Clinical evaluation of Ramipril in dogs with asymptomatic degenerative mitral valve disease

Abstract

Degenerative mitral valve disease (DMVD) is the most common cardiac disease in dogs. Angiotensin converting enzyme (ACE) inhibitors have beneficial effects on DMVD dogs with (ACVIM classification) stage C and D. However, the study determining effects of ACE inhibitors in DMVD stage B2 is still controversy. Ramipril is an angiotensin converting enzyme (ACE) inhibitors that has more lipophilic effects than other ACE inhibitors. It can suppress ACE in cardiac tissues effectively, so this drug may have more beneficial effects in treatment dogs with naturally occurring canine DMVD stage B2 (ACVIM classification) than other ACE inhibitors. In this study, we used 20 dogs with asymptomatic DMVD stage B2 with body weight between 3-12 Kg and older than 6 years. Dogs were single blinded randomized dividing into 2 groups. The owners themselves selected to either supplement or not supplement the drugs. Dogs in ramipril group (n= 10) received ramipril once a day at dose 0.22 mg/kg PO and control group (n= 10) did not receive any drug for 91 days. Complete physical examination, electrocardiography and echocardiography were performed in day 0, 28, 56 and 91. Echocardiographic examination was used to compare cardiac sizes and structural changes. For statistical analysis, independent t-test was performed to compare between dogs in ramipril and control groups. Repeated ANOVA was used to compare within groups between days 0, 28, 56, 91. p<0.05 was considered statistically significant. Cardiac chamber size, systolic function and severity of mitral regurgitation were not significantly different between the 2 groups throughout the study period. Two dogs in ramipril group increased in appetite, one dog had reduced frequency of cough and one had increased blood urea nitrogen and creatinine. In conclusion, the ramipril could not change cardiac size, severity of mitral regurgitation and systolic function compared with the control group in 91 days study period