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Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches

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A special issue of Veterinary Sciences (ISSN 2306-7381). This special issue belongs to the section "Veterinary Internal Medicine".

Deadline for manuscript submissions: 15 June 2026 | Viewed by 39204

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Dr. Ana Patrícia Fontes-Sousa

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Department of Immuno-Physiology and Pharmacology, Veterinary Hospital of the University of Porto—UPVET, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal
Interests: veterinary cardiology; mitral valve disease; cardiac biomarkers; pulmonary hypertension; cardiovascular pharmacology; echocardiography; heartworm disease

Prof. Dr. Luís Lobo

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1. Hospital Veterinário do Porto, Trav. Silva Porto 475, 4250-475 Porto, Portugal
2. Faculdade de Medicina Veterinária, Universidade Lusófona de Humanidades e Tecnologias, Campo Grande, 376, 1749-024 Lisboa, Portugal
3. Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, Apartado 55142, 4051-401 Porto, Portugal
Interests: veterinary cardiology; dilated cardiomyopathy; congenital heart disease; electrocardiography; mitral valve disease; minimally invasive surgery
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Dr. Maria João Miranda Pires

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Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
Interests: experimental pathology; veterinary cardiology

Special Issue Information

Dear Colleagues,

Cardiovascular diseases represent a significant concern in veterinary medicine, particularly in companion animals such as dogs and cats. As these pets are playing increasingly central roles in human families, protecting their health and wellbeing has become a top priority. Cardiac conditions in animals show a complexity comparable to those in human medicine, presenting challenges in terms of early detection, precise diagnosis, and the development of effective therapies. Addressing these challenges requires a commitment to advancing diagnostic and therapeutic approaches. This Special Issue, "Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches", will explore this rapidly evolving field, highlighting the importance of innovative techniques and personalized treatments. By focusing on early detection and tailored interventions, this collection of papers will underscore their critical role in enhancing quality of life for companion animals and extending their lifespan. This Special Issue will cover a diverse range of topics, including advanced imaging technologies, biomarker identification, genetic research, minimally invasive procedures, and the latest pharmacological innovations. It will provide a comprehensive overview of recent progress in diagnosing and managing cardiac conditions, from congenital anomalies to acquired diseases. By bringing together cutting-edge research and clinical expertise, this Special Issue will foster collaboration among scientists and veterinarians dedicated to companion animal cardiology. It will serve as a catalyst for further innovation, bridging gaps in knowledge and advancing the care provided to pets.

Dr. Ana Patrícia Fontes-Sousa
Prof. Dr. Luís Lobo
Dr. Maria João Miranda Pires
Guest Editors

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Keywords

companion animal cardiology
cardiac diagnostics in veterinary medicine
therapeutic approaches to animal heart disease
innovations in veterinary cardiology
cardiovascular diseases in dogs and cats

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Published Papers (11 papers)

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Research

Jump to: Review

18 pages, 7082 KB

Open AccessArticle

Comparative Study of Speckle Tracking Echocardiography in Normal and Hypertrophic Cardiomyopathy Cats

by Cho-Rok Jeong, Yoon-Joo Shin and Chul Park

Vet. Sci. 2026, 13(3), 277; https://doi.org/10.3390/vetsci13030277 - 17 Mar 2026

Viewed by 545

Abstract

Background: Speckle tracking echocardiography (STE) is a well-established tool in human cardiology for detecting subtle myocardial dysfunction using strain indices. In cats with hypertrophic cardiomyopathy (HCM), STE has been applied in several studies and has identified myocardial deformation abnormalities. This study aimed to identify sensitive echocardiographic markers of myocardial dysfunction in cats with HCM by comparing global strain and strain rate parameters with those of healthy cats. Methods: Sixty cats were examined, including 31 healthy controls and 29 HCM-affected cats. Echocardiographic assessments included global circumferential strain (GCS), global radial strain (GRS), global longitudinal strain (GLS), their corresponding strain rates (GCSR, GRSR, and GLSR), left atrial ejection fraction (LAEF), and atrial reservoir strain (RS). Results: GLS and GRS were significantly lower in HCM cats than in controls, while GCS showed no significant difference. Among strain rate parameters, only GRSR was significantly reduced in the HCM group. Additionally, both LAEF and RS were markedly decreased, suggesting atrial dysfunction associated with HCM. Conclusions: These findings indicate that GLS and GRS are reliable indicators of left ventricular dysfunction in feline HCM and that GRSR may offer additional insight into myocardial deformation dynamics. Overall, STE provides a useful, non-invasive tool for improving the diagnosis and clinical evaluation of feline HCM. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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19 pages, 1633 KB

