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Additional diagnostic tests

Serologic tests

Serum biochemistries, PCV/TS or complete blood count (CBC) panels, and urinalysis should be completed in all dogs prior to initiating any treatment for congestive heart failure (CHF).

NT-proBNP is a new blood test for cardiac disease in veterinary patients. NT-proBNP is released in proportion to stretch and stress in the heart and is used to assess the severity of heart disease.^1,2 Patients in heart failure have significant elevations of NT-proBNP, adding useful diagnostic information in the evaluation of patients with compatible clinical signs. Studies have also shown that elevated NT-proBNP levels are seen in patients with impending heart failure and in those with a poorer prognosis.

Echocardiography and electrocardiograms

Echocardiography is useful in determining a definitive diagnosis of the underlying structural disease as it provides a quantitative evaluation of heart chamber size, wall thickness, and the dynamic changes that occur during the cardiac cycle.³

In addition, the electrocardiogram (ECG) is the only diagnostic method that provides specific information about the etiology of an arrhythmia.³ The ECG is a good follow-up test when a cardiac arrhythmia is discovered during a routine physical exam.⁴

References:

1. Oyama MA, Rush JE, Rozanski EA, et al. Assessment of serum N-terminal pro-B-type natriuretic peptide concentration for differentiation of congestive heart failure from primary respiratory tract disease as the cause of respiratory signs in dogs. J Am Vet Med Assoc. 2009;235(11):1319–1325. 2. Oyama MA, Fox PR, Rush JE, Rozanski EA, Lesser M. Clinical utility of serum N-terminal pro-B-type natriuretic peptide concentration for identifying cardiac disease in dogs and assessing disease severity. J Am Vet Med Assoc. 2008;232(10):1496–1503. 3. Beardow AW. Veterinary cardiology diagnostics: assessing cardiac health in the 21st century. DX Consult. 2008;2(1):12–15. Available at: http:// www.idexx.com/pubwebresources/pdf/en_us/smallanimal/education/dx- consult/assess-cardiac-health-in-21st-century.pdf. Accessed January 30, 2011. 4. Cardiac Education Group. Canine cardiac diagnostic system: ABCD’s of canine cardiology. September 2010. Available at: www.cardiaceducationgroup.org/common/cms/documents/ ABCD_CEG_Brochurev13_R.pdf. Accessed January 17, 2011.

Important safety information

VETMEDIN should not be given in case of hypertrophic cardiomyopathy, aortic stenosis, or any other clinical condition where an augmentation of cardiac output is inappropriate for functional or anatomical reasons. The safety of VETMEDIN has not been established in dogs with asymptomatic heart disease or in heart failure caused by etiologies other than atrioventricularvalvular insufficiency or dilated cardiomyopathy. The safe use of VETMEDIN has not been evaluated in dogs younger than 6 months of age, dogs with congenital heart defects, dogs with diabetes mellitus or other serious metabolic diseases, dogs used for breeding, or pregnant or lactating bitches. Use only in dogs with clinical evidence of heart failure. The most common side effects reported in field studies were poor appetite, lethargy, diarrhea, dyspnea, azotemia, weakness, and ataxia. If side effects should occur, pet owners should contact their veterinarian. Please refer to the Full Prescribing Information here.