Background: Outcome-based cardiac risk stratification schemes are lacking for preclinical myxomatous mitral valve disease (MMVD). The Mitral INsufficiency Echocardiographic (MINE) score was developed as an easy-to-use severity classification of MMVD. Hypothesis/Objectives: The primary aim was to verify the efficacy of the MINE score in stratifying the cardiac risk in preclinical MMVD. Secondary aims were to evaluate a simplification of the original score and propose a definition of “advanced B2”. Animals: Seven hundred forty-nine dogs with preclinical MMVD. Methods: Retrospective, multicenter, cohort study. Clinical usefulness of the MINE score was tested by evaluating its association with median time to cardiac event. The Cox proportional hazards regression was used to evaluate the echocardiographic independent predictors of cardiac endpoint. Long-term outcome was analyzed using Kaplan–Meier curves and log-rank test. Results: Based on multivariate analysis, a simplified version of the MINE score was redefined including only the left atrium-to-aorta ratio, the left ventricular end-diastolic diameter, and the E-wave velocity. Mild cases had longer median time to cardiac event [2604 days, 95% confidence interval (CI) 2344–2604 days] in comparison to moderate (1216 days, 95% CI 998–1882 days) and severe cases (718 days, 95% CI 599–980 days; p < 0.001). Among stage B2, severe cases had shorter median time to cardiac event (718 days, 95% CI 599–980 days) in comparison to moderate (1141 days, 95% CI 980–1725 days) and mild cases (not available; p < 0.001). Conclusions and Clinical Importance: For this study cohort, the simplified version of the MINE score was clinically effective for risk stratification of preclinical MMVD. Dogs in stage B2 classified as “severe” can be defined “advanced” B2.

Background: Pulmonary stenosis (PS) usually is evaluated using echocardiography. A multiparametric approach, in addition to the maximum pressure gradient (PG), might be indicated to better characterize PS severity and address its management. Hypothesis/Objectives: Our hypothesis was that right heart size and function are associated with echocardiographic and clinical severity of pulmonary stenosis in dogs. Animals: Client-owned dogs with PS. Methods: Prospective, multicenter, observational study. Enrolled dogs underwent complete echocardiographic examination. Associations among right heart echocardiographic variables, PS transvalvular PG >80 mm Hg and presence of clinical signs (exercise intolerance, syncope, right-sided congestive failure, or some combination of these) were assessed using logistic regression analysis. Results: Eighty-eight dogs with PS. Twenty-eight dogs were symptomatic. Increased right ventricular end-diastolic free wall thickness (odds ratio [OR] > 100; 95% confidence interval [95%CI], 50- > 100; P = .01) and decreased aorta-to-pulmonary artery velocity time integral ratio (OR, < 0.001; 95%CI, 0.0-0.001; P = .005) were independently associated with PS PG >80 mm Hg. Decreased tricuspid annular plane systolic excursion (OR, 0.35; 95%CI, 0.15-0.77; P = .01) and increased right ventricular end-diastolic area (OR, 1.4; 95%CI, 1.08-2.02; P = .01) were independently associated with clinical severity. Conclusion and Clinical Importance: Structural and functional right heart echocardiographic variables are associated with echocardiographic and clinical severity in dogs with PS. A multiparametric approach is advised to better assess PS severity.

Two French bulldogs and one English bulldog affected by pulmonary valve stenosis and referred for pulmonary balloon valvuloplasty were diagnosed with different abnormalities of the external jugular veins. The diagnosis included unilateral absence of the right external jugular vein and bilateral hypoplasia of the external jugular veins, associated with persistent left cranial vena cava. Vascular ultrasound and computed tomography were used for the diagnosis. Jugular vein anomalies can affect decision-making regarding the central venous catheterization needed to perform procedures such as pulmonary balloon valvuloplasty or central catheter placement. Based on the results of the present case series, anomalies of external jugular veins should be considered in French and English bulldogs when the external jugular veins cannot be palpated or when echocardiography shows coronary sinus dilation. Vascular ultrasound or computed tomography may help identify jugular venous anomalies and should be considered in the preoperative evaluation of bulldogs that need to undergo interventional procedures requiring transjugular catheterization.

Background: Evaluating the size of the pulmonary artery (PA) is key for the echocardiographic assessment of pulmonary hypertension (PH) in dogs. Hypothesis/Objectives: To compare the diagnostic accuracy of the main PA (MPA) and right PA (RPA) sizes for the echocardiographic detection of PH in dogs, and to evaluate differences between precapillary and postcapillary PH dogs. Animals: Four hundred four dogs; 136 controls and 268 with PH. Methods: Prospective, multicenter, observational study. The MPA, maximum and minimum RPA diameter were normalized to body weight (MPA_N, RPAmax_N, and RPAmin_N). The MPA was also indexed to the ascending aorta (MPA/AO), while the RPA size was indexed to the aortic annulus (RPAmax/Aod and RPAmin/Aod). The right pulmonary artery distensibility index (RPADi) was also calculated. The diagnostic accuracy of PA parameters for PH was assessed through the receiver operating characteristic curve analysis and area under the curve (AUC). Measurement variability was assessed trough the coefficient of variation (CV). Results: The RPADi, RPAmin_N, and RPAmin/Aod showed similar diagnostic accuracy for the detection of PH (AUC = 0.975, AUC = 0.971, and AUC = 0.953, respectively), higher than MPA/AO (AUC = 0.926), MPA_N (AUC = 0.880), RPAmax_N (AUC = 0.814), and RPAmax/Aod (AUC = 0.803; P < .05). Aside from RPAmax variables, no differences were found between precapillary and postcapillary PH. RPA size parameters showed lower CVs in comparison to MPA/AO and RPADi. Conclusions and Clinical Importance: Although MPA/AO showed an excellent sensitivity and specificity for the detection of PH, the RPAmin exhibited a higher diagnostic accuracy and less measurement variability, thus could represent a new useful parameter for the detection of PH in dogs.

Percutaneous balloon dilation was performed in a Rhodesian Ridgeback and in an American Staffordshire Terrier affected by cor triatriatum dexter (CTD). Both cases had ascites without jugular venous distension or pleural effusion. In both dogs the CTD presented a perforated membrane but with different morphology: in one case the coronary sinus entered the caudal chamber of the CTD together with the caudal vena cava. In the other case, the coronary sinus communicated with the cranial chamber of the CTD together with the cranial vena cava. Percutaneous balloon dilation of the CTD was successfully performed, and both dogs had uneventful surgery recoveries. At two years of follow-up, the dogs were free from clinical signs and cardiac medication.