JSAP study finds dogs with MMVD could develop reductions in PCV

A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP),  has identified an inverse relationship between packed cell volume (PCV) and the severity of myxomatous mitral valve disease (MMDV) in dogs.

The study, which was funded by BSAVA-PetSavers, the charitable division of the BSAVA, was titled “The effects of myxomatous mitral valve disease severity on packed cell volume” and involved the retrospective analysis of prospectively collected data.

Data was collected from 289 dogs on more than one occasion (n=1465 visits) between 2004-2017. The research was conducted by the Royal Veterinary College in two first opinion practices in London. The study included a control population of patients seen at the same research clinic.

To be included in the study, dogs were required to have received an echocardiographic diagnosis of MMVD by a board-certified cardiologist alongside having available PCV measurements from the same examination. Dogs had repeated examinations every 6 months, and each time a jugular blood sample was obtained, measuring PCV (% whole blood), total solids (TS, g/L) and blood urea nitrogen (BUN, mmol/L). 

Standard right parasternal echocardiographic views were obtained, calculating the left atrial to aortic root ratio and the normalised left ventricular internal diameter at end diastole. The heart disease was then staged according to the American College of Veterinary Internal Medicine (ACVIM) guidelines.

Dr Jenny Wilshaw, corresponding author for the paper, said: “In this study, PCV appeared to decrease with increasing severity of preclinical disease, producing a significant difference when stages B1 and B2 were compared. Interestingly, this inverse relationship with ACVIM stage did not continue through to stage C. PCV in stage C was significantly greater than either preclinical stage, lying closer to that of the unaffected dogs.”

Dr Wilshaw continued: “A second analysis indicated that the increased PCV in stage C disease may be due to diuresis reducing plasma volume, as dogs receiving furosemide had higher values of PCV. We therefore concluded that dogs with MMVD may develop small reductions in PCV as a result of haemodilution. This study adds to our understanding of the pathophysiology of MMVD by suggesting that plasma volume is expanded as early as stage B1.

JSAP MMVD mxyomatous mitral valve disease PCV study

“Similar associations between left ventricular internal diameter at end diastole, furosemide administration and TS were observed when TS was analysed as the dependant variable. Haemodilution would not be expected to affect PCV in isolation, so finding these results for another component of blood provides further support for our interpretation.”

“In addition to ACVIM stage, several demographic factors also remained in the model. When grouped as Cavalier King Charles Spaniel (CKCS) or non-CKCS, PCV was significantly lower in CKCS.”

Nicola Di Girolamo, Editor of JSAP concluded: “Although retrospective, this study included a large population of dogs and appropriate statistical techniques to account for repeated measures from the same individual. Studies like this one are particularly welcome to the JSAP, as a base for further prospective research.”

BSAVA-PetSavers is funded solely by charitable donations and has invested more than £2 million in vital clinical research and training programmes over the past 40 years to advance clinical investigations into pet animal medicine and surgery. For further information on BSAVA-PetSavers visit their website.

The full article can be found in the June issue of the Journal of Small Animal Practice and can be read online here. It is open access and can be freely accessed by anyone.

The Journal of Small Animal Practice is published monthly and access to all articles is free for BSAVA members. For information on how to become a BSAVA member visit here.

1J. Wilshaw, M. Stein, N. Lotter, J. Elliott and A. Boswood (2021) The effect of myxomatous mitral valve disease severity on packed cell volume in dogs. Journal of Small Animal Practice, 62 (5). Available at: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13308