Abstract
Background: Cardiogenic pulmonary edema (CPE) is a life-threatening condition in dogs with myxomatous mitral valve disease (MMVD). Diagnosis and monitoring of CPE typically rely on repeated radiographic examinations, including vertebral heart size (VHS) and vertebral left atrial size (VLAS), which may be challenging in critically ill patients. Although diuretic therapy is routinely used for treatment, the relationship between body weight loss during treatment and changes in cardiac size has not been fully investigated. This study aimed to evaluate the association between body weight reduction and radiographic cardiac size changes following furosemide treatment in Maltese dogs with CPE. Because no previous studies have evaluated whether body weight reduction reflects complete radiographic resolution of pulmonary edema during treatment of cardiogenic pulmonary edema, we investigated whether body weight loss could serve as a practical adjunctive monitoring parameter. Methods: Medical records of 48 Maltese dogs diagnosed with cardiogenic pulmonary edema (CPE) and treated with continuous rate infusion (CRI) of furosemide between June 2020 and June 2022 were retrospectively reviewed. Dogs were divided into two groups according to prior administration of heart medications (pimobendan and enalapril). Body weight, vertebral heart size (VHS) and vertebral left atrial size (VLAS) were measured at presentation (D0) and after complete radiographic resolution of pulmonary edema (D1). Changes and change rates were calculated and correlations among body weight reduction, VHS and VLAS were analyzed. Group comparisons were performed using the Mann-Whitney test and pre- and post-treatment changes were analyzed using the Wilcoxon signed-rank test. Result: A total of 48 Maltese dogs met the inclusion criteria. Mean body weight decreased from 3.56±1.30 kg at D0 to 3.31±1.19 kg at D1, corresponding to a mean reduction rate of 6.89%. Mean VHS decreased from 11.76±0.93 to 11.03±0.96 and mean VLAS decreased from 3.04±0.33 to 2.86±0.32 after treatment. No significant differences in body weight loss rate, VHS change rate, or VLAS change rate were observed between dogs receiving heart medications and those not receiving such medications. Correlation analysis showed positive correlations between pre- and post-treatment body weight and between pre- and post-treatment VHS and VLAS values. However, body weight loss was not significantly associated with changes in radiographic cardiac indices.