Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic, and laboratory variables in dogs with myxomatous mitral valve disease receiving pimobendan or benazepril: the QUEST study.

BACKGROUND: Myxomatous mitral valve disease (MMVD) is an important cause of morbidity and mortality in dogs. OBJECTIVES: To compare, throughout the period of follow-up of dogs that had not yet reached the primary endpoint, the longitudinal effects of pimobendan versus benazepril hydrochloride treatment on quality-of-life (QoL) variables, concomitant congestive heart failure (CHF) treatment, and other outcome variables in dogs suffering from CHF secondary to MMVD. ANIMALS: A total of 260 dogs in CHF because of MMVD. METHODS: A prospective single-blinded study with dogs randomized to receive pimobendan (0.4-0.6 mg/kg/day) or benazepril hydrochloride (0.25-1.0 mg/kg/day). Differences in outcome variables and time to intensification of CHF treatment were compared. RESULTS: A total of 124 dogs were randomized to pimobendan and 128 to benazepril. No difference was found between groups in QoL variables during the trial. Time from inclusion to 1st intensification of CHF treatment was longer in the pimobendan group (pimobendan 98 days, IQR 30-276 days versus benazepril 59 days, IQR 11-121 days; P = .0005). Postinclusion, dogs in the pimobendan group had smaller heart size based on VHS score (P = .013) and left ventricular diastolic (P = .035) and systolic (P = .0044) dimensions, higher body temperature (P = .030), serum sodium (P = .0027), and total protein (P = .0003) concentrations, and packed cell volume (P = .030). Incidence of arrhythmias was similar in treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan versus benazepril resulted in similar QoL during the study, but conferred increased time before intensification of CHF treatment. Pimobendan treatment resulted in smaller heart size, higher body temperature, and less retention of free water.

Views on euthanasia and the rehoming of dogs in Norway and Iceland.

According to several previously published studies, large populations of dogs are sent to animal shelters in the UK and USA each year, and estimates indicate that a substantial percentage of the dogs in such shelters are euthanased annually. However, anecdotal evidence indicates a different situation in Norway and Iceland. This study explores the attitudes toward euthanasia of dogs in Norway and Iceland, and investigates the practice of rehoming of dogs in the two countries. A general reluctance toward euthanasia of dogs was expressed, and participants stressed the need to consider alternatives such as rehoming. Rehoming of dogs was found to be negligible in Norway relative to international trends, and less than 10 per cent of the dogs assigned for rehoming were euthanased. In Iceland, the rehoming of dogs is yet to reach levels that necessitate the setting up of animal shelters. There is, nevertheless, reason to continue to explore the attitudes toward euthanasia and rehoming of dogs in Norway and Iceland, because there is a lack of statistical data on the reasons behind the owners' decisions to give away or euthanase their dogs.

Changes in the relationships between dogs, owners and veterinarians in Norway and Iceland.

Norwegian and Icelandic dog owners were interviewed about aspects of their dog keeping and their attitudes to the veterinary profession. Dogs were found to play an important role in the lives of their owners, who had high expectations of their veterinarians, not only with respect to the treatment of their dogs but also with respect to themselves as clients. About one-third of owners reported problems related to a lack of trust and poor communications in encounters with their veterinarians.

Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study.

BACKGROUND: Myxomatous mitral valve disease (MMVD) continues to be an important cause of morbidity and mortality in geriatric dogs despite conventional therapy. HYPOTHESIS: Pimobendan in addition to conventional therapy will extend time to sudden cardiac death, euthanasia for cardiac reasons, or treatment failure when compared with conventional therapy plus benazepril in dogs with congestive heart failure (CHF) attributable to MMVD. ANIMALS: Two hundred and sixty client-owned dogs in CHF caused by MMVD were recruited from 28 centers in Europe, Canada, and Australia. METHODS: A prospective single-blinded study with dogs randomized to PO receive pimobendan (0.4-0.6 mg/kg/d) or benazepril hydrochloride (0.25-1.0 mg/kg/d). The primary endpoint was a composite of cardiac death, euthanized for heart failure, or treatment failure. RESULTS: Eight dogs were excluded from analysis. One hundred and twenty-four dogs were randomized to pimobendan and 128 to benazepril. One hundred and ninety dogs reached the primary endpoint; the median time was 188 days (267 days for pimobendan, 140 days for benazepril hazard ratio = 0.688, 95% confidence limits [CL]=0.516-0.916, P= .0099). The benefit of pimobendan persisted after adjusting for all baseline variables. A longer time to reach the endpoint was also associated with being a Cavalier King Charles Spaniel, requiring a lower furosemide dose, and having a higher creatinine concentration. Increases in several indicators of cardiac enlargement (left atrial to aortic root ratio, vertebral heart scale, and percentage increase in left ventricular internal diameter in systole) were associated with a shorter time to endpoint, as was a worse tolerance for exercise. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan plus conventional therapy prolongs time to sudden death, euthanasia for cardiac reasons, or treatment failure in dogs with CHF caused by MMVD compared with benazepril plus conventional therapy.

Comparison of the recurrence rate of gastric dilatation with or without volvulus in dogs after circumcostal gastropexy versus gastrocolopexy.

