Cavalier King Charles Spaniels (CKCSs) should begin cardiac screening at 1 year of age, with annual auscultation and echocardiography thereafter, given that 50% of the breed is affected by myxomatous mitral valve disease (MMVD) by age 6–7 years and nearly 100% by age 11.Journal of Vete…+1
The Danish Kennel Club mandatory breeding scheme, which combines auscultation and echocardiography, reduced the odds of mitral regurgitation murmur by 73% over an 8–10 year period in dogs that were products of the scheme, compared to no significant change in non-products.Journal of Vete… The UK breed scheme, which relied on auscultation alone, showed a benefit only in a subgroup — bitches examined by general practitioners showed murmur detection age increase from 8.6 to 9.2 years — but no benefit was seen in male dogs or dogs examined by cardiologists, and breeder compliance was poor.Journal of Vete…
Echocardiography is the gold standard for MMVD staging and should not be replaced by auscultation alone. The presence of a heart murmur does not reliably discriminate between ACVIM stage A and stage B1 MMVD in CKCSs.Animals Among individual non-echocardiographic screening tests, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and vertebral heart size (VHS) have the best discriminatory ability for identifying stage B2 disease, with areas under the curve of 0.855 and 0.843, respectively.Journal of Vete… An NT-proBNP ≥ 1138 pmol/L carries 90.1% specificity for stage B2, and a VHS ≥ 11.5 carries 90.6% specificity for stage B2.Journal of Vete…
Breed-specific radiographic reference values must be used when interpreting VHS in CKCSs. The breed-specific VHS mean is 10.08 ± 0.56 (95% range 9.87–10.29), which is significantly higher than the general canine reference of 9.7 ± 0.5.Veterinary Radi… Breed-specific mean VLAS is 1.79 ± 0.3 (95% range 1.68–1.9), modified VLAS is 2.23 ± 0.44 (95% range 2.06–2.39), and radiographic left atrial dimension is 1.2 ± 0.34 (95% range 1.07–1.33) — all significantly lower than previously published general canine reference values.Veterinary Radi…
Prognosis is influenced by findings at young age. Moderate to severe mitral regurgitation detected at 1–3 years of age is associated with increased cardiac mortality, and increased left ventricular end-systolic internal dimension normalized for body weight at that age predicts both cardiac and all-cause mortality.Journal of Vete… Approximately 60% of male CKCSs die before age 10, compared to approximately 50% of females, and cardiac causes account for 26% of deaths in the breed.Journal of Vete…
| Screening Test | CKCS-Specific Cutoff / Reference Value | Discriminatory Performance for Stage B2 | Key Caveat |
|---|---|---|---|
| NT-proBNP | ≥ 1138 pmol/L | AUC 0.855; specificity 90.1% | Blood-based; requires laboratory submission Journal of Vete… |
| VHS (radiograph) | ≥ 11.5 (breed-specific mean 10.08 ± 0.56) | AUC 0.843; specificity 90.6% | General canine cutoff of 9.7 underestimates normal in CKCS Veterinary Radi…+1 |
| Four-test model (PE + ECG + radiograph + biomarkers) | Combined model | AUC 0.971 | Requires full workup; not a single-test screen Journal of Vete… |
| Auscultation alone | — | Murmur does not distinguish stage A from B1 | Insufficient as sole screening tool Animals |
Would you like guidance on the specific echocardiographic criteria that distinguish stage B1 from stage B2 MMVD in CKCSs?