Open AccessArticle

Evaluation of Urinary Tubular Biomarkers in Dogs with Myxomatous Mitral Valve Disease Across ACVIM Stages

by Pablo Cardenal-Morales, José Ignacio Cristóbal, Rafael Barrera, Alberto Ezquerra-Durán, Paloma Nicolas, Patricia Ruiz, Ángela Durán-Galea and Francisco Javier Duque

Vet. Sci. 2026, 13(3), 243; https://doi.org/10.3390/vetsci13030243 - 3 Mar 2026

Viewed by 1106

Abstract

Myxomatous mitral valve disease (MMVD) is the most common acquired heart valve disease in dogs and it may contribute to cardiovascular–renal axis disorders (CvRD) in dogs. Sensitive and early biomarkers of renal involvement are needed. In this prospective and observational study, 84 dogs were enrolled (20 healthy dogs and 64 dogs with MMVD), categorised using the American College of Veterinary Internal Medicine guidelines. Serum and urinary parameters were analysed, including tubular biomarkers expressed as creatinine-ratios: urinary alkaline phosphatase (uALPc), gamma-glutamyl transferase (uGGTc), N-acetyl-β-D-glucosaminidase (uNAGc), and cystatin C (uCystc). uALPc, uGGTc, and uNAGc were higher in MMVD than in controls; uALPc and uGGTc were increased from stage B1, uNAGc was higher in stages with cardiomegaly (B2 and C+D), and uCystc increased mainly in clinical stages (C+D). Serum renal markers increased only in clinical stages. ROC analysis showed good discrimination for MMVD with uALPc (AUC 0.87) and uGGTc (0.86); for cardiomegaly with uALPc (0.77) and uNAGc (0.75); and for congestive heart failure with SDMA (0.85) and uCystc (0.75). No urinary biomarker was associated with daily furosemide dose. Urinary tubular biomarkers, particularly uALPc and uGGTc, detect early CvRD in dogs with MMVD and complement traditional serum markers. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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16 pages, 3804 KB

Open AccessArticle

The Role of Phase Angle in Non-Invasive Fluid Assessment in Dogs with Patent Ductus Arteriosus: A Novel Method in Veterinary Cardiology

by Zongru Li, Ahmed Farag, Ahmed S. Mandour, Tingfeng Xu, Kazuyuki Terai, Kazumi Shimada, Lina Hamabe, Aimi Yokoi, Shujun Yan and Ryou Tanaka

Vet. Sci. 2025, 12(10), 1007; https://doi.org/10.3390/vetsci12101007 - 17 Oct 2025

Viewed by 1038

Abstract

Background: Patent ductus arteriosus (PDA) in dogs causes persistent left-to-right shunting, leading to pulmonary overcirculation, left heart volume overload, and potential congestive heart failure. Accurate assessment of fluid imbalance is essential but challenging with conventional echocardiography or biomarkers. Phase angle (PhA), derived from bioelectrical impedance analysis (BIA), may serve as a non-invasive marker of extracellular fluid distribution and cellular integrity. Objectives: This study aimed to evaluate PhA as an indicator of thoracic fluid imbalance in dogs with PDAby analyzing its correlation with pulmonary velocity (PV) and end-diastolic volume (eV), as well as its responsiveness to surgical correction. In addition, we assessed the relationships between PhA and echocardiographic structural indices (LA/Ao, TDI Sep E/Em, TDI Lat E/Em) and examined the influence of the measurement region. Methods: PhA was measured at 5, 50, and 250 kHz in 30 PDA-affected and 15 healthy dogs, with electrode placement across thorax, trunk, and abdomen. Echocardiography evaluated PV, eV, and PDA-specific structural parameters. Results: Thoracic PhA at 5 kHz was significantly reduced in PDAdogs, strongly correlated with PV and moderately with eV. Postoperative measurements showed progressive PhA recovery. Only TDI Lat E/Em correlated with mid-frequency PhA, while other structural indices showed minimal association. Thoracic PhA was lower than trunk or abdominal values, indicating that thoracic measurements may better capture localized extracellular fluid changes in PDAcompared with other regions. Conclusion: Thoracic PhA at 5 kHz effectively reflects extracellular fluid changes in PDA, complements structural echocardiography, and tracks postoperative fluid normalization. Its non-invasive nature supports clinical utility for monitoring hemodynamic burden and therapeutic response. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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11 pages, 3806 KB

