MMVD: Staging the Murmur Before It Stages You — CE Course — CE Portal | Dr. Rosie DVM
MMVD: Staging the Murmur Before It Stages You
Dr. Rosemary Stolzer-Bolton, DVM, DVMCanineFree Preview
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 1.0 RACE CE credit.
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
Meet Bella — Is My Dog in Heart Failure?Preview
module-1-meet-bella
7 min
2
Valve Degeneration — From Nodules to Volume Overload
module-2-pathophysiology
8 min
3
ACVIM Staging — Drawing the Line Between B1 and B2
module-3-acvim-staging-diagnostics
9 min
Final Assessment
10 questions · Passing score: 70%
Complete all course modules to unlock the assessment. Upon passing, your CE certificate will be generated automatically.
4
Evidence-Based Treatment — From EPIC to Emergency
module-4-conventional-treatment
10 min
5
Integrative Cardiac Support — What the Evidence Actually Says
module-5-integrative-cardiac-support
8 min
6
Bella's Results — Staging, Starting, and Staying Ahead