An echocardiogram for a dog or cat costs roughly $400 to $900, more where a board-certified cardiologist performs it and a full Doppler study is included. It is an ultrasound of the heart: a live image of the chambers, valves and walls, with blood flow measured as it moves.
Most owners arrive here after a routine visit at which a veterinarian listened to their pet's chest, said the word murmur, and suggested a referral. So it is worth being precise about what that means.
A murmur is a sound, not a diagnosis
A murmur is turbulent blood flow the stethoscope can hear. It says something is disturbing flow. It does not say what, where, or how badly.
Some murmurs are harmless — young animals often have innocent flow murmurs that disappear with growth, and anaemia or fever can produce one that resolves with the underlying cause. Others indicate a leaking valve, a hole between chambers, or a thickened heart muscle.
Crucially, loudness correlates poorly with severity. A loud murmur can come from a trivial lesion, and a serious one can be quiet. In cats the relationship is worse still: hypertrophic cardiomyopathy — the most common feline heart disease, and one that can cause sudden death or a devastating aortic thromboembolism — is frequently present with no murmur at all, and some cats with loud murmurs have structurally normal hearts.
This is why an echocardiogram is not an upsell after a murmur is heard. Listening has genuinely reached the limit of what it can tell anyone.
Echocardiogram versus ECG
These are constantly confused, and they measure different things.
- An ECG (electrocardiogram) records the heart's electrical activity. It diagnoses rhythm problems — beats too fast, too slow, or irregular. It says almost nothing about structure. It costs roughly $50–$150.
- An echocardiogram images the heart's structure and function. It shows chamber sizes, wall thickness, valve appearance and leakage, and how well the muscle contracts. It says nothing about rhythm disturbances that are not happening at that moment.
A pet who faints may need both. A pet with a murmur usually needs the echo. And a rhythm problem that comes and goes may need a Holter monitor — a wearable ECG worn for 24 hours — because a five-minute recording will miss an intermittent arrhythmia.
What the echo actually decides
The concrete payoff, and the reason the test earns its cost, is treatment timing.
The most common canine heart disease is myxomatous mitral valve disease, in which the mitral valve degenerates and leaks. It progresses through stages, and there is a specific point — when the heart has begun to enlarge in response to the leak but before any signs of heart failure — at which starting the medication pimobendan meaningfully delays the onset of congestive heart failure.
Identifying that point requires measuring the heart. It cannot be done by listening, and it cannot be done from a radiograph alone. Start too early and you medicate a dog that does not need it; wait until the pet is coughing and breathless and the window has passed. That measurement is what you are paying for.
In cats, the echo distinguishes hypertrophic cardiomyopathy from other causes and identifies the enlarged left atrium that predicts clot formation — which changes whether clot-prevention medication is warranted, and that decision matters enormously given how catastrophic feline aortic thromboembolism is.
What happens during the study
Your pet lies on a padded table, usually on their side, sometimes on a table with a cut-out that lets the probe reach from underneath. A patch of chest is clipped on both sides. The study takes 30–60 minutes.
Sedation is generally avoided where possible, and this is deliberate rather than stoicism: sedatives change heart rate, contractility and blood pressure, which changes the very measurements being taken. Most pets tolerate it well with quiet handling. Where an animal is too stressed to lie still, a carefully chosen light sedation is used and its effect accounted for.
If your pet is in respiratory distress, the full study waits. Oxygen and stabilisation come first — a cat in congestive heart failure can deteriorate fatally from the handling alone — and a brief focused scan answers the immediate question until they are stable enough for the rest.
Free monitoring you can do at home
Count your pet's breaths while they are asleep: watch the chest rise for 30 seconds and double it. A sleeping respiratory rate consistently above 30 breaths per minute is one of the earliest and most reliable signs that fluid is building in the lungs, often appearing before coughing or any visible change in behaviour.
Cardiologists ask owners to track this because it works, it costs nothing, and a rising trend over several days is a reason to call before it becomes an emergency.
How often to repeat it
For a pet on heart medication, typically every 6–12 months, and sooner if the resting respiratory rate rises, exercise tolerance drops, coughing begins, or a fainting episode occurs. For a murmur graded as mild with a structurally normal heart, an annual recheck examination may be enough, with a repeat echo only if the murmur changes.
Cost, itemised
- ECG alone: $50–$150
- Echocardiogram, general practice: $300–$500
- Echocardiogram with full Doppler, board-certified cardiologist: $500–$900
- Cardiology consultation: $150–$300, often bundled
- Chest radiographs, usually taken alongside: $150–$400
- Blood pressure measurement: $40–$100
- NT-proBNP blood test: $100–$200
- Holter monitor, 24 hours: $300–$600
The relevant specialist credential is Diplomate of the American College of Veterinary Internal Medicine in Cardiology (DACVIM–Cardiology), which requires a residency and board examination and is verifiable through the college.
Who isn't a candidate
- Concurrent condition: A patient in active respiratory distress must be stabilised with oxygen and, where indicated, diuretics before a full study — a cat in congestive heart failure can decompensate fatally during restraint.
- Other: Sedation is generally avoided where possible because sedative drugs alter heart rate, contractility and blood pressure, which changes the measurements the study exists to produce.
- Other: Not a contraindication but a scope limit — an echocardiogram assesses structure and function, not rhythm. An arrhythmia needs an ECG or a Holter monitor; the two tests answer different questions.
Common questions
How much does an echocardiogram cost for a dog or cat?
Roughly $400 to $900. A study in general practice runs $300–$500; a full Doppler study with a board-certified cardiologist $500–$900, plus $150–$300 for the consultation. Chest radiographs usually accompany it at $150–$400, and blood pressure or an NT-proBNP blood test may be added.
Does a heart murmur mean my pet has heart disease?
Not necessarily. Some murmurs are innocent, and loudness correlates poorly with severity — a loud murmur can be trivial and a quiet one serious. In cats the picture is worse: hypertrophic cardiomyopathy is often present with no murmur at all. An echocardiogram is what turns a sound into a diagnosis.
What is the difference between an echocardiogram and an ECG?
An ECG records electrical activity and diagnoses rhythm problems, costing about $50–$150. An echocardiogram images the heart's structure and function — chamber size, wall thickness, valve leakage, contraction strength. They answer different questions, and an intermittent rhythm problem may need a 24-hour Holter monitor rather than either.
Does my pet need sedation for an echocardiogram?
Usually not, and it is actively avoided where possible, because sedatives alter heart rate, contractility and blood pressure — the exact measurements the study exists to produce. Most pets tolerate the 30–60 minute scan with quiet handling and a clipped patch on each side of the chest.
How often should a pet with heart disease have an echocardiogram?
Typically every 6–12 months once on medication, and sooner if the sleeping respiratory rate rises, exercise tolerance falls, coughing starts, or the pet faints. Counting sleeping breaths at home — a rate consistently above 30 per minute is a warning — is free and is one of the earliest signs of fluid accumulating in the lungs.
Sources
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