Open AccessArticle

Disopyramide Therapy in Cats with Obstructive Hypertrophic Cardiomyopathy Non-Responsive to Carvedilol

by Shuji Satomi, Ryohei Suzuki, Yunosuke Yuchi, Haruka Kanno, Miyuki Nomura, Takahiro Teshima and Hirotaka Matsumoto

Vet. Sci. 2025, 12(10), 999; https://doi.org/10.3390/vetsci12100999 - 16 Oct 2025

Viewed by 1503

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common cardiomyopathy in cats and is classified as obstructive (HOCM) or non-obstructive based on anatomical differences in the left ventricular outflow tract (LVOT). In severe obstructive cases, while beta-blockers are the recommended initial treatment in humans, some patients exhibit treatment resistance. For these cases, the addition of the antiarrhythmic agent disopyramide is common. However, its use in cats has only been documented in a case report. In this study, the use of disopyramide resulted in a significant reduction in the LVOT velocity and cardiac troponin I levels. Additionally, no significant adverse effects were observed. These findings suggest that disopyramide could be a potential therapeutic option for the treatment in cats with HOCM. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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11 pages, 1900 KB

Open AccessArticle

Monoplane Simpson’s Method Is Reliable for Left Atrial Volume Assessment in Small Dogs with Myxomatous Mitral Valve Disease

by Minsuk Kim, Minwoong Seo and Chul Park

Vet. Sci. 2025, 12(10), 994; https://doi.org/10.3390/vetsci12100994 - 15 Oct 2025

Viewed by 1667

Abstract

Left atrial enlargement is a key marker of disease progression and prognosis in dogs with myxomatous mitral valve disease. Echocardiographic assessment of left atrial volume provides a more comprehensive measure than linear dimensions, yet different two-dimensional methods may yield variable results. This study aimed to compare the monoplane Simpson’s method of discs and the biplane area–length method for estimating left atrial volume indexed to body weight in dogs across different stages of disease. Dogs were prospectively evaluated with transthoracic echocardiography, and left atrial volumes were calculated using both techniques. Both indices clearly distinguished dogs with enlarged atria from controls and stage B1 patients. However, the two methods were not interchangeable, regardless of atrial size, as demonstrated by the Bland–Altman analysis. In conclusion, both techniques are clinically useful for assessing left atrial remodeling, but because they are not interchangeable, clinicians should consistently use one method. The monoplane Simpson’s method may be particularly practical for routine clinical application due to its convenience. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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12 pages, 789 KB

Open AccessArticle

The Hemoglobin, Albumin, Lymphocyte, and Platelet Score as a Prognostic Indicator for Dogs with Congestive Heart Failure Secondary to Myxomatous Mitral Valve Disease

by Jayeon Park, Yeon Chae, Sungjae Lee, Yoonhoi Koo, Hakhyun Kim, Byeong-Teck Kang and Taesik Yun

Vet. Sci. 2025, 12(9), 908; https://doi.org/10.3390/vetsci12090908 - 18 Sep 2025

Cited by 1 | Viewed by 1597

Abstract

Reliable prognostic indicators for congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD) in dogs are limited. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, a prognostic marker in humans, has not been evaluated in veterinary medicine. This study aimed to assess the HALP score’s utility for predicting short-term mortality in dogs with CHF due to MMVD. This retrospective study included 54 small-breed dogs. The HALP score was calculated as: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/platelets (/L). Six-, nine-month, and one-year mortality were assessed. The HALP score was significantly higher in survivor groups. Receiver operating characteristic (ROC) analysis showed good predictive accuracy for six- and nine-month mortality (area under the curve > 0.7). A cut-off of 11.13 for six-month mortality yielded 44.44% sensitivity and 94.44% specificity. Kaplan–Meier analysis confirmed that a higher HALP score was associated with significantly longer survival. The HALP score appears to be a valuable, novel prognostic indicator for short-term mortality in dogs with CHF due to MMVD. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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9 pages, 751 KB

Open AccessArticle

Preliminary Evaluation of NT-proBNP and cTnI as Predictors of Procedure Safety in Dogs Undergoing Transcatheter Edge-to-Edge Mitral Valve Repair

by Jeong-Min Lee, Seung-Keun Lee, Kyoung-A Youp, Ah-Ra Lee, Young-Wook Cho, Youn-Seo Jung and Sun-Tae Lee

