Background: In dogs with chronic valvular heart disease (CVHD), early recognition of pulmonary edema (PE) is of paramount importance. Recent studies in dogs showed that lung ultrasound examination (LUS) is a useful technique to diagnose cardiogenic PE. Objectives: To describe LUS features in dogs with different stages of CVHD, and to determine its diagnostic accuracy in detecting PE using thoracic radiography as the reference standard. Animals: Sixty-three dogs with CVHD. Methods: Prospective, multicenter, cross-sectional study. Each dog underwent physical examination, echocardiography, thoracic radiography, and LUS. The LUS findings were classified as absent, rare, numerous, or confluent B-lines. Sensitivity, specificity, and positive and negative predictive values of LUS B-lines to identify PE were calculated using thoracic radiography as the reference standard. Results: Dogs in stage B1 had absent or rare B-lines in 14 of 15 cases (93.3%). Dogs in stage B2 had absent or rare B-lines in 16 of 18 cases (88.9%). All dogs in stage C, without radiographic signs of PE, had absent or rare B-lines. Dogs in stage C, with radiographic signs of PE, had numerous or confluent B-lines in 18 of 20 cases (90%). Lung ultrasound examination detected PE with a sensitivity of 90%, specificity of 93%, and with positive and negative predictive values of 85.7 and 95.2%, respectively. Conclusions and Clinical Importance: Lung ultrasound examination showed good diagnostic accuracy to identify cardiogenic PE and might be helpful in staging dogs with CVHD. Lung ultrasound examination should be considered as a new, noninvasive diagnostic tool for clinicians managing CVHD in dogs.

Background There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables. Hypothesis/Objectives To propose an easy‐to‐use echocardiographic classification of severity of MMVD in dogs. Animals Five hundred and sixty dogs with MMVD. Methods This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium‐to‐aorta ratio, left ventricular end‐diastolic diameter normalized for body weight, fractional shortening, and E‐wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4‐5), moderate (score: 6‐7), severe (score: 8‐12), late stage (score: 13‐14). Results Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877‐2810 days), moderate (1882 days, 95% CI 1341‐2434 days), severe (623 days, 95% CI 432‐710 days), and late stage (157 days, 95% CI 53‐257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001). Conclusions and Clinical Importance The MINE score is a new easy‐to‐use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.

Background Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH). Hypothesis/Objectives To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right‐sided congestive heart failure (R‐CHF). Animals 89 dogs with PH and 74 healthy dogs. Methods Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end‐diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively). Results RVEDA index was higher in dogs with moderate PH (10.8 cm²/m²; range, 6.2‐14.4 cm²/m²) and severe PH (12.4 cm²/m²; range, 7.7‐21.4 cm²/m²) than in those with mild PH (8.4 cm²/m²; range, 4.8‐11.6 cm²/m²) and control dogs (8.5 cm²/m²; range, 2.8‐11.6 cm²/m²; P < .001). RVEDA index was significantly higher in dogs with R‐CHF (13.7 cm²/m²; range, 11.0‐21.4 cm²/m²) than in dogs without R‐CHF (9.4 cm²/m²; range, 4.8‐17.1 cm²/m²; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R‐CHF. Conclusions and Clinical Importance The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R‐CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.

The diagnostic accuracy of a smartphone electrocardiograph (ECG) in evaluating heart rhythm and ECG measurements was evaluated in 166 dogs. A standard 6-lead ECG was acquired for 1 min in each dog. A smartphone ECG tracing was simultaneously recorded using a single-lead bipolar ECG recorder. All ECGs were reviewed by one blinded operator, who judged if tracings were acceptable for interpretation and assigned an electrocardiographic diagnosis. Agreement between smartphone and standard ECG in the interpretation of tracings was evaluated. Sensitivity and specificity for the detection of arrhythmia were calculated for the smartphone ECG. Smartphone ECG tracings were interpretable in 162/166 (97.6%) tracings. A perfect agreement between the smartphone and standard ECG was found in detecting bradycardia, tachycardia, ectopic beats and atrioventricular blocks. A very good agreement was found in detecting sinus rhythm versus non-sinus rhythm (100% sensitivity and 97.9% specificity). The smartphone ECG provided tracings that were adequate for analysis in most dogs, with an accurate assessment of heart rate, rhythm and common arrhythmias. The smartphone ECG represents an additional tool in the diagnosis of arrhythmias in dogs, but is not a substitute for a 6-lead ECG. Arrhythmias identified by the smartphone ECG should be followed up with a standard ECG before making clinical decisions.