A young (> 1-year-old) spayed female domestic shorthair cat was referred for evaluation of lethargy and stertorous breathing of 3 days' duration. The cat's age was estimated on the basis of closure of vertebral body physes. The cat had been adopted and spayed at a local shelter 1 week prior to evaluation. On physical examination, the cat was thin, had bilateral nasal discharge, and had a rectal temperature of 40.2°C (104.4°F; reference range, 38.1° to 39.2°C [100.6° to 102.6°F]). The cat had a heart rate of 200 beats/min (reference range, 120 to 240 beats/min) with a regular cardiac rhythm;
Sample Population—Owners of 201 dogs with heart disease.
Procedures—Owners each completed a questionnaire that was designed to ascertain the relative importance of quality versus quantity of life for their pet and to assess the owners' willingness to trade survival time for quality of life, if that were possible. Analyses were performed to evaluate factors associated with owner willingness to trade time for quality of life.
Results—Most owners (170/197 [86%]) were willing to trade survival time for quality of life for their heart disease–affected dogs; of those owners, 88 (52%) were willing to trade 6 months. Owners were highly concerned with detection of perceived pet suffering and their pet's ability to interact with them. Owners whose pets had respiratory difficulty or fainting episodes and were treated on an outpatient basis had a greater willingness to trade survival time than owners of dogs that were treated on an emergency basis. Among owners willing to trade time for quality of life, younger owners and those whose pets had fainting episodes were willing to trade the most amount of time.
Conclusions and Clinical Relevance—Results indicated that quality of life is highly important to owners of dogs with heart disease. Owners' priorities partly depend on owner age and the pet's clinical circumstances; ongoing client-veterinarian communication is important to optimize treatment success as perceived by owners.
Objective—To determine the effect of long-term
administration of enalapril on renal function in dogs
with severe, compensated mitral regurgitation.
Design—Randomized controlled trial.
Animals—139 dogs with mitral regurgitation but
without overt signs of heart failure.
Procedure—Dogs were randomly assigned to be
treated with enalapril (0.5 mg/kg [0.23 mg/lb], PO,
q 24 h) or placebo, and serum creatinine and urea
nitrogen concentrations were measured at regular
intervals for up to 26 months.
Results—Adequate information on renal function
was obtained from 132 dogs; follow-up time ranged
from 0.5 to 26 months (median, 12 months). Mean
serum creatinine and urea nitrogen concentrations
were not significantly different between dogs receiving
enalapril and dogs receiving the placebo at any
time, nor were concentrations significantly different
from baseline concentrations. Proportions of dogs
that developed azotemia or that had a ≥ 35% increase
in serum creatinine or urea nitrogen concentration
were also not significantly different between groups.
Conclusions and Clinical Relevance—Results suggest
that administration of enalapril for up to 2 years
did not have any demonstrable adverse effects on
renal function in dogs with severe, compensated
mitral regurgitation. (J Am Vet Med Assoc 2002;221:
Animals—124 dogs with compensated mitral valve regurgitation (MR).
Procedures—Dogs randomly assigned to receive enalapril or placebo were monitored for the primary endpoint of onset of CHF for ≤ 58 months. Secondary endpoints included time from study entry to the combined endpoint of CHF-all-cause death; number of dogs free of CHF at 500, 1,000, and 1,500 days; and mean number of CHF-free days.
Results—Kaplan-Meier estimates of the effect of enalapril on the primary endpoint did not reveal a significant treatment benefit. Chronic enalapril administration did have a significant benefit on the combined endpoint of CHF-all-cause death (benefit was 317 days [10.6 months]). Dogs receiving enalapril remained free of CHF for a significantly longer time than those receiving placebo and were significantly more likely to be free of CHF at day 500 and at study end.
Conclusions and Clinical Relevance—Chronic enalapril treatment of dogs with naturally occurring, moderate to severe MR significantly delayed onset of CHF, compared with placebo, on the basis of number of CHF-free days, number of dogs free of CHF at days 500 and study end, and increased time to a combined secondary endpoint of CHF-all-cause death. Improvement in the primary endpoint, CHF-free survival, was not significant. Results suggest that enalapril modestly delays the onset of CHF in dogs with moderate to severe MR.