What is the Cardiac Education Group (CEG)?

The Cardiac Education Group is a group of board-certified veterinary cardiologists from both academia and private practice that offers independent recommendations for the evaluation and treatment of canine heart disease. The group is committed to providing resources and information on the diagnosis, treatment and management of heart disease and heart failure in dogs and cats in order to promote early detection and diagnosis with greater accuracy and confidence.

What is the mission of the CEG?

The CEG mission is to offer educational recommendations and resources that will help veterinarians diagnose, treat and manage heart disease and heart failure in dogs and cats, improving the lives of pets with heart disease.

What does the CEG aim to promote and facilitate?

  • Educational activities to increase veterinarians’ skills and confidence in diagnosing, treating and managing heart disease and heart failure
  • Tools and resources to help veterinarians detect and diagnose heart disease earlier and with greater accuracy
  • Recommendations to ensure dogs with heart failure receive optimal care and treatments to promote longevity and quality of life
  • On-line resources for veterinarians
  • Collaboration among pet owners and veterinarians pertaining to canine heart health

Who are the CEG members?

John D. Bonagura, DVM, MS, Diplomate ACVIM
Professor, Veterinary Clinical Sciences, Ohio State University

Barret Bulmer, DVM, Diplomate ACVIM
TUFTS Veterinary Emergency Treatment & Specialteis, Walpole, MA

Whit Church, DVM, Diplomate ACVIM
Arizona Veterinary Specialists, Gilbert, AZ

Sonya Gordon, DVM, DVSc, Diplomate ACVIM
Associate Professor of Cardiology, Texas A&M University

Brian Scansen, DVM, Diplomate ACVIM
Assistant Professor of Cardiology, Service Head, Cardiology & Cardiac Surgery, Colorado State University

Alan Spier, DVM, PhD, Diplomate ACVIM
Florida Veterinary Specialists, Tampa, FL

Rebecca Stepien, DVM, MS, Diplomate ACVIM
Clinical Professor, School of Veterinary Medicine,
University of Wisconsin-Madison

What is Myxomatous Mitral Valve Disease (MMVD)?

As the name suggests MMVD affects the mitral valve which is located on the left side of the heart between the atrium and the ventricle. MMVD is a slowly progressive condition in which the mitral valve thickens. Normally, heart valves form a perfect seal when closed ensuring that blood flows in the right direction through the heart. Therefore the function of the mitral valve is to channel blood from the left atrium into the left ventricle. However, in MMVD the thickening of the mitral valve results in an imperfect seal and allows blood to “leak” backward into the atrium as the ventricle contracts.

How prevalent is Myxomatous Mitral Valve Disease (MMVD)?

MMVD affects about:

  • 10% of dogs between the ages of 5 and 8 years
  • 20–25% of dogs between the ages of 9 and 12 years
  • 30–35% of dogs more than 13 years old

This form of heart disease usually occurs in small to medium size dogs. The most susceptible breeds are Cavalier King Charles Spaniels, Poodles, Schnauzers, Chihuahuas, and Fox Terriers. Also, male dogs are more commonly affected than females.

What are the clinical signs of Congestive Heart Failure (CHF) in dogs?

Eventually all forms of heart disease will likely result in CHF. As heart disease progresses the heart weakens and blood continues to leak backward into the atrium. This overloads the atrium and causes fluid to leak out of the blood vessels into the lungs (known as pulmonary edema). In addition, blood flow out of the heart slows reducing blood flow to the key organs. At this stage, the signs of CHF become evident.

What are the clinical signs of Congestive Heart Failure (CHF)?

The most common signs of CHF include:

  • Coughing
  • Changes in breathing
    (difficulty breathing, shortness of breath, labored breathing, rapid/fast breathing)
  • Changes in behaviour
    (tiring easily, reluctance to exercise/not wanting to go for walks, less playful, slowing down/lack of energy, depressed/withdrawn)
  • Poor appetite
  • Weight loss
  • Fainting/collapsing
  • Weakness
  • Restlessness, especially at night

Some or all of the clinical signs above may appear, and all have an impact on the dog’s quality of life.

How are Myxomatous Mitral Valve Disease (MMVD) and Congestive Heart Failure (CHF) diagnosed?

The diagnosis of CHF due to MMVD is usually preceded by the detection of a heart murmur during routine veterinary check-ups using a stethoscope. A heart murmur is the sound caused by blood leaking backward into the atrium from the ventricle. To diagnose CHF the veterinarian will need to complete a thorough clinical history and physical examination. They may also recommend some of the following tests:

  • Radiographs (x-rays): to check for any enlargement of the heart or fluid accumulation in the lungs
  • Echocardiography (ultrasound): to show any thickening of the heart valve edges or enlargement of the chambers of the heart
  • Blood tests

How are Myxomatous Mitral Valve Disease (MMVD) and Congestive Heart Failure (CHF) managed?

Treatment of CHF due to MMVD begins when the dog shows clear clinical signs of heart failure, and is tailored for the individual pet. Since surgery to prevent further deterioration is rarely possible in canine patients, management of heart failure seeks to improve quality of life and extend life expectancy through daily medication.

What is the most common form of heart disease in cats?

Hypertrophic cardiomyopathy (HCM) is most common in cats. HCM causes the heart’s muscle to thicken, making it difficult for the heart to pump blood through the body. Thickening of the heart muscle can also be a natural response to other diseases, such as hyperthyroidism, kidney disease and hypertension.

[i] Sisson D. Valvular heart disease in dogs. Abstract at WSAVA 2002.
[ii] Ware WA. Cardiovascular disease in small animal medicine. Ames, IA: Blackwell Publishing.