Back from the vets: The aftemath

Yesterday morning I set off with the children for school, with Smudge, Toby and Primrose along with us, because after dropping the children to school it was out to Bideford to see a Cardiologist vet for their annual heart checks. 

Smudge, Toby and Primrose in the car ready to go and get their hearts examined

Having changed vets a couple years ago, I have been visiting Cardiologist Vet Mark Pattersons who is part of HeartVets which is a specialist-led cardiology consultancy service for assessment and treatment of cardiorespiratory problems in veterinary patients, predominantly dogs, cats and horses at one of the clinics he attends near Newton Abbot, but I recently found out that one of his partners Jo Harris comes to a vet clinic in Bideford, which is easier to get to for us. 
My appointment was at 10am and this was the first time meeting Jo Harris, who I found a very pleasant person to deal with. We did the two girls first. Both these Cavaliers are now five years old, with Smudge being six years old this coming Spring, she is the older of the two. World stats tell us that at least 50% of Cavaliers have a murmur by the age of 5 years old. As most Cavaliers a heart murmur is first picked up by a GP Vet and most GP Vets struggle to pick up a murmur by listening for ir until it is a Grade 2 or a 3 murmur, I suspect the figure of 50% of Cavaliers having the first signs of MVD could possible be much higher. Using a Cardiologist vet each year with my Cavaliers we are picking up MVD earlier than GP vets and most often years before it will cause any symptoms for the dog.

The strength or loudness of the heart murmur is graded on a 1-6 scale, where 

​Grade 1-2Soft, faint heart murmur, dogs usually do not show any symptoms at this stage

Grade 3-4Louder murmur, the valve is becoming leakier and your dog may start to cough or show symptoms

Grade 5-6These are advanced stages of heart disease and your dog will be showing symptoms and may have obvious difficulty when breathing

​Smudge went first and the vet could hear a very faint sound on her heart and it was not constant, but she could hear something. So she would have to record that a murmur was heard. She did say that it could possibly be an innocent flow murmur and I decided for piece of mind to have her heart scanned called an echocardiograph to find out the origin of the murmur, because I have two of her crossbreed offspring retained to breed from. So Smudge would have to stay at the vets for the vet to scan her once she had finished the clinic and booking other customers in. We then done Primrose, who also has a very slight sound and was Graded between 0-1. Primrose, we are not breeding from her again and I have kept no offspring back from her, so I felt there was no need to investigate the murmur further at this stage and like her Mum, Ysobel who is close to nine years old and had a slight murmur diagnosed at the same time and as of yet has not progressed further, I suspect this will not cause Primrose any problems for several years hopefully. Lastly Toby had his heart listened to, who is now three years old and he was given the all clear, thankfully.

Diagram given to me to explain the Mitrial Valve prolapse that Smudge has.

So I then left Smudge behind and headed home with the other two and had arranged to come back to pick Smudge up around 2pm. When I got back to pick up Smudge the vet went through what she had found and the sound was coming from a very mild prolapse of the Mitrial Valve with two small jets of mitrial regurgitation. This is causing a murmur that she Graded 0-1 and although I know she explained that this although being MVD it is so mild that Smudge has a very good possibility of making old age without this causing her any problems. For her age and being a Cavalier this is actually classed as a pretty good result. Cavalier breeders need to start being honest about MVD, most Cavaliers will have some onset of this condition as they hit five and just over, unless we start being honest and open things are going to get worse for this breed not better and the Cardiologist vet Jo Harris echoed yesterday what her veterinary colleague Mark Patterson has said to me over the years,that this in the UK is getting worse in Cavaliers not better. We need a breeding protocol for hearts soon or we are going to lose this breed sooner than breeders realize.
​I have published above the diagram that was used to show me what is going on with Smudge's heart and below is the part of the certificate showing the Grade she received yesterday.

Smudge's certificate for grading of her heart.

​In a November 2015 article on the Cavalierhealth.org website, a team of Danish and Swedish cardiologists (A.C. Birkegård, M.J. Reimann, T. Martinussen, J. Häggström, H.D. Pedersen, L.H. Olsen) reported that the Danish Kennel Club's 2001 mandatory MVD breeding scheme has reduced the risk of having a mitral regurgitation murmur caused by MMVD by 73% among 997 cavalier King Charles spaniels. They re-stated Denmark's MVD breeding guidelines as:

1. Dogs examined at 1½ years of age or older were approved for breeding until 4 years of age if cardiac health criteria were fulfilled.

2. To continue breeding after 4 years of age, the dogs had to be reexamined. In January 2007, an additional restriction was added, requiring a reexamination after 6 years of age for male dogs.

3. At all examination time points, dogs were excluded from breeding if they had MVP (mitral valve prolapse by echocardiograph) grade 3 or a mitral regurgitation murmur grade 3 or higher. 

4. Dogs with grade 2 murmurs were excluded if they had:
• MVP grades 2 or 3;
• Mitral regurgitation murmur of 1 at a maximum combined with a MVP grade 2 at a maximum; or 
• A grade 2 murmur combined with a degree of MVP not above grade 1.
• Before 2007, dogs with a grade 3 MVP were approved if they had a murmur grade not above 1.The researchers concluded:
"Our study shows that a breeding scheme based on cardiac auscultation and echocardiography markedly decreased the risk of having a mitral regurgitation murmur caused by MMVD after an 8- to 10-year period. The reduction in risk was only significant for offspring where both parents had been approved by the breeding scheme (PB), not for offspring where 1 or both parents not were approved by the breeding scheme (non-PB). The risk of having moderate to severe MVP (MVP > 1) was not decreased after the 8- to 10-year period, but PB had lower risk of MVP > 1 than did non-PB within the years 2010 and 2011. ... A mandatory breeding scheme based on auscultation and echocardiography findings significantly decreased the prevalence of MMVD over the 8- to 10-year period. Such a breeding scheme therefore is recommended for CKCS."

Using these Danish breeding guidelines you will see that Smudge who has been heart examined every year of her life and at nearly six, has her first signs of very mild MVD, falls within the breeding requirements which are showing an improvement in occurrence and timing of onset of MVD. So I feel that with her two offspring Bumble and Blottie who we have kept back from Smudge's litter with our Brittany Spaniel, Henry, we will see an improvement in heart health. We have to be realistic with MVD. There is no magic wand, it is about putting MVD back into old age with Cavaliers, to many of these beautiful natured dogs, don't even make five years old and without a protocol that figure will rise and rise. 

At Poundlane we don't do health testing to look like we are doing something, crossing the t's and dotting the i's and then use health testing to jack up the price of our pups, we do it with the hope to over time improve health for our dogs.  It cost me £315 on the scheme to scan Smudge's heart yesterday. That don't make a dog breeder a fucking hero though, because Smudge gave me three litters of pups an amazing nine, six and nine adding up to twenty four pups. I've kept two, that we hope to breed from in the future. You do the math. She has more than paid for her keep and much, much more. The heroes at Poundlane are the dogs.

Please sign the petition https://www.change.org/p/the-kennel-club-stop-registerin-g-cavalier-king-charles-spaniel-puppies-unless-their-parents-are-mri-scanned-and-heart-tested Lets save the Cavalier from being bred to death.