Treatment options for heart disease
How are preclinical MMVD and CHF managed?
Currently, there is no cure for CHF caused by MMVD. Surgery to prevent further deterioration is rarely possible in canine patients. Therefore, management of heart failure is most often the approach, with the goals being to improve quality of life and extend life expectancy, usually through daily medication.
The 2009 guidelines from The American College of Veterinary Internal Medicine (ACVIM) recommend that treatment of heart failure begin when the dog shows clear clinical signs of disease (stage C in the visual shown).
Recent results from the EPIC Study, however, show that pimobendan, when administered to dogs in stage B2—before clinical signs of heart failure appear—succeeded in delaying the onset of CHF. These findings suggest that early treatment of MMVD delivers substantial benefits.
STAGE A
No disease is present at this stage.
STAGE B1
Murmur detected but no radiographic or echocardiographic evidence of cardiac remodelling. No clinical signs of heart failure.
STAGE B2
Murmur detected along
with radiographic or echocardiographic findings of left‑sided heart enlargement.
No clinical signs of heart failure.
STAGE C
Structural abnormality and current or previous clinical signs of heart failure.
STAGE D
End-stage heart disease that fails to respond to standard treatment. Clinical signs
of heart failure.
Stages of heart disease and failure from the 2009 ACVIM Guidelines for the Diagnosis and Treatment of Valvular Heart Disease.1