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.

• 1. Differentiate between preclinical and clinical heart disease in dogs, with emphasis on MMVD.
• 2. Apply the ACC/AHA-adapted staging system (A–D) to classify patients and guide management.
• 3. Develop stage-based diagnostic and therapeutic plans, including considerations for limited-resource settings.
• 4. Communicate effectively with clients about prognosis, treatment costs, and monitoring strategies.
• 5. Implement individualized management plans that optimize patient outcomes while balancing client financial constraints.