Cardiology Update: Canine Valvular Disease and Feline Cardiomyopathies

This meeting will be held at the Watershed Stewardship Center in West Creek Reservation in Parma, OH. This meeting is sponsored by Purina.

Myxomatous Valve Disease in Dogs, Part 1 – Staging & Preclinical Disease: Myxomatous (degenerative) valvular disease is the most important cause of heart disease and cardiac failure in dogs. This session focuses on clinical recognition, practical approaches to staging, and when to start treatment.

Objectives/Outcomes for participants:
1. Offer an overview of the clinical, imaging, and laboratory diagnosis and staging of acquired (myxomatous, degenerative) valvular heart disease in the dog.
2. Outline the ACVIM staging of myxomatous valvular heart disease in the dog.
3. Explain the diagnostic imaging findings (radiography, echocardiography) typical of mild to advanced myxomatous valve disease of the dog.
4. Describe the value and challenges of using blood natriuretic peptide (NT-proBNP) concentrations in the assessment of myxomatous valve disease of the dog.
5. Summarize the preclinical therapy of myxomatous valve disease of the dog and the criteria that justify starting treatment before the onset of clinical signs.

Myxomatous Valve Disease in Dogs, Part 2 – Management Approaches: This (continuation) session focuses on the therapy of myxomatous valvular disease in dogs, emphasizing the appropriate use of cardiac drugs and the management of heart failure.

Objectives/Outcomes for participants:
1. List the three major classes of drugs used in the management of heart disease and heart failure in dogs with myxomatous valve disease
2. List the direct vasodilator drugs sometimes used in the treatment of myxomatous valve disease and their relative indications
3. Outline an approach for treating acute left-sided heart failure in the dog.
4. Outline an approach for treating and monitoring the canine patient with chronic congestive heart failure; indicate the level of evidence supporting each treatment.
5. Discuss potential treatments for complications and comorbidities associated with chronic valvular disease, including airway diseases, arrhythmias, pulmonary hypertension, and chronic kidney disease.

Feline Cardiomyopathy Part 1 – Diagnosis of Feline Cardiomyopathies: This session details the relevant pathology, causes, and clinical outcomes of feline myocardial diseases. Diagnostic tests used for recognition and staging of cardiomyopathies are reviewed. A diagnostic approach to the assessment of asymptomatic feline heart murmurs is emphasized. Finally, the practical use of cardiac biomarkers and critical aspects of clinical examination and diagnostic imaging are discussed.

Objectives/Outcomes for participants:

1. Draw a picture of the left ventricle in the main types of feline cardiomyopathy and indicate the
fundamental functional problems with each form.
2. List the differential diagnosis of systolic heart murmurs in cats and rank these based on likelihood in kittens (cats <6 months), mature cats, and cats >7 years of age.
3. Describe the clinical use of ELISA-based and reference laboratory tests for NT-proBNP in cats with a heart murmur or signs of respiratory distress.
4. Conduct a diagnostic workup for cardiac murmurs in cats.
5. Discuss an overview of the benefits and limitations of echocardiography and thoracic radiography for assessing cats with preclinical cardiomyopathy and those with heart failure.

Feline Cardiomyopathies, Part 2 – Outcomes & Management: This session considers outcomes, prognosis, and different approaches to managing feline cardiomyopathies. Cats with asymptomatic hypertrophic cardiomyopathy, acute and chronic congestive heart failure, and arterial thromboembolism in cats are considered. Case vignettes are used to emphasize clinical relevancy.

Objectives/Outcomes for participants:
1. Discuss the relevant issues related to managing asymptomatic feline hypertrophic cardiomyopathy.
2. Outline an approach for recognizing and managing acute congestive heart failure (CHF) in cats with cardiomyopathy.
3. Outline an approach for the chronic management (treatment and follow-up) of congestive heart failure (CHF) in cats with cardiomyopathy.
4. List the clinical signs of arterial thromboembolism and the related clinical laboratory findings.
5. Discuss the prevention and potential treatments for arterial thromboembolism associated with feline cardiomyopathies.

John Bonagura graduated from the Ohio State University, was a rotating intern at the Animal Medical Center in New York, and completed residencies and specialty board certifications in Cardiology and Internal Medicine at Ohio State. For most of his career, John was Head of Cardiology & Interventional Medicine at Ohio State, where he achieved the rank of tenured Professor and is currently Professor Emeritus. Dr. Bonagura was visiting research fellow at Edinburgh University, Scotland, and completed a five-year term as the Gilbreath-McLorn Endowed Professor of Veterinary Cardiology at the University of Missouri before rejoining the faculty at Ohio State in 2001. John moved to the North Carolina State University College of Veterinary Medicine in 2019, where he is currently affiliated.

John served a three-year term as President of the ACVIM specialty of Cardiology and is a member of the Board. He is the long-time Editor of Kirk’s Current Veterinary Therapy and co-author of a Colour Atlas of Veterinary Cardiology and the recently published Ware: Cardiovascular Diseases in Companion Animals. He currently serves on the editorial Board of the Journal of Veterinary Cardiology and the American Society of Echocardiography CASE. In addition, Dr. Bonagura has written or co-authored over 300 scientific publications and book chapters. He is the recipient of multiple college awards for teaching in the professional and graduate programs at Ohio State, andthe OSU campus Award for Distinguished Teaching. Additional honors include the Bourgelat award of the British Small Animal Veterinary Association, Doctor Honoris Causa from the University of Barcelona, Kirk Lifetime Achievement Award from the American College of Veterinary Internal Medicine, Faculty Achievement Award of the American Association of Veterinary Clinicians, and distinguished Alumnus awards from The Ohio State University College of Veterinary Medicine and the Animal Medical Center.