Effect of pimobendan on physical fitness, lactate and echocardiographic parameters in dogs with preclinical mitral valve disease without cardiomegaly

Abstract

Pimobendan has gained enormous importance in the treatment of mitral valve disease in dogs. The current consensus statement of the American College of Veterinary Internal Medicine (ACVIM) recommends a treatment for dogs with symptomatic disease and dogs with asymptomatic disease with radiographic and echocardiographic signs of cardiomegaly. To investigate whether these dogs also benefit from a therapy with pimobendan, 21 dogs with mitral valve disease ACVIM B1 underwent a standardized submaximal exercise test on a treadmill. In this double-blinded and randomized study, the animals were divided into two groups, one receiving pimobendan and the other a placebo. At the first visit and at every follow-up appointment (at days 90 and 180), heart rate during the complete exercise test and lactate before and after running were measured. In addition to this, a questionnaire was completed by the dogs’ owners and all dogs were given an echocardiographic examination to detect any changes and to observe if the disease had progressed. Due to the diagnosis of leishmaniosis, one dog in the pimobendan group was retrospectively removed from the study so that 20 dogs were included for statistical analysis. No differences were observed at any time between the pimobendan-group and the placebo-group regarding heart rate. At day 180, the increase in lactate after exercise was significantly lower than in the placebo-group. The increase in the pimobendan-group at day 180 was lower than at day 90. Most of the dog owners from the pimobendan-group declared that their dogs were more active at day 90 (6/10) and at day 180 (8/10), while most dog owners from the placebo-group observed no changes regarding activity at day 90 (8/10) and day 180 (6/10). It can be concluded that the results of this study indicate that some dogs with mitral valve disease ACVIM B1 might benefit from a therapy with pimobendan.

The effect of treatment with pimobendan in dogs with preclinical mitral valve disease – a placebo-controlled double-blinded crossover study

“…These findings might indicate a positive effect of pimobendan treatment in some dogs at stage ACVIM B1. As in previous studies, no major adverse effects could be detected in the pimobendan treatment group [ 8 , 9 , 31 ].…”

“…All dogs included in the study underwent an SSET on a motorised treadmill (“quasar”, h/p/cosmos sports and medical GmbH, Nussdorf-Traunstein, Germany) as recently established by Wall et al and utilised in the predecessor study by Iwanuk et al [ 8 , 9 , 19 ]. Before starting the examinations for the study, dogs had been accustomed to the treadmill and the speed of the treadmill had been slowly increased to their respective comfort speed.…”

“…While there have been negative reports regarding the effect of pimobendan in dogs with preclinical DMVD [ 6 , 7 ] , a recent study by our group showed some promising results concerning the effect on cardiac biomarkers and quality of life of dogs as assessed by the owners [ 8 , 9 ]. In this previous study, dogs of stage ACVIM B1 were randomly allocated to either group A (receiving pimobendan) or group B (receiving placebo), and underwent echocardiography, standardised submaximal exercise testing (SSET) and investigation of cardiac biomarkers.…”

Evaluation of a Treadmill-Based Submaximal Fitness Test in Pugs, and Collecting Breed-Specific Information on Brachycephalic Obstructive Airway Syndrome

“…A standardised, submaximal exercise test on a treadmill has already been developed and tested in dogs with early mitral valve disease [ 33 ], and has been used to investigate the effect of medication in these patients [ 34 , 35 ]. These studies, and others, showed that it is possible to acclimatise untrained dogs to a treadmill [ 33 , 34 , 36 , 37 , 38 ].…”

Assessment of Right Ventricular Function, Blood Lactate Levels, and Serum Peptidomics Profiles Associated With Mitral Valve Disease in Dogs

“…Dogs have been classified into stages A, B, C, and D ( 4 , 5 ). High blood lactate concentrations are frequently observed in dogs with abnormal thoracic radiographs such as cardiomegaly and pulmonary parenchyma ( 6 ). Dogs with degenerative mitral valve disease often have impaired renal function.…”