This presentation is a practical, clinically relevant review of the latest updates in the diagnosis and management of mitral valve disease in dogs. Recent data, including the 2021 BESST study and 2019 ACVIM guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs, will be discussed with tips to apply the findings to your daily practice.


1. Three main takeaways from the ACVIM guidelines include the following:

  • Stage your MMVD patients
  • Treatment beginning in stage B2
  • Quadruple therapy including an ACEi and Spironolactone for CHF

2. RAAS activation in MMVD causes:

  • Chronic vasoconstriction
  • Cardiac fibrosis/remodeling
  • Retention of sodium and water

3. BESST study summary:

  • Broad-spectrum RAAS inhibition improves time to cardiac endpoint in dogs with stage C MMVD

About the Author

Dr. Susanne Heartsill, DVM, DABVP (Canine and Feline Practice)

Dr. Heartsill is a 1999 graduate of Mississippi State University College of Veterinary Medicine and is the founder of Downtown Animal Hospital in Memphis, Tennessee. After 20 years in practice, Dr. Heartsill joined Ceva Animal Health as a Veterinary Services Manager. Always passionate about companion animal cardiology, Dr. Heartsill became the Cardiology Technical Marketing Manager for the U.S. in December 2020. Now residing on a small farm in Auburn, Alabama with her family, Dr. Heartsill enjoys everything about horses and the great outdoors.