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Published on: June 14, 2017
Iron status in dogs with myxomatous mitral valve disease
A Savarese1, M Probo1, C Locatelli1
1Department of Veterinary Medicine (DIMEVET), University of Milan, via Celoria 10, 20133 Milan, Italy.
Insights
Iron deficiency is common in dogs with heart failure (HF), particularly those with myxomatous mitral valve disease (MMVD). Low iron levels correlate with more severe HF and reduced survival, highlighting its importance in canine cardiovascular health.
Area of Science:
- Veterinary Cardiology
- Canine Internal Medicine
- Iron Metabolism
Background:
- Iron deficiency is prevalent in human heart failure (HF) and linked to poor outcomes.
- Chronic kidney disease (CKD) is a common HF comorbidity, increasing anemia risk.
- Myxomatous mitral valve disease (MMVD) is the leading cause of HF in dogs.
Purpose of the Study:
- To investigate iron status in dogs with MMVD-related HF.
- To explore the relationship between iron status and HF severity.
- To assess iron status in dogs with and without CKD.
Main Methods:
- Retrospective study of 54 dogs with MMVD.
- Evaluation of iron status via serum iron concentration (SIC), unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), and % saturation (%SAT).
- Analysis of iron status in relation to American College of Veterinary Internal Medicine (ACVIM) and International Renal Interest Society (IRIS) classifications, HF symptoms, and survival.
Main Results:
- 18% of dogs had low SIC; 33% of symptomatic dogs and 100% of acutely decompensated HF dogs had low SIC.
- Low SIC was significantly associated with higher ACVIM HF classification (OR=6.383, p=0.014).
- Dogs with low SIC exhibited shorter survival (p=0.020), though only HF symptoms impacted survival in multivariate analysis. Azotemic dogs had lower SIC (p=0.02).
Conclusions:
- Iron deficiency is a significant finding in dogs with MMVD-related heart failure.
- Low serum iron concentration is linked to increased HF severity and poorer prognosis in dogs.
- Further research into iron supplementation in canine heart failure is warranted.
Abstract:
In humans, iron deficiency represents a relevant occurrence in heart failure (HF), with or without anaemia, and is associated with the worst outcome. Moreover, chronic kidney disease (CKD) is a well-known comorbidity of HF and is strongly associated with the risk of developing anaemia. The most common cause of HF in dogs is myxomatous mitral valve disease (MMVD). To the best of our knowledge, no studies have examined the iron status in dogs with HF, with and without CKD. The aim of this retrospective study was to evaluate the iron status in dogs affected by MMVD and how strong is the relation with HF. The retrospective study included 54 dogs with complete case records, echocardiography and laboratory analyses. Iron status was evaluated by measuring serum iron concentration (SIC), un- saturated iron binding capacity (UIBC), total iron binding capacity (TIBC), and percentage of saturation (%SAT). The prevalence of dogs showing low serum iron concentration (SIC) was 18% in the whole population, 33% in symptomatic patients, 100% in dogs with acute decompensated HF. No signif- icant differences in SIC, UIBC, TIBC and %SAT median values were found among dogs classi- fied in different ACVIM (American College of Veterinary Internal Medicine) classes, between symptomatic and non-symptomatic patients, and among IRIS (International Renal Interest Soci- ety) classes. Azotemic and non-azotemic patients presented a significant difference in SIC mean values (p=0.02). Generalised linear model (GLM) revealed that dogs with low SIC were at high- er risk of being included in a higher ACVIM class (OR=6.383, p-value=0.014). Log-rank analysis showed shorter survival in dogs with low SIC (p=0.020), multivariate Cox analysis revealed that only HF symptoms can affect survival.
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