Abstract: Background: Anemia is an independent negative prognostic indicator in dogs with congestive heart failure, representing a target for improving quality of life and survival. Gastrointestinal bleeding may potentiate anemia in dogs with heart failure from myxomatous mitral valve disease (MMVD). Potential risk factors for gastric ulcerations and erosions (GUE) with MMVD include acquired platelet dysfunction from loss of functional von Willebrand factor (vWF) due to shear stress from mitral regurgitation and chronic intestinal hypoperfusion from decreased cardiac output.
Hypothesis/Objectives: Dogs with MMVD Stage C have more GUE compared to age-matched controls.
Animals: Six client-owned MMVD Stage C and five healthy dogs enrolled. Exclusion criteria included liver, kidney, or GI disease and antibiotic, steroid, NSAID, or gastric acid suppressant use within 21 days.
Methods: Prospective case-control study evaluating GI mucosa by video capsule endoscopy (VCE), platelet closure time (PC), vWF antigen assay, and complete blood count. Blinded investigator performed VCE scoring.
Results: All MMVD dogs had GUE, three of which had diffuse GUE. Five had irregular/thickened mucosa. Four healthy dogs had GUE defined as single, few, or multiple with no diffuse GUE, and only two had irregular mucosa. PCV and vWF antigen assay did not differ between groups. Dogs with MMVD had significantly increased PC with ADP/collagen compared to controls (p=0.0143, Wilcoxon Exact Test).
Conclusions and clinical importance: Dogs with MMVD Stage C had more severe GUE and irregular gastric mucosa, and platelet dysfunction might be a contributing factor. Larger studies should assess overall prevalence as well as potential therapeutic options.
