Clinical judgment required. This calculator is a decision-support tool, not a substitute for veterinary consultation.

ACVIM Heart Disease StagingCanine

ACVIM consensus staging for myxomatous mitral valve disease (MMVD) and dilated cardiomyopathy (DCM) in dogs. Classifies heart disease into stages A (at risk, no structural disease), B1 (murmur present without significant cardiac remodeling), B2 (asymptomatic with significant cardiac enlargement — LA:Ao >= 1.6 and LVIDDN >= 1.7), C (current or past congestive heart failure), and D (refractory CHF despite standard therapy). Based on the 2019 ACVIM consensus guidelines (Keene et al.). Used for mitral valve disease staging, heart murmur evaluation, cardiac enlargement assessment, congestive heart failure classification, pimobendan initiation criteria, and cardiac treatment planning. Common queries: 'what stage heart disease is my dog' or 'when to start pimobendan for MMVD'.

Species

Heart murmur detected

Is a cardiac murmur present on auscultation?

Cardiac enlargement on imaging

Radiographic or echocardiographic evidence of significant remodeling (LA:Ao >= 1.6 and LVIDDN >= 1.7)

Pulmonary edema or pleural effusion

Radiographic evidence of cardiogenic pulmonary edema or pleural effusion

History of congestive heart failure

Has the patient had clinical signs of CHF at any time (current or resolved)?

Refractory to standard CHF therapy

Does the patient remain symptomatic despite standard heart failure treatment (furosemide, pimobendan, ACE inhibitor)?

ACVIM Stage

Low—0

Stage A — at risk breed, no structural disease. No treatment indicated; monitor annually