Health
What murmur grade needs an echocardiogram?
Most practices image at grade III and above, or at any grade if the dog has a cough, fainting, or a rising breath rate. Grades I and II in a well dog are often monitored.
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Chow Chow Heart Murmurs: Reading the Finding You Just Got
Quick answer
What murmur grade needs an echocardiogram?
Most practices image at grade III and above, or at any grade if the dog has a cough, fainting, or a rising breath rate. Grades I and II in a well dog are often monitored.
Grades run from I to VI, and the number your vet says out loud in ten seconds decides how urgently everything else needs to happen.
Owners who left the clinic with a number and no explanation, and owners of older Chows whose murmur has been described differently by two different vets and who cannot tell whether it has genuinely changed.
Important reminder
This guide is not medical advice. If your dog shows pain, sudden behavior change, or worsening symptoms, consult a licensed veterinarian.
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What this problem looks like
A heart murmur in a Chow Chow is a finding, not an illness. The task is to work out whether the turbulence comes from a structurally abnormal valve, from a temporary state such as fear or anaemia, or from an unrelated problem such as thyroid disease. Most owners meet the word for the first time in a routine appointment and leave with more anxiety than information.
Common triggers
- Fear or restraint at the clinic raising heart rate and turbulence
- Anaemia from any cause thinning the blood
- Fever or acute illness on the day of examination
- Thyroid disease, which is documented in this breed
- Age-related degeneration of valve tissue in senior dogs
Because cardiac disease is not among the ten documented Chow Chow health issues, murmurs in this breed are usually age-related or incidental rather than inherited. They become steadily more likely across a lifespan that commonly runs from nine to fifteen years, as valve tissue changes with age in any medium-sized dog.
Why this happens
Breed factors
The Chow contributes less to the murmur itself than to how reliably it gets heard and interpreted. A grooming rating of 5 out of 5 reflects a coat dense enough to damp heart sounds, so grade assignment on this breed is systematically conservative unless the coat is parted. A stranger-friendliness rating of 2 means most Chows arrive at the clinic tense, with an elevated heart rate that exaggerates turbulence. Documented thyroid disease provides a genuine non-cardiac route to an abnormal sound.
Environment factors
Busy consulting rooms with barking in the background make soft murmurs undetectable, so the same dog can be graded differently by the same vet on a quiet Tuesday and a chaotic Saturday. Rotating between clinics removes the continuity that makes grade comparison possible. And in households where a low-energy dog is only brought in when visibly unwell, murmurs get discovered late and without any prior grade to compare against.
What you can do at home (once it is not an emergency)
When to talk to your vet
A murmur alone is rarely an emergency, but the signs that turn it into one are: collapse, breathing with the mouth open at rest, standing with elbows out and neck extended, frothy or pink discharge from the nose or mouth, or a sleeping breath rate above forty. Any of those means today. Do not try to judge by gum colour, because Chow gums and tongue are naturally blue-black and will not show pallor or cyanosis reliably. Arrange a normal appointment within a week or two for a new grade, a cough that starts after lying down, a breath count trending upward, or a puppy murmur still present at sixteen weeks.
At home, alongside your vet's plan
- Keep a single running note of every murmur grade with its date, the clinic and the vet, so change is measurable rather than remembered.
- Ask for the coat to be parted over the left chest before the vet listens, since dense undercoat genuinely mutes the sound.
- Book appointments at quiet times of day and arrive early enough for your dog to settle before the exam.
- Take a weekly sleeping breath count so a recheck has a trend behind it instead of a single number.
- Bring a short phone video of any coughing or unusual breathing at home, because those episodes never happen in the consulting room.
More Chow Chow health & behavior issues
- Chow Chow Heart Conditions: Spotting Trouble in a Stoic Breed
- Chow Chow Heart Problems: What Exercise Reluctance Really Means
- Chow Chow Kidney Disease: Early Detection and Daily Management
- Chow Chow Kidney Stones and Urinary Stones: Types and Emergencies
- Chow Chow Liver Shunts: What Owners Actually Pay
- Chow Chow Pancreatitis and Diabetes: One Organ, Two Failures
- Chow Chow Pancreatitis: The Praying Position and the Holiday Trigger
- Gastric Dilatation-volvulus (GDV/BLOAT) in Chows
- Intervertebral Disc Disease (IVDD) in Chows
- Intervertebral Disc Disease (IVDD) Type I in Chows
- Chow Chow Eye Disorders: What Hides Behind the Fur
- Chow Chow Gastrointestinal Disorders: The Slow-Burn Stomach
- Chow Chow Hip Dysplasia: Signs, Management and Honest Outcomes
- Chow Chow Hypothyroidism: Coat, Weight and Testing Pitfalls
- Chow Chow Luxating Patellas: The Skip Step and What Grades Mean
Heart Murmurs in other breeds
- Cocker Spaniel Heart Murmurs: Signs, Lifespan & Treatment
- Dachshund Heart Murmurs: Signs, Lifespan & Treatment
- English Cocker Spaniel Heart Murmurs: Signs & Treatment
- German Shepherd Heart Murmurs: Signs, Lifespan & Treatment
- Great Dane Heart Murmurs: Signs, Lifespan & Treatment
- Havanese Heart Murmurs: Signs, Lifespan & Treatment
- Jack Russell Terrier Heart Murmurs: Signs & Treatment
- Labradoodle Heart Murmurs: Signs, Lifespan & Treatment
- Maltese Heart Murmurs: Signs, Lifespan & Treatment
- Miniature Schnauzer Heart Murmurs: Signs & Treatment
See all Chow Chow health problems, which breeds are prone to heart murmurs, or the full Chow Chow breed guide for temperament, exercise needs and ownership costs.
