Serial echocardiographic evaluation in a Shih Tzu dog with myxomatous mitral valve disease

Case report

Authors

  • Tatiane Layla Gonçalves Faculdade Qualittas
  • Renata Benedetti Cepinho São Paulo State University image/svg+xml

DOI:

https://doi.org/10.31533/pubvet.v20n7e1985

Keywords:

Diastole, hemodynamics, prognosis, regurgitation, remodeling

Abstract

Myxomatous mitral valve disease (MMVD) is the most prevalent cardiac disease in small animal practice, requiring careful monitoring to determine the optimal timing for therapeutic intervention. This study reports the serial echocardiographic follow-up of a 10-year-old male Shih Tzu dog diagnosed with MMVD. Two echocardiographic examinations were performed at a three-month interval (from February to May 2026). At the first examination, the patient presented with mild left atrial enlargement (left atrium-to-aorta [LA/Ao] ratio of 1.62) and significant mitral regurgitation. At the second examination, progression of left atrial dilation (LA/Ao ratio of 1.69) and increased ventricular contractility (ejection fraction increasing from 67% to 79%) were observed, suggesting that the patient was approaching the criteria used for ACVIM stage B2. Comparative analysis demonstrated the importance of Doppler echocardiography for the early detection of hemodynamic alterations and for risk stratification of congestive heart failure. It is concluded that serial monitoring is essential for the appropriate clinical management of myxomatous mitral valve disease in predisposed breeds.

References

Balzan, G., Rodrigues, A. S., Malaggi, V. B., Bortolanza, M. C., Santos, J. B., & Llorente, M. (2021). Insuficiencia cardíaca congestiva: evolución clínica, enfermedades relacionadas - Informe de caso. Epicentro - Revista de Investigación Ciencias de la Salud, 1(1). https://doi.org/10.59085/2789-7818.2021.10.

Bonagura, J. D., & Lehmkuhl, L. B. (1999). Clinical echocardiography of the dog and cat. In: Fox PR, Sisson D, Moïse NS (Eds.). Textbook of Canine and Feline Cardiology: Principles and Clinical Practice. 2nd ed. Philadelphia: Saunders.

Boon, J. A. (2011). Veterinary Echocardiography. 2nd ed. Ames: Wiley-Blackwell.

Boswood, A., Häggström, J., Gordon, S. G., Wess, G., Stepien, R. L., Oyama, M. A., Keene, B. W., Bonagura, J., MacDonald, K. A., & Patteson, M. (2016). Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC study—a randomized clinical trial. Journal of Veterinary Internal Medicine, 30(6), 1765–1779. https://doi.org/10.1016/j.asams.2017.03.008.

Detofano, J., Silva, A. C. A., Almeida, L. G., Mattei, A. S., Giordani, C., Castro, L. L. D., & Guterres, K. A. (2024). Bloqueio atrioventricular de terceiro grau associado à doença valvar mixomatosa de valva mitral, aórtica e tricúspide em um cão idoso: Relato de caso. Revista Inovavet, 2(1). https://doi.org/10.18226/30855713.v2.n1.04.

Dobler, G. H., Oliveira, H. S., & Almeida, M. R. (2023). Estudo anatômico das lesões endocardiose em cães, prevalência e epidemiologia. Arquivos de Ciências Veterinárias e Zoologia da UNIPAR, 26(1cont). https://doi.org/10.25110/arqvet.v26i1cont-006.

Keene, B. W., Atkins, C. E., Bonagura, J. D., Fox, P. R., Häggström, J., Fuentes, V. L., Oyama, M. A., Rush, J. E., Stepien, R., & Uechi, M. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of Veterinary Internal Medicine, 33(3), 1127–1140. https://doi.org/10.1111/jvim.15488. Acesso em: 2 abr. 2020.

Morgan, K. R. S., Monteith, G., Raheb, S., Colpitts, M., & Fonfara, S. (2020). Echocardiographic parameters for the assessment of congestive heart failure in dogs with myxomatous mitral valve disease and moderate to severe mitral regurgitation. The Veterinary Journal, 263, 105518. https://doi.org/10.1016/j.tvjl.2020.105518.

Oliveira, E. C. V. (2026). Análise Eletrocardiográfica em Pacientes Veterinários. Anais do Congresso Brasileiro de Cardiologia Veterinária.

Oyama, M. A. (2015). Pathogenesis of canine myxomatous mitral valve disease: current concepts and future directions. Veterinary Journal, 206(1), 6-15.

Perin, C., Bariani, M. H., Franco, D. F., & Filadelpho, A. L. (2007). Endocardiose da valva mitral em cães. Revista Cientifica de Medicina Veterinária, 8.

Reinero, C., Visser, L. C., Kellihan, H. B., Masseau, I., Rozanski, E., Clercx, C., Williams, K., Abbott, J., Borgarelli, M., & Scansen, B. A. (2020). ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. Journal of Veterinary Internal Medicine, 34(2), 549–573. https://doi.org/10.1111/jvim.15725.

Reynolds, C. A., Brown, D. C., Rush, J. E., Fox, P. R., Nguyenba, T. P., Lehmkuhl, L. B., Gordon, S. G., Kellihan, H. B., Stepien, R. L., Lefbom, B. K., Kate Meier, C., & Oyama, M. A. (2012). Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: The PREDICT cohort study. Journal of Veterinary Cardiology, 14(1), 193–202. https://doi.org/10.1016/j.jvc.2012.01.008.

Schober, K. E., Hart, T. M., Stern, J. A., Li, X., Samii, V. F., Zekas, L. J., Scansen, B. A., & Bonagura, J. D. (2010). Detection of congestive heart failure in dogs by Doppler echocardiography. Journal of Veterinary Internal Medicine, 24(6), 1358–1368. https://doi.org/10.1111/j.1939-1676.2010.0592.x.

Silva, T. L. S., Silva, A. T., Lima, E. P. O., Santos, C. C., Santos, C. S., Caminha, M. F. C., & Silva, S. L. (2022). Diagnósticos e intervenções de enfermagem para pacientes com insuficiência cardíaca congestiva em unidade de terapia intensiva: revisão integrativa. Revista Eletrônica Acervo Saúde, 15(2). https://doi.org/10.25248/reas.e9724.2022.

Published

2026-08-10

Issue

Section

Medicina veterinária

How to Cite

1.
Gonçalves TL, Cepinho RB. Serial echocardiographic evaluation in a Shih Tzu dog with myxomatous mitral valve disease: Case report. Pubvet [Internet]. 2026 Aug. 10 [cited 2026 Oct. 20];20(07):e1985. Available from: https://ojs.pubvet.com.br/index.php/revista/article/view/4825