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Myxomatous mitral valve disease in dogs
  1. Adrian Boswood

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Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK e-mail: aboswood@rvc.ac.uk

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DEGENERATIVE mitral valve disease is the most common cardiac disease of dogs and, as such, it is a major cause of morbidity and mortality. The frequency with which dogs are affected by this condition has two implications. First, dogs affected by this disease will be regularly encountered by veterinary surgeons working in small animal primary-care practice; and second, successfully managing patients with this condition can have a major impact, improving both the quality of life and longevity of a large number of dogs.

There have been significant, recent advances in our understanding of how to manage patients with this disease. The recent demonstration of the effectiveness of therapy before the onset of signs of heart failure (Boswood and others 2016) has necessitated a re-evaluation of our approach to this disease. In order to apply best evidence, it is necessary to appreciate how the disease progresses, how it is most effectively diagnosed and how patients with this condition can be ‘staged’; that is, how the continuum of patients with the disease can be subdivided into different groups in order to best apply evidence-based medicine.

Finally, a new challenge is posed by the change in management that has recently occurred. To achieve the best outcomes for this condition we now advocate the chronic administration of therapy to dogs that, to their owners, demonstrate no obvious outward signs of ill health. This is a very different circumstance to that in which most veterinary medicines are administered. Motivating clients to adhere to long-term treatment regimes is as much a part of the success of therapy as the correct diagnosis and staging of the patient.

This edition of In Practice Focus brings together a useful collection of articles that, in light of recent evidence, outline our current understanding of how best to approach this common disease. The articles cover the pathogenesis and progression of the disease, the optimal diagnostic approach, evidence-based management and monitoring, and finally the challenges of maximising adherence to a treatment protocol.

I hope you will find these articles interesting and useful and, through applying the guidance that they outline, that they enable you to optimally manage the patients with this common condition entrusted to your care.

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