Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005–2014

Kellihan, Heidi B.; Waller, Kenneth R.; Pinkos, Alyssa; Steinberg, Howard; Bates, Melissa L.

doi:10.1016/j.jvc.2015.04.002

Cited by 47 publications

(66 citation statements)

References 26 publications

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“…(Class IIa, LOE: expert opinion). Sildenafil, (starting at 1‐2 mg/kg PO q8h, and titrating if needed) is used by panelists to treat Stage D heart failure from MMVD that is complicated by clinically relevant estimated pulmonary hypertension. Pulmonary hypertension is recognized as an increasingly frequent complication of MMVD, either as a direct consequence of severe mitral valve regurgitation or as an independent comorbidity that can be responsible for clinical signs including syncope, cough, and shortness of breath (dyspnea), and sometimes radiographically evident pulmonary infiltrates . (Class I, LOE: moderate) The occurrence of ascites or jugular distension in patients with primarily left‐sided heart disease is suggestive of pulmonary hypertension and should prompt an attempt to conclusively diagnose and identify patients that may benefit from sildenafil.…”

Section: Guidelines For Diagnosis and Treatment Of Mmvdmentioning

confidence: 99%

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

Keene

Atkins

Bonagura

et al. 2019

Veterinary Internal Medicne

520

880

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This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.

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Section: Guidelines For Diagnosis and Treatment Of Mmvdmentioning

confidence: 99%

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

Keene

Atkins

Bonagura

et al. 2019

Veterinary Internal Medicne

520

880

View full text Add to dashboard Cite

show abstract

“…D2. Echocardiography to assess the probability of PH should be considered when thoracic radiography shows evidence of tortuous, blunted, or dilated pulmonary arteries; asymmetric radiolucent lung fields on dorsoventral or ventrodorsal views; patchy, diffuse alveolar infiltrates; a bulge in the region of the pulmonary trunk or right‐sided cardiac enlargement Consensus in 7/7 members of the panel and 5/5 advisory reviewers …”

Section: Guidelines For Diagnostic Evaluation Of Dogs With Suspected Phmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

Self Cite

192

383

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Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

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“…Sildenafil is a highly selective PDE-5 inhibitor used to block the inactivation of cGMP by PDE-5, which leads to pulmonary arterial vasodilation (McLaughlin & McGoon, 2006). Several studies have demonstrated the benefits of sildenafil in dogs with PH caused by different pathogeneses such as respiratory disease and left heart disease, while the most recent retrospective study evaluated the effects of sildenafil and pimobendan in dogs with PH caused by lung disease or hypoxia, which showed overall poor survival rates (Bach et al, 2006;Brown, Davison, & Sleeper, 2010;Kellihan, Waller, Pinkos, Steinberg, & Bates, 2015;Kellum & Stepien, 2007;Murphy, Russell, Bianco, & Nakamura, 2017;Nakamura et al, 2011;Toyoshima, Kanemoto, Arai, & Toyoshima, 2007). In addition, the most guidelines from the human medicine for the management of PH advise against the use of PAH-approved therapies (which include sildenafil) in people with PH from left heart disease or PH from chronic lung Received: 15 September 2017 Basic information related to the pharmacokinetics of sildenafil in dogs is scarce.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of single‐dose sildenafil administered orally in clinically healthy dogs: Effect of feeding and dose proportionality

Akabane

Sato

Sakatani

et al. 2018

Vet Pharm & Therapeutics

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Basic information related to the pharmacokinetics of sildenafil in dogs is scarce. This study aimed to describe the pharmacokinetic properties of oral sildenafil and determine the effect of feeding and dose proportionality. The effect of feeding on pharmacokinetics of sildenafil (1 mg/kg) was investigated using a crossover study with six dogs. In addition, the dose proportionality of sildenafil ranging 1-4 mg/kg was evaluated using five dogs in the fasted states. The plasma concentrations of sildenafil were determined using high-performance liquid chromatography, and pharmacokinetic parameters were calculated using a noncompartmental analysis. Sildenafil administrations were well tolerated in all studies. Feeding reduced the area under the curve extrapolated to infinity (AUC ) and the maximum plasma concentration (C ) significantly. The elimination half-life (T ) did not differ between the fasted and the fed states. For dose proportionality, nonproportional increases in AUC and C at 1-4 mg/kg doses were detected by a power model analysis.

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Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005–2014

Cited by 47 publications

References 26 publications

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Pharmacokinetics of single‐dose sildenafil administered orally in clinically healthy dogs: Effect of feeding and dose proportionality

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