Practical Approaches: Managing MMVD without a Cardio Consult

Myxomatous mitral valve disease (MMVD) is the most common acquired heart disease in dogs, and general practitioners are frequently required to manage these cases without direct access to a cardiology consultation. This paper reviews practical strategies for recognizing and managing MMVD through the preclinical and clinical stages, emphasizing the adapted American College of Cardiology/American Heart Association staging system (A–D). Stage-based diagnostic and therapeutic recommendations are outlined, with consideration given to financial constraints commonly encountered in practice. Approaches for client communication, prioritization of diagnostics and therapy, and development of tiered management plans (“First Class,” “Business Class,” and “Economy Class”) are presented to help veterinarians provide effective and individualized care.