Epidemiology

Many scientific advances have improved our knowledge of cardiac disease and congestive heart failure (CHF) in dogs. In addition to new cardiac medications, recent advances have improved our understanding of nutritional interventions and nutritional pharmacology. Cardiovascular disease is still one of the most common life-threatening disorders in dogs. Most canine cardiac diseases cannot be cured and the disease process is typically progressive, leading to advanced CHF or lethal cardiac arrhythmias. Nutritional interventions for cardiac disease remain one of the mainstays of therapy and one of the more exciting avenues for further scientific investigation.

Lisa M. FREEMAN
DVM, PhD, Dipl ACVN

Lisa Freeman graduated from Cummings School of Veterinary Medicine at Tufts University with a Doctorate of Veterinary Medicine in 1991. After completing an internship in Small Animal Medicine and Surgery at North Carolina State University College of Veterinary Medicine, she completed a residency in Small Animal Clinical Nutrition at the Cummings School of Veterinary Medicine at Tufts University. She was awarded a PhD in Nutrition by the Tufts University School of Nutrition for her work on cytokines, body composition, and the effect of fish oil supplementation in canine dilated cardiomyopathy. Lisa Freeman received board certification by the American College of Veterinary Nutrition in 1997. She is currently an Associate Professor and Clinical Nutritionist at the Cummings School of Veterinary Medicine at Tufts University. Her research interests include nutritional modulation of cardiac disease and critical care nutrition.

John E. RUSH
DVM, MS, Dipl ACVIM (Cardiology), Dipl ACVECC

John Rush graduated from The Ohio State University School of Veterinary Medicine with a Doctorate of Veterinary Medicine and a Masters degree in Veterinary Physiology in 1984. After completing an internship in Small Animal Medicine and Surgery at the Animal Medical Center in New York City, he completed a residency in Small Animal Cardiology and Internal Medicine at the University of Wisconsin-Madison. Dr. Rush was board certified by the American College of Veterinary Internal Medicine, in the specialty of Cardiology, in 1988. He joined the faculty at the Cummings School of Veterinary Medicine at Tufts University in 1989, and achieved board certification by the American College of Veterinary Emergency and Critical Care in 1993. He served as Section Head and residency director for the Emergency and Critical Care Section until 2003. Dr. Rush is currently a Professor and Associate Chair for the Clinical Sciences Department at the Cummings School of Veterinary Medicine at Tufts University.

1. Epidemiology

Many risk factors and clinical associations have been identified for cardiovascular disorders in dogs. Breed predispositions are recognized for most of the common cardiovascular diseases (Table 1). Many small to medium sized dog breeds are predisposed to acquired chronic valvular disease (CVD; endocardiosis), while dilated cardiomyopathy (DCM) and pericardial disease are the most common causes of congestive heart failure (CHF) in large breed dogs.

Certain cardiovascular disorders are recognized to have a sex predisposition; for example, female dogs are predisposed to patent ductus arteriosus and male dogs are predisposed to CVD, idiopathic pericardial disease, and bacterial endocarditis.

Dogs with renal or adrenal disease can develop systemic hypertension and this can predispose or contribute to existing cardiac disease.