What to expect, and how you know it is working
A low-grade murmur in a well dog is typically rechecked in six months. If imaging is indicated, expect one to four weeks to get it done. Grades are compared over years, not weeks, so the value of good record-keeping only shows up much later.
Success is knowing the murmur's grade, its likely cause, what would make it matter, and when the next check falls. It is not the murmur disappearing, because most do not.
How murmurs are graded, I through VI
Grading is subjective and depends on the listener, the room and the dog's heart rate, which is why the same murmur can be called a II by one vet and a III by another. Written records over time beat any single opinion.
- Grade I. Barely audible, and only after listening carefully in a quiet room. On a Chow this is the grade most likely to be missed entirely if the vet listens through the coat rather than parting it.
- Grade II. Soft but heard immediately once the stethoscope is in place. Very often monitored rather than imaged, provided the dog is otherwise well.
- Grade III. Clearly audible and moderate. This is usually the threshold where imaging stops being optional in most practices.
- Grade IV. Loud, with no palpable vibration through the chest wall. Expect a same-month referral conversation.
- Grade V and VI. Loud enough that a vibration, called a thrill, can be felt with a hand on the chest. Grade VI is audible with the stethoscope lifted slightly off the skin. Both warrant prompt cardiology input.
Innocent murmurs, and murmurs that are really something else
Puppies can have soft flow murmurs that vanish by around sixteen weeks. These are innocent, and the correct response is to recheck rather than to panic or to cancel a purchase. If a Chow puppy's murmur is still there at five months, or is louder than a grade II, it has stopped being innocent and needs looking at.
Anaemia produces murmurs by thinning the blood so it flows turbulently through perfectly normal valves. So does fever, and so does the adrenaline of a frightened dog. A Chow rated 2 out of 5 for stranger tolerance who has been restrained by two unfamiliar people has a heart rate far above baseline, and that alone can make a soft murmur audible or a moderate one sound worse. A recheck on a calmer day, ideally by the same vet, is a genuinely useful test.
The last confounder is thyroid disease, which is on this breed's documented health list. Thyroid hormone drives heart rate, and both too much and too little change what the chest sounds like. A basic blood panel is often the cheapest step between hearing a murmur and understanding it.
Two vets, two grades, one quiet room: Tofu's recheck
Tofu, a seven-year-old Chow, was graded II at his regular clinic in March and IV at an out-of-hours visit in July for an unrelated paw injury. His owner Ines went home convinced the murmur had doubled in six months. Her own vet asked one question: how was he behaving at the emergency clinic. Tofu had been muzzled, held by two nurses, and panting hard. At a booked appointment on a quiet weekday, with the coat parted and the room silent, he graded II again. Ines now books rechecks for first appointment of the morning, and the note in her phone lists grade, date and clinic. The murmur has read II or low III for three years running.
Key takeaway: Context changes the grade. Compare murmurs measured under similar conditions, and treat a jump recorded during a stressful emergency visit as a question rather than a verdict.
Frequently asked questions
Does a murmur mean my Chow Chow has heart failure?
No. Most dogs with murmurs never develop failure, and many carry the same low-grade murmur for years without symptoms. Failure is defined by fluid backing up into the lungs or abdomen, which is a clinical picture, not a sound.
Why did one vet say grade II and another say grade III?
Grading depends on the listener's ear, the ambient noise, and how fast the dog's heart was beating at that moment. On a heavily coated breed it also depends on whether the coat was parted. Ask for grades to be written down, and where possible see the same vet for rechecks.
My Chow puppy has a murmur. Should I return the puppy?
Not on that alone. Soft flow murmurs in young puppies commonly resolve by about four months. Ask the breeder to put in writing that they will take the puppy back if it persists, book a recheck at sixteen weeks, and make the decision then with information instead of now with anxiety.
Can the double coat hide a murmur?
It can mute one. Dense undercoat sits between the stethoscope and the chest wall and damps the sound, which pushes a genuine grade II toward sounding like a grade I. Parting the coat over the left chest takes seconds and is worth asking for.
What symptoms would tell me the murmur has started to matter?
A cough that appears when the dog lies down, a resting or sleeping breath rate that climbs above thirty, reduced appetite, a fuller-looking belly, or any fainting. Those move the situation from a sound to a condition.
Does a murmur affect anesthesia for a dental or spay?
It can change the drug protocol, the fluid rate and the monitoring. That is a reason to disclose it clearly, not a reason to skip needed dental work. Ask what the murmur means for the specific procedure being planned.
Quick answers
View more answersBehavior
Can a scared Chow's murmur sound worse than it is?
Yes. Fear raises heart rate and turbulence, and this breed scores 2 out of 5 for stranger tolerance. A recheck on a calm day is a fair request.
Health
Do puppy murmurs go away?
Soft flow murmurs often resolve by around sixteen weeks. One still present at five months, or louder than grade II, needs investigation.
Health
What should I write down after the appointment?
The grade, the date, the vet's name, and where on the chest it was loudest. That four-item note makes the next comparison meaningful.
Related DogBreedCompass guides
- Chow Chow heart disease workup – Readers who understand the grade next want the diagnostic pathway.
- thyroid problems in Chow Chows – Thyroid disease is a documented breed issue that changes cardiac findings.
- Chow Chow heart conditions overview – Detection depends on how a stoic, low-energy breed is monitored at home.
- Chow Chow breed profile – Grooming access to the chest wall is part of routine coat care.
- Chow Chow cost breakdown – Imaging and rechecks change the yearly budget for this breed.
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