Mitral Valve Disease

Cavalier King Charles Spaniels are generally healthy, sturdy, small dogs. However, as with many other breeds, there are health concerns. The number one health concern is a form of degenerative valve disease called Mitral Valve Disease (MVD). Please take time to review this health summary.

Cavalier Clubs throughout the world are active in fighting diseases and disorders in this beloved breed by providing health clinics, funding breed specific research and delivering breed education programs. The findings from surveys performed by the late George A. Padgett, DVM, Veterinary Pathologist & Professor Emeritus at the College of Veterinary Medicine of Michigan State University and author of Control of Canine Genetic Diseases, indicate that mixed-breed dogs have more genetic diseases than purebred dogs. There are 215 known diseases in mixed-breed dogs, with 71 percent of them having defective genes. The idea that a mixed-breed dog is likely to have fewer genetic diseases than a purebred is a misconception. 

Click Here to read more about Degenerative Valve Disease by Dr. Robert Prošek

 

What is Mitral Valve Disease (MVD)?

The heart consists of 4 chambers, 2 atria and 2 ventricles, with the atrioventricular valves ensuring the blood flows from the atria to the ventricles when the heart is beating. A defect or weakness in the mitral valve, or left atrioventricular valve, allows some blood to move back into the left atrium. This is known as mitral regurgitation. This means the heart is less efficient at pumping blood through the body. The following images are color doppler images of mitral valve regurgitation.  A heart with healthy valves (no regurgitation) would show only blue and red on the color doppler.  The green color shown in the images below is indicative of backflow.

mvdregurge2     mvdregurge

Mitral valve insufficiency is the most common of the acquired cardiac diseases in older dogs, affecting over 1/3 of dogs older than 10 years. However, in certain breeds including the Cavalier King Charles Spaniel, mitral valve insufficiency develops at a younger age, due to an inherited predisposition for the disorder.

Symptoms

The first signal that a dog might have Mitral Valve Disease is the development of a heart murmur. However, a dog with a heart murmur may live a full life span, depending up the progression of the disease in that particular dog. Some dogs that have developed heart murmurs at young ages have lived to the average lifespan of that breed. A veterinarian, while listening to a dog's heart, may hear a heart murmur on the left side. (Please note there are other causes for heart murmurs. To diagnose MVD, it will depend upon where the regurgitation is heard). The veterinarian will then grade the murmur for severity from Grade 1 (mild) to Grade 6 (severe) and depending upon the grade will advise proper treatment.

Severe Mitral Valve Disease will eventually lead to Congestive Heart Failure.

Implication for Owner

The Cavalier will have their heart checked during his or her annual visit to the veterinarian. Cavaliers that develop murmurs might have early signs of MVD. If the disease is present and progresses, the murmur will become more audible, the dog may become intolerant of exercise, respiratory rate will increase, fluid will begin to accumulate in the lungs and the dog will develop coughing and labored breathing.  In most cases, a Cavalier will not need heart medications until late in life.  There are treatments available to assist with management of advancing MVD. A board Certified Veterinary Cardiologist should be consulted to determine the exact mode of therapy for each Cavalier. 

Implication for breeders

At present, MVD inheritance in the Cavalier is speculated in the veterinary community, however, research funded by the ACKCSC Charitable Trust is ongoing to confirm this hypothesis.  The inheritance is suspected to be polygenetic (several genes involved) with multifactorial influences (e.g., dog's environment, food and weight). In other words, there would be a genetic predisposition for the disease but other factors will come into play similar to other species (such as humans).  The Cavalier King Charles Spaniel has been studied and screened for over 20 years thanks to the dedication and generosity of owners, breeders and cardiologists in the USA.  To date, other purebreds and mixed breed dogs predisposed to MVD have not been studied and screened to the level of Cavaliers.

The recommended health screenings for Cavaliers are annual auscultations (listening to the heart with a stethoscope) by board certified cardiologists and doppler (Echocardiogram) if there is a question on auscultation.  The ACKCSC, Regional Cavalier clubs and local AKC all Breed Clubs are hosting and making health clinics with cardiologists accessible to breeders and owners throughout the USA.   Currently, the recommended practice is to wait until a Cavalier is two years old or older before the first breeding and to know the parents and ancestral cardiac status.  Cavaliers with early onset presentations of MVD (before four years of age) should not be bred and breeders need to work with the guidance of their cardiologists.

Another important factor in Mitral Valve Disease is the rate of progression of the disease (if present) and this is why breeders and owners are recommended to continue to monitor their Cavalier's heart on an annual basis.

By having Cavaliers screened annually by board certified cardiologists for evidence of heart murmurs and breeding unaffected older dogs, breeders are striving to move the age of onset of the disease as far as possible.  Some Cavaliers have not presented with cardiac disease even at advanced ages.  In reality though, cardiac diseases cannot be totally eradicated in dogs or humans.

In closing, we must understand that this is a greater canine (mixed breeds & purebred) health issue.  "Degenerative valve disease accounts for about 75% of cardiovascular disease in dogs. Approximately 60% of affected dogs have degeneration of the mitral valve, 30% have lesions in both the tricuspid and mitral valve leaflets, and 10% have only tricuspid valve disease. In dogs, the disease is age and breed related, with older, small-breed dogs demonstrating a higher incidence.  There is also a slight predisposition among male dogs".  Quote Source:  Degenerative Valve Disease by:  Dr. Robert Prosek.

GRANTS FUNDED BY THE ACKCS CHARITABLE TRUST

Mitral Valve Disease in Cavalier King Charles Spaniels, University of Pennsylvania. Note:  Research began Sept. 1, 2006 with funds from an anonymous donor of $80,000.00

 AKC/CHF GRANT #00908:  Serotonin Type2A Receptor Antagonist Therapy for Preventing the Progression of Myxomatous Mitral Valve Disease.  This proposal represents a novel translational study that targets a potential underlying pathogenesis of canine mitral valve disease.

    

 

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