phoebe got that much and more and returned a priceless gift: the knowledge that the depth of love for family defies chronological time.