MMVD: Staging the Murmur Before It Stages You

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

1. 1
   Meet Bella — Is My Dog in Heart Failure?Preview

   module-1-meet-bella

   7 min
2. 2
   Valve Degeneration — From Nodules to Volume Overload

   module-2-pathophysiology

   8 min
3. 3
   ACVIM Staging — Drawing the Line Between B1 and B2

   module-3-acvim-staging-diagnostics

   9 min