I had the pleasure of going to a recent Continuing Education meeting in Dallas on the ABCDs of Chronic Mitral Valve Disease in dogs. We know that dogs get heart disease, but mostly old dogs get mitral valve heart disease that progresses to Congestive Heart Disease, not coronary artery disease like people that causes heart attacks (but some people do get congestive heart disease too). The valves leak blood backward, which is inefficient for the heart as a pump. This makes the heart work harder, get larger, stretch, and ultimately fail. We can monitor the heart size with radiographs or echocardiography (like an ultrasound of the heart). The back pressure causes fluid buildup in the lungs, which makes the dogs cough and have lower stamina.
As a vet in general practice, I see a lot of old dogs that develop heart murmurs (the turbulence of the leaky valves). Most start out not causing the dog any symptoms, but can progress to congestive heart disease, which shortens dogs’ life and decreased their stamina and quality of life. The average from time of congestive heart disease diagnosis to point of euthanasia is 12 months. We have been looking for years for treatments to slow or stop this progression. Humans have the option of valve replacement surgery, which was pioneered on dogs, but seldom done in pet dogs.
The most common treatment for dogs with CHD is diuretics (water pills), blood pressures medicines, and (in the old days) digitalis to strengthen a weak heart. For the last several years, we have had a new drug called pimobendan ( Vetmedin), and it has replaced digitalis. Worldwide, a large double blinded placebo study called the EPIC study was done which studied the effects of pimbobendan on early congestive heart disease. These dogs had to have a slightly enlarged heart on echocardiography but not symptomatic or on other heart medicines. The study convincingly showed that the dogs on pimobendan hearts got smaller, the onset of any symptoms was delayed, and they lived longer overall. The median life expectancy on the dogs on the placebo was 25 months, but the dogs on pimbobedan life expectancy increased to 41 months, or 16 months of good quality life longer! And the time to first heart symptoms went from 13 months to 21 months. Sign me up for that!
For more information: https://www.epictrial.com/ but when it prompts you if you are a US citizen, click NO so you can see the international findings. If you click yes, it directs you to the website for Vetmedin brand of pimobendan, and doesn’t include these new findings yet.
