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Background: Predicting progression of myxomatous mitral valve disease (MMVD) in dogs can be challenging., Hypothesis/objectives: The mitral regurgitation severity index (MRSI) will predict time to congestive heart failure (CHF) and all-cause death in dogs with MMVD., Animals: Eight hundred sixty-nine client-owned dogs., Methods: Retrospective study pooling data from 4 previous samples including dogs with MMVD stage B2 or C. MRSI was calculated as: (heart rate [HR]/120) × left atrium-to-aorta ratio (LA:Ao) × (age in years/10) × 100. Alternative MRSI formulas substituting radiographic measures of left atrial size were also calculated. Cox proportional hazard modeling and time-dependent receiver-operator characteristic curves quantified prognostic performance., Results: For Stage B2 pooled samples, MRSI > 156 was predictive of time to CHF (median 407 vs 1404 days; area under the curve [AUC] 0.68; hazard ratio 3.02 [95% CI 1.9-4.9]; P < .001). MRSI > 173 was predictive of all-cause death (median survival 868 vs 1843 days; AUC 0.64; hazard ratio 4.26 [95% CI 2.4-7.5]; P < .001). MRSI showed superior predictive value compared to the individual variables of HR, LA:Ao, and age. Variations of the MRSI equation substituting radiographic vertebral left atrial size for LA:Ao were also significantly predictive of outcome in stage B2. MRSI was not consistently predictive of outcome in Stage C., Conclusions and Clinical Importance: MRSI was predictive of outcome (onset of CHF and all-cause death) in MMVD Stage B2, demonstrating utility as a useful prognostic tool. Echocardiographic LA:Ao can be effectively replaced by radiographically determined LA size in the MRSI formula., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: Evidence regarding optimal treatment duration in dogs with aspiration pneumonia (AP) and the role of thoracic radiographs (TXR) and lung ultrasonography (LUS) in the long-term follow-up of affected dogs is lacking. C-reactive protein (CRP) is a reliable acute phase protein to monitor bacterial pneumonia in dogs., Hypothesis: Investigate the safety of antimicrobial discontinuation based on clinical improvement and serum CRP normalization, as well as the usefulness of TXR and LUS for follow-up., Animals: Dogs diagnosed with AP and treated with antimicrobials., Methods: Prospective observational study. Antimicrobials were discontinued based on clinical improvement and serum CRP normalization after 1, 3, or 5 weeks. At each consultation, a quality-of-life questionnaire, physical examination, serum CRP, TXR, and LUS were assessed. Short- (2 weeks) and long-term (>1 month) follow-ups after treatment discontinuation were performed to monitor for possible relapses., Results: Seventeen dogs were included. Antimicrobials were discontinued after 1 week in 12 dogs (70.6%) and 3 weeks in the remaining 5 dogs (29.4%). Short-term relapse was not observed in any dog and long-term relapse was diagnosed in 3 dogs. Thoracic radiographs and LUS were useful for diagnosis, but did not add additional information during follow-up, because image normalization lagged behind clinical improvement and serum CRP normalization., Conclusion and Clinical Importance: Dogs with AP can be safely and effectively treated using a short-term antimicrobial regimen discontinued after clinical improvement and serum CRP normalization. Imaging might still be useful for complicated cases with a less favorable response to treatment., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)