Vet. Sci. 2025, 12(3), 223; https://doi.org/10.3390/vetsci12030223 - 2 Mar 2025

Viewed by 3070

Abstract

Myxomatous mitral valve disease (MMVD) in dogs can be treated with transcatheter edge-to-edge mitral valve repair (TEER), an emerging minimally invasive surgical technique. However, reports on prognostic markers for preoperative evaluation remain limited. This study evaluated the association of preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) levels with procedure safety in dogs undergoing TEER. A retrospective analysis was conducted on 25 dogs diagnosed with stage C (n = 18) or D (n = 7) MMVD that underwent TEER between September 2023 and January 2025. Preoperative NT-proBNP and cTnI values were measured and compared between survivors and non-survivors. Among the survivors, 15 and 4 dogs were stages C and D, respectively. Among the non-survivors, three and three dogs were stages C and D, respectively. Non-survivors had higher median NT-proBNP levels (3557 pmol/L; range: 774–10,000) and cTnI levels (0.39 ng/mL; range: 0.22–0.51) than survivors (NT-proBNP: 1262.6 pmol/L, range: 500–8773; cTnI: 0.1 ng/mL, range: 0.01–3.6). However, the two groups showed no significant differences in NT-proBNP (p = 0.187) or cTnI (p = 0.869). Increased preoperative NT-proBNP and cTnI levels were not strong predictors of procedure safety in dogs with MMVD stages C and D undergoing TEER. Further studies with larger sample sizes and longer follow-up periods are needed to better evaluate the prognostic value of these biomarkers in this population. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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Review

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16 pages, 687 KB

Open AccessReview

Reframing Heart Failure as a Multiorgan Network Disorder: Translational and Regenerative Perspectives in Veterinary Cardiology

by Mitsuhiro Isaka, Hiromu Udagawa, Yuji Hamamoto and Eunryel Nam

Vet. Sci. 2026, 13(5), 435; https://doi.org/10.3390/vetsci13050435 - 29 Apr 2026

Viewed by 586

Abstract

Heart failure (HF) has traditionally been regarded as a primary myocardial disorder in veterinary medicine. However, accumulating evidence suggests that HF represents a systemic syndrome characterized by dynamic multiorgan interactions. In human cardiovascular research, cardiorenal and cardiointestinal paradigms have reshaped disease conceptualization, yet comparable integrative frameworks remain underdeveloped in veterinary cardiology. Naturally occurring canine HF—particularly myxomatous mitral valve disease and dilated cardiomyopathy—offers a clinically relevant translational platform in which systemic remodeling unfolds within an intact physiological lifespan. This review proposes a systems-based perspective that integrates spontaneous canine HF with controlled in vivo experimental models. We outline four main pathways of interaction: (1) the heart–gut axis, wherein reduced perfusion can influence inflammation and disruption of the intestinal barrier; (2) the heart–bone axis, wherein endocrine factors like osteoprotegerin and osteocrin can impact remodeling of the cardiovascular system; (3) the heart–vascular endothelium axis, wherein inflammatory signaling and dysfunction of the vascular endothelium are hallmarks; and (4) the neurocardiac axis, which reflects an imbalance in the autonomic nervous system. Emerging regenerative and organelle-based strategies—including mesenchymal stem cell therapy and mitochondrial transplantation—are discussed within this multiorgan framework. Rather than focusing solely on cardiac contractility, these approaches may function as systemic inflammatory modulators, and endothelial, metabolic, and autonomic pathways. Canine HF can be better understood as a multiorgan network condition; reframing it in this way can help researchers in the field of translational cardiology create more comprehensive diagnostic and treatment plans. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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26 pages, 837 KB

Open AccessReview

One Health Insights into Pulmonary Hypertension: Bridging Human and Canine Medicine

by Ana Reis-Ferreira, Joana Castanheira-Moreira, Helena Coelho-Pinho, Marta Mendes, Luís Lobo, Carmen Brás-Silva, Mário Santos and Ana Patrícia Fontes-Sousa

