MMVD: Staging the Murmur Before It Stages You
Myxomatous mitral valve disease is the most common acquired cardiac disease in dogs — and the line between watchful waiting and a 15-month head start runs through a single echocardiographic threshold. Follow Bella, a 7-year-old Cavalier King Charles Spaniel, from a routine wellness murmur through ACVIM staging, pimobendan initiation, and a complete long-term management plan grounded in EPIC trial evidence. Earn RACE CE credit (approval pending; hours assigned at approval).
Learning Objectives
- 1Distinguish ACVIM Stages B1 and B2 using echocardiographic thresholds (LA:Ao ≥1.6, LVIDD-N ≥1.7) and VHS criteria, and identify Stage B2 as the evidence-based treatment threshold
- 2Explain the dual mechanism of pimobendan as a calcium sensitizer and phosphodiesterase III inhibitor, and apply EPIC trial data to justify initiation at Stage B2 without concurrent diuretics or ACE inhibitors
- 3Construct the multimodal Stage C treatment protocol (pimobendan, furosemide 2 mg/kg q12h, ACE inhibitor, spironolactone) and implement appropriate renal and electrolyte monitoring after each drug class
- 4Evaluate Stage D escalation options including torasemide conversion, hydralazine or amlodipine for afterload reduction, digoxin for atrial fibrillation rate control, and sildenafil for secondary pulmonary hypertension
- 5Analyze the evidence base for integrative cardiac supplements (omega-3 fatty acids, CoQ10, taurine) and implement a resting respiratory rate home monitoring protocol that detects decompensation before clinical crisis
Course Syllabus
- 17 minMeet Bella — Is My Dog in Heart Failure?Preview
module-1-meet-bella
- 28 minValve Degeneration — From Nodules to Volume Overload
module-2-pathophysiology
- 39 minACVIM Staging — Drawing the Line Between B1 and B2
module-3-acvim-staging-diagnostics
- 410 minEvidence-Based Treatment — From EPIC to Emergency
module-4-conventional-treatment
- 58 minIntegrative Cardiac Support — What the Evidence Actually Says
module-5-integrative-cardiac-support
- 67 minBella's Results — Staging, Starting, and Staying Ahead
module-6-case-resolution
Final Assessment
10 questions · Passing score: 70%
Complete all course modules to unlock the assessment. Upon passing, your CE certificate will be generated automatically.