OBJECTIVE: To compare the recurrence rate of acute gastric dilatation with or without volvulus (GDV) after circumcostal gastropexy (CCGP) or gastrocolopexy (GCP) in dogs. STUDY DESIGN: A prospective, double-blind, multicenter, randomized, controlled, clinical trial with two groups (A and B). ANIMALS: Fifty-four client-owned dogs presented for treatment of GDV. METHODS: Dogs with acute GDV that had not previously had a gastropexy performed were included. The preoperative treatment before gastropexy was standardized. A CCGP was performed on dogs in group A, and a GCP was performed on dogs in group B. Postoperative treatment was standardized, but deviation did occur according to the special needs of particular patients. A minimal follow-up time of 180 days was required for dogs not excluded from the study. The median follow-up time in group A was 700 days; in group B, it was 400 days. The occurrence of abdominal pain and gastrointestinal problems after surgery were recorded by the owners. RESULTS: There was no significant difference in the recurrence rate of GDV between the two groups. At the end of the study, the recurrence rate was 9% and 20% in group A and in group B, respectively. CONCLUSIONS: Both surgical techniques are effective in preventing recurrence of GDV.

Spinal cord astrocytoma in a cat.

A nine-year-old neutered male domestic shorthaired cat with a history of spinal pain and progressive hindlimb dysfunction was presented to the Norwegian School of Veterinary Science. Following neurological and myelographic examination, an intramedullary mass affecting several lumbar spinal cord segments was diagnosed. A neoplastic lesion was suspected and a poor prognosis was given. On postmortem examination, the spinal cord was found to be dorsally flattened from the 12th thoracic vertebra to the fifth lumbar vertebra and severely thickened with a dorsal cleft from the fifth to the seventh lumbar vertebra. Histologically, the tumour was diagnosed as an anaplastic astrocytoma.

Comparison of two surgical treatments of gastric dilatation-volvulus in dogs.

The purpose of this randomized clinical study was to compare the effect of 2 surgical methods in the treatment of gastric dilatation-volvulus (GDV) in dogs. One group of dogs (group A) was treated with and one group (group B) without fixation of the stomach. Group A consisted of 21 cases (including 2 dropouts) and group B of 10 cases. The dogs in group A received decompression, anatomical repositioning of the stomach and a circumcostal gastropexy and the dogs in group B (the control group) received the same treatment without gastropexy. Supportive treatment was the same for both groups. The randomization of the dogs in groups A and B was successful with only small differences between the 2 groups in the breed, age, sex and initial decompression methods. At the end of the study (censoring time), the median survival times were significantly different between group A and group B, respectively 549 and 107 days. There were no recurrences in group A while in group B 3 dogs (50%) experienced a recurrence within 6 months. The overall death rates within the first year were 32% in group A and 80% in group B. The death rates caused by GDV and GDV related causes only, after one year of follow-up, were 19% and 71% for groups A and B, respectively. This study shows that treatment that included circumcostal gastropexy significantly reduced the recurrence of GDV and prolonged the postoperative survival time compared with treatment that did not include fixation of the stomach.

Acute gastric dilatation in cats: a case series.

Acute gastric dilatation (AGD) is a well-known, acute, life-threatening disease in dogs but its feline counterpart is much less known. This paper provides descriptions of 2 cases of AGD in cats that the authors have seen. Including these a total of 10 cases of feline AGD have been reported. No breed or sex predilection was found among the cases. Age distribution ranged from 11 weeks to 13 years. All 10 cats with AGD had enlarged abdomens on presentation. In 3 of the cases this was the only presenting sign and all 3 were simple, uncomplicated gastric dilatations, that were easily corrected by gastric decompression. Four of the 10 cats with AGD had dyspnea in addition to enlarged abdomens and only one of these cats survived, suggesting that this combination of clinical signs might indicate a guarded prognosis. Five out of the 10 cats with AGD had gastric torsion, 2 of these with concomitant diaphragmatic hernia. Four of the 5 cats with gastric torsion survived after appropriate surgery. Diaphragmatic hernia was a concurrent condition in 3 cats with signs of AGD. A mortality of 30% was observed in cats with AGD. Treatment was successful in 7 out of 10 cases and consisted of shock therapy combined with gastric decompression or surgery. Prognosis seems favorable once the initial acute stage has been overcome. Recurrence has only been recorded in one cat. Conclusions drawn from the available material are: 1) clinical signs and therapeutical management of AGD are similar in cats and dogs, 2) the age of the patients seem to differ between feline and canine AGD, 3) more information is needed to fully assess the prognosis and recurrence rate of feline AGD.

A retrospective study of conservative treatment of gastric dilatation-volvulus in the dog.

A retrospective study of 103 dogs with gastric dilatation-volvulus (GDV) treated conservatively during the period 1985-1989 was performed. The date and number of recurrences, and the date and cause of death along with breed, age and sex were collected from clinic records and from a questionnaire sent to the owners (77% response). The treatment consisted of emptying the stomach with a stomach tube, gastrocentesis if necessary and treating shock. All of the affected dogs were from moderate to large sized breeds and the study showed that particular breeds appear to be predisposed to GDV. The average age was 7.2 years and there was no gender predisposition. Sixty-six per cent of the dogs survived the initial treatment and 50% of the dogs were still alive 1 month after treatment. Thirty-nine dogs (71%) received recurrence between 5-760 days after initial treatment. Fifty-six per cent had recurrence within 3 months and all except 2 dogs, within 1 year. Data for the time of death, regardless of cause, was available for 68 dogs. Of these 59 (81%) died within a year after initial treatment. Conservative treatment was found to be an adequate life-saving procedure in the acute stage of GDV, but could not alone prevent recurrence of the disease.