Vet. Sci. 2026, 13(4), 341; https://doi.org/10.3390/vetsci13040341 - 31 Mar 2026

Viewed by 845

Abstract

Pulmonary hypertension is a progressive syndrome characterised by pulmonary vascular dysfunction, inflammation, maladaptive remodelling, and progressive right-ventricular strain. Translational progress remains limited because experimental models reproduce only selected aspects of the complexity of human disease. This narrative review evaluates naturally occurring canine disease as a comparative and spontaneous model of human pulmonary hypertension within a One Health framework. To achieve this, we synthesise recent human and veterinary literature, international consensus statements, and key registry and imaging studies. We outline current human definitions and diagnostic pathways based on right-heart catheterisation, together with the veterinary probability-based approach centred on echocardiography; compare epidemiology across species; and summarise contemporary mechanisms spanning vascular dysfunction, immune and metabolic signalling, and right-ventricular adaptation. We then examine canine conditions that parallel major human pulmonary hypertension phenotypes, including left-heart disease due to myxomatous mitral valve degeneration, fibrotic interstitial lung disease in West Highland White Terriers, sleep-related airway obstruction in brachycephalic breeds, and rare venous and capillary disorders. When combined, these spontaneous models provide opportunities to investigate disease-modifying techniques other than vasodilation and allow for the longitudinal, real-world evaluation of imaging, functional assessments, and circulating biomarkers. To improve care for both veterinary and human patients, we conclude by outlining priorities for mechanism-based clinical trials, shared outcome measures, prospective registries and biobanks, and harmonised definitions. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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28 pages, 4376 KB

Open AccessReview

Systemic Arterial Hypertension and Factors Associated with Blood Pressure Dysregulation in Companion Animals

by Felipe Gaia de Sousa, Fabiana Silva Fádel Queiroz, Ruthnéa Aparecida Lázaro Muzzi, Júlio César Cambraia Veado and Suzane Lilian Beier

Vet. Sci. 2025, 12(5), 453; https://doi.org/10.3390/vetsci12050453 - 9 May 2025

Cited by 2 | Viewed by 3930

Abstract

Systemic arterial hypertension (SAH), characterised by a persistent increase in BP beyond the reference values for the species, is a concerning and detrimental clinical condition. The aim of this manuscript is to present the state of the art on SAH in companion animals, including the different types of hypertension, diagnostic and therapeutic approaches, and the factors associated with its occurrence, such as the role of stress. It also discusses the benefits and challenges related to the measurement process. SAH is categorised into types based on the underlying cause: situational, secondary, and idiopathic (the least frequently observed). The situational type occurs when stress is the primary factor, such as during veterinary visits, contact with other animals, or in cases of ‘white coat syndrome’. If the stressor is removed, BP values tend to normalise. The most common type of SAH is the secondary form, which is associated with an underlying condition, such as renal, cardiac, endocrine, or neurological diseases, or a combination of these. Diagnosing SAH is a challenging task for many veterinarians due to factors related to handling the animal, managing the equipment, and interpreting the results. Consequently, many professionals either take inaccurate measurements or misinterpret the results, often prescribing antihypertensive medications prematurely or unnecessarily. Despite being a well-standardised and well-documented process, challenges persist. Treatment often involves antihypertensive drugs, either alone or in combination, alongside management of the underlying causes, when present. Therefore, BP values should be obtained correctly, with clinical-therapeutic decisions carefully aligned with the factors that may influence them. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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32 pages, 5087 KB

Open AccessReview

Clinical-Diagnostic and Therapeutic Advances in Feline Hypertrophic Cardiomyopathy

by Felipe Gaia de Sousa, Ana Cristina Ribeiro Mendes, Luisa Pimenta de Carvalho and Suzane Lilian Beier

Vet. Sci. 2025, 12(3), 289; https://doi.org/10.3390/vetsci12030289 - 19 Mar 2025

Cited by 3 | Viewed by 21294

Abstract

A comprehensive literature review was conducted to summarise existing evidence and the latest therapeutic advancements in feline HCM. The disease phenotype is characterised by the development of concentric hypertrophy, which is variable but often asymmetric, primarily affecting the left ventricle. The HCM is marked by diastolic dysfunction, resulting in a reduced intracavitary internal diameter due to the disordered alignment of cardiomyocytes and excessive collagen deposition, which thickens the myocardial tissue and impairs relaxation. There is strong evidence supporting the role of genetic mutations in sarcomeric genes in the development of HCM. Clinical signs vary but are frequently associated with congestive heart failure (CHF) and ATE. Diagnosis is based on a combination of clinical evaluation, laboratory tests, and imaging studies, although certain aspects of the disease remain insufficiently understood and require further research. Therapeutic management focuses on controlling clinical signs, slowing disease progression, and improving both quality of life and life expectancy. However, ongoing studies are essential to refine diagnostic strategies and explore novel treatment options for better disease management. Full article

(This article belongs to the Special Issue Advances in Companion Animal Cardiology: Diagnostic and Therapeutic Approaches)

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