Anaesthetic management of dogs with myxomatous mitral valve disease

Myxomatous mitral valve disease is the most commonly acquired heart disease in the dog. Affected dogs have a reduced forward stroke volume as a result of the regurgitant flow back through the compromised mitral valve leaflets. Primary care practitioners will be all too familiar with the challenges of performing a general anaesthetic on these animals and unfortunately, there is no ideal protocol for every case. Having knowledge of the haemodynamic changes that occur with myxomatous mitral valve disease, compared to structurally normal hearts, as well as a good understanding of pharmacological effects of agents used in general anaesthesia, is essential in the safe management of these cases. This article will summarise disease pathophysiology, concurrent cardiac medications and commonly used pre-anaesthetic, induction and maintenance agents available in primary care practice for use in dogs with myxomatous mitral valve disease.