Objectives: To estimate the prevalence of canine diabetes mellitus (DM) in primarycare clinics in England, to identify risk factors associated with DM and to describe the survival of affected dogs.Methods: Cases of DM were identified within the electronic patient records of 89 small-animal practices. A nested case-control study identified risk factors for the diagnosis of DM using logistic regression models. Cox proportional hazards models were used to analyse variables associated with survival.Results: Four-hundred and thirty-nine canine DM cases were identified, giving an apparent prevalence of 0.34% (95% confidence interval 0.31 -0.37%). Neutered males were at an increased risk of diabetes compared to entire males, whereas neutering was not associated with DM in females. Compared with crossbred dogs, Yorkshire terriers had increased odds, whereas German shepherd dogs and golden retrievers had lower odds of DM. Being classified as overweight and having a diagnosis of pancreatitis, hyperadrenocorticism or a urinary tract infection were positively associated with DM. Older dogs and those diagnosed with pancreatitis had a higher hazard of death, whereas insured and neutered dogs had a lower hazard.Clinical significance: This study provides an objective assessment of canine DM using primary-care veterinary practice data and is a valuable benchmark against which future epidemiological trends in DM can be assessed and improvements in the management of DM in primary-care practice can be judged.

BackgroundTo date, epidemiological studies on degenerative mitral valve disease (DMVD) in dogs have largely reported referral caseloads or been limited to predisposed breeds. Analysis of primary‐care data to identify factors associated with DMVD would help clinicians identify high‐risk individuals and improve understanding.ObjectivesTo estimate the prevalence of and identify risk factors for DMVD in dogs attending primary‐care veterinary practices in England.AnimalsCases were identified within the electronic patient records of 111,967 dogs attending 93 practices. Four hundred and 5 dogs were diagnosed with DMVD (diagnosed cases) and a further 3,557 dogs had a heart murmur (HM) consistent with DMVD (possible cases).MethodsRetrospective cross‐sectional study design. Prevalence was adjusted for the sampling approach. Mixed effects logistic regression models identified factors associated with DMVD.ResultsPrevalence estimates of diagnosed DMVD and HMs consistent with DMVD (both diagnosed and possible cases) were 0.36% (95% confidence interval [CI]: 0.29–0.45) and 3.54% (95% CI: 3.26–3.84) respectively. In the multivariable analysis, males had higher odds of diagnosed DMVD than did females (odds ratio [OR] 1.40, 95% CI: 1.12–1.74). Insured dogs had increased odds of DMVD compared with noninsured dogs (OR 3.56, 95% CI: 2.79–4.55) and dogs ≥20 kg had approximately half the odds of DMVD diagnosis compared with dogs <20 kg (OR 0.51, 95% CI: 0.36–0.74). Strong associations between a DMVD diagnosis and individual breeds and age were identified.Conclusions and Clinical ImportanceDegenerative mitral valve disease was a common disorder in practice‐attending dogs. Knowledge of identified risk factors for DMVD could improve clinical diagnosis and direct future research.

Background: Several risk factors already have been determined for dogs with degenerative mitral valve disease (DMVD). Risk factors often have been considered in isolation and have not always taken into account additional information provided by the history and physical examination (PE).Hypothesis/Objectives: Data obtained from history and PE of dogs with DMVD provide prognostic information and can be used for risk stratification.Animals: Client-owned dogs (n = 244) with DMVD recruited from first opinion practice. Methods: Prospective longitudinal follow-up of dogs with DMVD. History and PE data were obtained at 6-month intervals and analyzed with time-dependent Cox models to derive relative risk of cardiac death. Independent hazard ratios were used to derive a clinical severity score (CSS), the prognostic value of which was evaluated by analyzing the median survival times for different risk groups and ROC analysis. Analysis of the progression of CSS over time also was undertaken.Results: History of cough, exercise intolerance, decreased appetite, breathlessness (difficulty breathing) and syncope with PE findings of heart murmur intensity louder than III/VI and absence of respiratory sinus arrhythmia were independently associated with outcome and allowed development of the CSS. Clinical severity score distinguished groups of dogs with significantly different outcomes.Conclusions and Clinical Importance: Routinely obtained clinical findings allow risk stratification of dogs with DMVD. Results of ancillary diagnostic tests may be complementary to history and PE findings and always should be interpreted in conjunction with these findings.

Background Prognostic risk factors were identified for dogs with degenerative mitral valve disease (DMVD) monitored by veterinary cardiologists. The value of these measurements has not been determined in the wider primary care setting. Objectives To evaluate whether plasma cardiac biomarkers and data obtained from routine history‐taking and physical examination are predictive of survival in dogs with DMVD attending primary care practice. Animals Eight‐hundred and ninety‐three dogs with a presumptive diagnosis of DMVD recruited from 79 primary care veterinary practices in the United Kingdom. Methods Prospective cohort study. Primary care veterinary practitioners recorded clinical data. Plasma N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin I (cTnI) were measured at presentation. Cox regression models evaluated associations between risk factor variables and hazard of death (all‐cause mortality and cardiac‐related death). Flexible parametric models generated predicted survival probabilities for dogs with different combinations of prognostic risk factor variable values. Results Dogs with higher NT‐proBNP and cTnI concentrations, higher heart rates, older dogs, females, and those reported to be exercise intolerant, dyspneic, and diagnosed with selected comorbidities had an increased hazard of death due to any cause. Dogs with higher concentrations of plasma biomarkers, higher heart rates, and heart murmur intensities, those with exercise intolerance and those receiving potent diuretics had a higher hazard of cardiac‐related death. Conclusions and Clinical Importance Cardiac biomarkers and key clinical findings identified in this study can help primary care veterinary practitioners identify dogs with DMVD that are at highest risk of death.