Treatment of canine heart disease

Chronic valvular heart disease (CVHD) accounts for 75 per cent of canine heart  disease and around 10 per cent of cases seen by first-opinion vets. Cardiomyopathies are less common but make up around 20 per cent of cases. Typically, this is dilated cardiomyopathy (DCM) but other terminologies are used for variations. The diagnosis and treatment of canine heart disease, especially CVHD, is one in which there  has been recent progress with important clinical research studies and a better understanding of the disease in recent years. Arrhythmias and congenital and pericardial disease constitute a small proportion of the caseload seen in first-opinion practice. Management of arrhythmias is complicated by a lack of evidence-based medicine (EBM) and a limited range of drugs available. A list of drugs used for treatment of canine cardiac disease is given in the table on pages 22 and 23, including reference to whether these are currently licensed for use in dogs in the UK. Implantable pacemakers are now routine for a number of bradycardias, but implantable defibrillators are not yet practicable in dogs. Treatment of arrhythmias ideally centres on the resolution or management of the underlying cause. Interventional procedures for resolving some arrhythmias are now available and interventional procedures for some  congenital conditions are now routine. Management of pericardial disease still relies on drainage and in some cases surgical intervention. However, because these conditions are much less common, the focus of this article will be CVHD and DCM. Veterinarians increasingly appreciate the importance of making decisions based, where possible, on data from EBM. Cardi­ology is one field in which large strides have been made in recent years; however, controversy still exists and in some areas there is a paucity of data. Where EBM is not available or is of limited value, there is reliance on a combination …