The journey of a dog and his family: Dealing with MMVD

This episode is sponsored by Boehringer Ingelheim.

In this episode of The Vet Blast Podcast presented by dvm360, our host, Adam Christman, DVM, MBA, had a chat with Whit Church, DVM, DACVIM (Cardiology), to walk through the full life cycle of myxomatous mitral valve disease in dogs, using the real case of Vinnie, a Chihuahua, as a guide.

They explore how this common small-breed heart disease begins, how to catch it early, what truly helps slow progression, and how to navigate difficult but compassionate end-of-life decisions with clients.

Below is a partial transcript, edited lightly for clarity.

Adam Christman, DVM, MBA: So let's walk through the journey. Let's kind of paint the stage for our listeners here. We're going to walk you through a patient story from the very beginning, from conception and early development of the disease, and explain how mitral valve disease begins. So take it away.

Whit Church, DVM, DACVIM (Cardiology): I thought we could talk about a patient named Vinnie that developed degenerative valve disease. [I] got to follow this patient for years over time. The thing about valve disease is we believe it's heritable, but we don't actually know of a specific gene. It seems to be within a range of chromosomes, [though] it's probably more multifactorial, and there's probably several genes involved. But it also seems to have an age trigger, and maybe even environmental if you throw in high blood pressure and some things on top of that, as far as why it progresses to severe disease in some [while] others don't seem to get it very badly.

But…Vinnie started out as a 7-year-old male, neutered Chihuahua that came in because of a heart murmur and wasn't having any symptoms. But [he] had a left-sided murmur that the veterinarian found, [ultimately deciding] to refer for a cardiac workup. So I see Vinnie, listened to the heart murmur, [and] it was 2 out of 6. We did decide to do an echocardiogram. That was the only test we really did other than [an electrocardiogram], which we did at the time. We evaluate the blood pressure with [an echocardiogram] by measuring the velocity of the leak in the mitral valve, which was normal. There was no heart enlargement.

We basically said, “Hey, look; you have this leak in your valve. We can tell the valve is degenerative. We'll see you in 12 months and see if there's any progression.” That's a really common scenario for veterinary patients, especially small-breed dogs. Small-breed dogs are the main breeds that get this disease. The Cavalier King Charles spaniel, Chihuahuas, [and] dachshunds are really predisposed to it—Maltese. I usually say any little white dog, and that is kind of who we're really looking for with this disease.

Want to hear the rest of Vinnie’s story? Check out the full episode on dvm360.com, or wherever you listen to podcasts.