Self-Reported Utilization of International Guidelines for Staging Dogs with Myxomatous Mitral Valve Degeneration: A Survey among Veterinary Practitioners

Abstract

Background: ACVIM developed and published guidelines for staging myxomatous mitral valve degeneration in dogs in 2009. An updated version was published in 2019. The present study aimed to investigate whether these guidelines are actually used by the intended public more than a decade after their first publication. Methods: An online survey was distributed among Dutch and Belgian veterinarians through online channels and mailing lists. Results: Of the 524 responses, only 363 complete surveys were analyzed. The ACVIM guidelines are used by 60% of the respondents. Veterinarians find it more difficult to differentiate stage B1 from B2 in asymptomatic dogs compared to diagnosing stage C. Three-quarters of the respondents would recommend echocardiography for an incidentally detected new murmur with an intensity of 3 out of 6 in an adult dog. Two-thirds of the respondents find coughing a convincing finding for stage C disease. Close to half of the respondents associate a horizontal, dull percussion line with pulmonary edema. For confirming cardiogenic pulmonary edema, 98% of the respondents used thoracic radiographs. Conclusions: Veterinary practitioners might not have the expected training and equipment to be able to apply the guidelines in their practices, especially in the differentiation of stage B1 from stage B2.

Self-Reported Utilization of International (ACVIM Consensus) Guidelines and the Latest Clinical Trial Results on the Treatment of Dogs with Various Stages of Myxomatous Mitral Valve Degeneration: A Survey among Veterinary Practitioners

“…Regarding the profile of the practice, 18% of the respondents worked in a mixed practice where both small and large animals were welcome, and 82% of the respondents worked in a practice accepting companion animals only [ 25 ]. The sizes of the practices where the respondents worked are presented in Figure 1 [ 25 ]. The number of responding veterinarians equals roughly 12% of the total practicing veterinarians focusing on companion animals in the Netherlands [ 26 ].…”

“…Of the 363 respondents, 60% reported using the ACVIM guidelines for staging MMVD, and the remaining 40% did not [ 25 ].…”

“…We conclude that the majority of veterinarians who participated in our survey practice evidence-based veterinary medicine, as 76% would never prescribe an ACE inhibitor for dogs with stage B MMVD. Interestingly, these veterinarians are more likely to use the ACVIM staging guidelines (as ACE inhibitors are recommended by half of the panelists) than those who do not utilize the guidelines [ 25 ]. In addition, we found that veterinarians working in large practices (≥25 veterinarians) are significantly less likely to prescribe ACE inhibitors for asymptomatic adult dogs with a heart murmur than the respondents who work in small practices.…”

“…The questionnaire was part of a larger survey, which consisted of additional questions on diagnosing the various stages of MMVD. The results of the questions on diagnostics are reported in a different paper [ 25 ].…”

“… Sizes of the veterinary practices based on the number of veterinarians employed. Most respondents (38%) worked in a practice with 2 to 5 veterinarians [ 25 ]. Reprinted with permission.…”