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New trial / research completed relating to heart murmur and CHF


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Both of my boys have been recently diagnosed with heart murmurs which has been confirmed as mitral valve regurgitation referred to as myxomatous mitral valve degeneration (MVVD).

 

Luckily we seem to have caught it early as both of their hearts are within normal range despite the confirmed diagnosis. Took them to see a cardiologist @ Texas A&M and the experience was great. During the visit the cardiologist referred to a recently completed trial that I did some research on below:

 

There have been two veterinary medicine trials within the past couple of years that have proven that pimobendan (vetmedin) can significantly increase a dog's life span and quality of life as compared to an ACE inhibitor (like benazepril / enalapril) which have been the gold standard prescription once a dog has entered the CHF stage (algongside other supplemental drugs like furosemide, beta blockers, etc). This was discovered in the QUEST trial.

 

https://www.epictrial.com/epic-trial/faqs/#whatisquest

 

Not only that, but it gets better! Following the QUEST trial they then posed the question, "Well, if pimobendan is this effective at elongating and improving a dogs life that has entered CHF - does it help stave off CHF in a dog with MVVD that is pre-clinical (not showing symptoms like coughing, fluid build up, significantly enlarged heart)? Turns out, YES IT DOES!

 

https://www.epictrial.com/epic-trial/faqs/#whatisepic

 

Here's the cliff notes of the latest study which is very promising:

 

"Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit."

 

https://www.ncbi.nlm.nih.gov/pubmed/27678080

 

Would be interested to hear if anyone else was aware of this new information and what you all think. Hoping to pass this on to give you & yours a better shot when dealing with MVVD / CHF. :)

 

Here's a link to the full EPIC study that went in the Journal of Veterinary Internal Medicine:

 

http://onlinelibrary.wiley.com/doi/10.1111/jvim.14586/pdf

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Interesting! FWIW, I had a dog with MVVD. It was caught early as a heart murmur. She was started on enalapril when she was still subclinical but after an ultrasound showed some enlargement (about a year post initial diagnosis via cardiac u/s). The enalapril stabilized her - the next u/s a year later showed no more progression and she remained symptom free.

 

She was diagnosed around 9 and lived to 12 when I lost her to cancer. Up until the cancer she remained quite healthy and active.

 

I think that the early catch/diagnosis/treatment really made a difference for her. I'm not sure of the cost of those meds today but 6-7 years ago the enalapril was significantly cheaper. I used to pay $10/3 month supply.

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Megan was diagnosed with a mild heart murmur and placed on Enalapril about a year ago. We have not done an ultrasound or any other testing but so far the murmur seems to have remained stable and does not hold her back. She's 14 and also in Stage 2 chronic renal failure.

 

This sounds like some very good news for many dogs and owners! Thanks for sharing!

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Megan was diagnosed with a mild heart murmur and placed on Enalapril about a year ago. We have not done an ultrasound or any other testing but so far the murmur seems to have remained stable and does not hold her back. She's 14 and also in Stage 2 chronic renal failure.

 

This sounds like some very good news for many dogs and owners! Thanks for sharing!

 

Sue R - thanks for the reply. Sending good BC vibes Megan's way!

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I used both enalapril and Vetmedin for Willow. Given the expense of the Vetmedin, I'd opt for the enalapril first, but then age of the dog and other financial factors figure in to that. I don't remember at what age Willow was found to have a significant murmur, but she lived to be just a few weeks shy of 16, even though she was not on Vetmedin the entire time she was being treated for the murmur/heart enlargement.

 

J.

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When Tyra was diagnosed with a heart murmur at 13 we decided to save the Vetmedin for down the road if things got worse. She was maintained on enalapril and spironolactone until she died at 15 1/2 from cancer. The Vetmedin was a lot more expensive than both the other meds together

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One of

the dogs I take care of is on vetmedin and Lasix . A year ago the owners thought she was dying. She had irregular heartbeat and heart failure. Fluid was building up. Now she is running around and doing well. She still coughs sometimes. The improvement was dramatic.

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One of

the dogs I take care of is on vetmedin and Lasix . A year ago the owners thought she was dying. She had irregular heartbeat and heart failure. Fluid was building up. Now she is running around and doing well. She still coughs sometimes. The improvement was dramatic.

 

Great to hear a first hand account of the drastic difference this treatment can help supplement.

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I used both enalapril and Vetmedin for Willow. Given the expense of the Vetmedin, I'd opt for the enalapril first, but then age of the dog and other financial factors figure in to that. I don't remember at what age Willow was found to have a significant murmur, but she lived to be just a few weeks shy of 16, even though she was not on Vetmedin the entire time she was being treated for the murmur/heart enlargement.

 

J.

 

Did you continue working Willow once the murmur was found / her heart enlarged? Both of my boys are still within the normal limits but I'd rather not work them if that means shortening their lives. Especially when dealing with whether you can push a dog or not to keep working after a bad gather, etc. How to tell the difference between the dog not wanting to work for you and not being able to?

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  • 2 weeks later...

Sorry for my slow response; I don't get here as often as I used to. Willow was older when diagnosed with mitral valve problems and I think she was already retired at that time. That said, we still took long walks, and she raced around with the rest of the pack without any problems.

 

J.

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