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Hi Karen, I am so sorry to hear that Jack is not well.
From what I've read in your original post, Jack is not seeing nor hearing well, he has an advanced heart murmur, he paces quite a bit but still maintaining normal function.Your post mentioned coughing, but wasn't explicit. Is he coughing?Has any labwork been run to determine if there is any organ dysfunction or other abnormality?
Is Jack otherwise comfortable?
With this additional info, I'll be best able to help you.