Mitral Valve Disease
Myxomatous Mitral Valve Disease (MMVD) is the most common acquired heart disease in dogs, accounting for approximately 75% of all canine heart disease. The mitral valve leaflets undergo progressive myxomatous degeneration, becoming thickened and distorted, leading to valve incompetence (regurgitation) and eventually congestive heart failure.
Symptoms & Signs
- Heart murmur (often detected years before symptoms)
- Coughing (especially at night or with excitement)
- Exercise intolerance
- Rapid breathing
- Fainting (syncope)
- Abdominal distension
- Weight loss
- Restlessness at night
Causes & Risk Factors
Progressive myxomatous degeneration of valve tissue with genetic predisposition. The valve leaflets accumulate glycosaminoglycans, becoming thickened, elongated, and incompetent. Small breeds are most commonly affected. Cavalier King Charles Spaniels have particularly early onset and high prevalence.
Diagnosis
Cardiac auscultation (left apical systolic murmur, graded I-VI). Echocardiography for staging (ACVIM stages A-D): valve morphology, chamber dimensions, regurgitation severity. Thoracic radiographs for heart size and pulmonary edema. NT-proBNP as biomarker.
Treatment
Stage B1 (murmur, no enlargement): monitoring. Stage B2 (enlargement): pimobendan to delay heart failure onset. Stage C (heart failure): pimobendan, furosemide, ACE inhibitor (benazepril/enalapril). Stage D (refractory): additional diuretics, sildenafil. Mitral valve repair surgery at specialized centers.
Prevention
Breeding programs with cardiac screening (echocardiography at age 5+ for Cavaliers). Avoiding breeding of dogs with early-onset murmurs. No proven dietary or lifestyle prevention.
Prognosis
Stage B1: many dogs live years without progression. Stage B2 with pimobendan: median 1300+ days to heart failure. Stage C with treatment: median survival 6-14 months. Stage D: weeks to months. Surgical repair can be curative.
Affected Breeds (2)
| Breed | Species | Size |
|---|---|---|
| Cavalier King Charles Spaniel | Dog | Small |
| Whippet | Dog | Medium |