Dr. Scansen is originally from Snohomish, Washington and graduated with Bachelor of Science degrees in both Oceanology and Zoology from the University of Washington. He attended veterinary school at Michigan State and graduated DVM and MS degrees with high honors. He went on to complete an internship at the Ohio State University in Small Animal Medicine and Surgery and stayed at OSU for a residency in Cardiology. He then completed a fellowship in Interventional Radiology & Endoscopy at the University of Pennsylvania and the Animal Medical Center. Dr. Scansen is a Diplomate of the ACVIM, specialty of Cardiology, a founding member of the Veterinary Interventional Radiology & Interventional Endoscopy Society, and an Associate Editor of the Journal of Veterinary Cardiology. He served on the faculty of the OSU College of Veterinary Medicine from 2008 to 2015 as an Assistant Professor and has been an Associate Professor of Cardiology and service head of the Cardiology & Cardiac Surgery Section at Colorado State University since November 2015. His research interests include congenital heart disease in animals, advanced cardiac imaging, and minimally-invasive therapeutics.
Degenerative mitral valve disease
Ventricular arrhythmias
Dilated cardiomyopathy
Pulmonary valve stenosis
Patent ductus arteriosus
Heart murmur evaluation
Hypertrophic cardiomyopathy
Secondary cardiomyopathy – hyperthyroid, hypertensive, etc
Restrictive or non-specific cardiomyopathy
Ventricular septal defect
We are seeing a population of dogs with a dilated cardiomyopathy phenotype in breeds that traditionally have not been associated with this disease. An association has been made with diets that contain carbohydrates from non-grain sources leading to the suspicion of a nutritional form of cardiomyopathy, but a clear cause-and-effect has not been elucidated.
Several studies have shown an increase in survival and a delay in clinical signs for dogs with advanced heart disease that receive the inodilator pimobendan. In degenerative mitral valve disease, dogs with heart enlargement randomized to pimobendan had a median time to heart failure or cardiac death of 1,228 days as compared to the 766 days for dogs in the placebo group.
Pulmonary hypertension is a condition that often leads to confusion. Dogs can present with respiratory signs and have a loud heart murmur, either from concurrent mitral valve disease or from tricuspid insufficiency, and a presumption is made that the patient is in left-sided congestive heart failure. In reality, many pulmonary conditions (as well as some cardiac conditions) may lead to pulmonary hypertension and cause respiratory signs as well as a heart murmur. Pulmonary hypertension impacts the heart, to be sure, but the therapy for pulmonary hypertension is much different than how we treat heart failure. Pulmonary hypertension can also be confusing as it requires an echocardiogram to support the diagnosis, which may not always be available to the practitioner.
In my opinion, congenital heart disease is the condition which is most benefited from by early diagnosis. Not only are several forms of congenital heart disease curable or dramatically improved with therapy (such as patent ductus arteriosus and pulmonary valve stenosis), but the disease exists in young patients that may have a decade or more of life in front of them. Additionally, the best screening tool for diagnosis is the cheapest – your stethoscope. If a heart murmur is missed in puppies or kittens, the disease may lead to devastating complications later in life that would have been avoidable with treatment. My advice to practitioners is to presume juvenile animals have a heart condition and listen carefully enough to the heart during the first several visits to convince yourself there is no heart murmur present. This requires a quiet room and a well-restrained patient – not always easy when evaluating young animals.
The stethoscope and your physical examination remain the best screening tools available for the detection of heart disease. Get in the habit of a thorough physical examination, always listen to multiple areas (right and left, cranial and caudal) of the thorax for sufficient time to hear heart sounds clearly and rule in our out abnormal sounds, and pay attention to historical clues – the patient is less active, cough is now present, exercise tolerance is limited, etc.
Pet owners can play a vital role in monitoring their pets with heart disease. Teaching clients to measure the sleeping respiratory rate of the animal on a daily basis and to track this parameter over time can provide valuable information to the veterinarian. Animals that decompensate from heart disease (i.e., develop heart failure) typically have an escalation in their sleeping respiratory rate in the days preceding decompensation. Clients can learn to monitor the animal’s respiratory rate easily and can detect progressive disease before it turns into a crisis.
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Boswood A, Haggstrom J, Gordon SG, et al. Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study-A Randomized Clinical Trial. J Vet Intern Med 2016;30:1765-1779.
Haggstrom J, Boswood A, O'Grady M, et al. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. J Vet Intern Med 2008;22:1124-1135.
Summerfield NJ, Boswood A, O'Grady MR, et al. Efficacy of pimobendan in the prevention of congestive heart failure or sudden death in Doberman Pinschers with preclinical dilated cardiomyopathy (the PROTECT Study). J Vet Intern Med 2012;26:1337-1349.