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We grade heart murmurs based on how loud they are on a scale of 1-6.
A grade 4/6 murmur is relatively loud, but doesn't necessarily mean that your dog has heart disease requiring treatment.
A new heart murmur is basically a red flag, informing us that we need to do further diagnostic testing to see if any treatment is required at this point.
The next step is an echo - ultrasound of his heart. This will look for the cause of that sound (often turbulent blood flow through a valve that isn't closing effectively). The most common cause in aging dogs is mitral valve regurgitation.
Echo with a cardiologist can let us know if medications would be a good idea to treat or slow progression of heart disease.
Is he having any problems with coughing or intolerance for exercise?