“…Urinary aldosterone to creatinine ratio (UAC) is associated with the rate of change of left ventricular size in dogs with MMVD, suggesting that aldosterone production increases during periods of active remodelling [13]. Spironolactone is a mineralocorticoid receptor antagonist that has been shown to prolong survival times in dogs with advanced MMVD and CHF secondary to MMVD, when given in combination with standard therapy [14]. The use of spironolactone in dogs with compensated MMVD has not been reported, although a study investigating its effects in combination with benazepril is currently ongoing.…”