Impact of Doxorubicin on Cardiac Function in Dogs: Ejection Fraction Changes and Heart Failure Risk

Area of Science:

• Veterinary Medicine
• Cardiology
• Pharmacology

Background:

• Doxorubicin is a vital antitumor antibiotic in veterinary oncology.
• Cardiotoxicity is a major side effect, potentially leading to heart failure and treatment cessation.
• Assessing doxorubicin's impact on cardiac function in dogs is crucial for treatment management.

Purpose of the Study:

• To systematically review and meta-analyze the cardiotoxic effects of doxorubicin on canine ejection fraction (EF).
• To evaluate the influence of different administration routes on doxorubicin-induced cardiotoxicity.
• To synthesize evidence on doxorubicin's impact on cardiac function in dogs undergoing cancer treatment.

Main Methods:

• Systematic literature search across eight databases, screening 3587 articles.
• Inclusion of fifteen eligible studies reporting on doxorubicin protocols in dogs.
• Assessment of study methodologies, results, and risk of bias, including echocardiographic findings.

Main Results:

• Thirteen studies reported cardiac changes, with varying toxicity based on administration route.
• Intracoronary doxorubicin administration was more toxic, leading to heart failure in all six studies.
• Intravenous administration resulted in heart failure in six of nine studies, with a mean EF reduction of 21.24% across four meta-analyzed studies.

Conclusions:

• Doxorubicin significantly impairs cardiac function and worsens heart disease in dogs.
• The route of administration critically influences the severity of doxorubicin's cardiotoxic effects.
• Close patient monitoring is essential to manage doxorubicin's impact on cardiac health in veterinary patients.