9: Diuretic strategy and overcoming resistance, with Prof Mark Oyama

Message our hosts, Kieran and Jose.Mitral valve disease is the most common heart disease diagnosed in dogs. Our understanding of it affects how we manage a wide range of scenarios, from asymptomatic heart murmurs detected at annual vaccination, to patients with respiratory signs or those about to undergo sedation or anaesthesia, or simply receive fluid therapy. Join Professor Michele Borgarelli, from the Virginia Maryland College of Veterinary Medicine, as he speaks to Kieran and Jose about an innovative dataset on over 6000 dogs with mitral valve disease, the LOOK-Mitral Registry, and how research like this can inform decision making in the clinic.

Message our hosts, Kieran and Jose.Vets understand that the cornerstone of treatment for congestive heart failure in animals is the use of loop diuretics, such as furosemide. But resistance occurs in all patients over time, and intensification of diuretic treatment is a vital part of managing patients with clinical signs - both for left- and right-sided manifestations of disease. How are we best to approach this, and what can we do when using diuretic drugs to make the best decisions that will have positive benefits for our patients? Join Jose and Kieran as they welcome Prof Mark Oyama, from the University of Pennsylvania, to discuss strategic use of diuretic drugs in the clinic and the most up to date research on how to judge diuretic efficacy in acute and chronic heart failure patients.

Message our hosts, Kieran and Jose.As veterinary cardiologists, we rely on ultrasound every day to assess cardiac structure and function. Whilst important for owners to understand the cause of a murmur or clinical signs, we use echo to make critical decisions about when and how to treat, and inform conversations with owners about prognosis. The impact of echo on the lives of our patients is greater than anything else we do. But it may not be as accurate as you think... Learn how to best use echocardiography to make decisions, and which echo measurements may be best to select for accuracy, by joining Jose and Kieran as they speak to Dr Lance Visser, Assistant Professor at Colorado State University, about his research work in veterinary echo and his advice on how best to use this fundamental tool.

Message our hosts, Kieran and Jose.Horses are highly evolved athletes, with mind-bending changes to the cardiovascular system achieved during exercise. How does the spectrum of heart disease compare to that seen in dogs and cats? Join our hosts, Jose and Kieran, as they enjoy a rapid-fire review of equine cardiac disorders with Prof Colin Schwarzwald, director of the Clinic of Equine Internal Medicine at the Vetsuisse Faculty, University of Zurich.

Message our hosts, Kieran and Jose.Hypertrophic cardiomyopathy (HCM) affects 1 in 7 cats overall, and has huge implications for feline health and wellbeing across the globe. Strategies to detect early disease are fundamentally important to both pet owners and cat breeders, so that individual animals and the wider breed can be cared for as needed. Screening for HCM in apparently healthy cats has become a hot topic, and who could be better to join Jose and Kieran for a discussion on that subject than Prof Jens Häggström? Jens is leader of the internationally recognised PawPeds echo screening programme, and originator of the some of the largest studies on feline disease ever published. Listen in as he shares insights into their most recent data and his opinions on how best to approach screening for early disease.

Message our hosts, Kieran and Jose.Dilated cardiomyopathy is one of the most challenging diseases in veterinary cardiology. Early detection is key to maximising benefit for individual dogs, but clinical signs are lacking and physical exam may be unremarkable. Adding to this, echocardiographic diagnosis may be subtle, or changes may be caused by a an underlying disease process which is reversible or self-limiting, rather than a primary myocardial disease itself. Prof Sonya Gordon, from Texas A&M University, joins Kieran and Jose to discuss the difficulties with DCM, and her approach to overcoming these to get the most for her patients.

Message our hosts, Kieran and Jose.We all learned about the renin-angiotensin-aldosterone system in school... Or did we? This fantastic, in-depth interview on our current understanding of the RAAS will provide a revolutionary new perspective on how we may be able to harness the maladaptive systems that are activated in heart failure for positive purposes in our patients. Join Jose and Kieran as The Animal Heartbeat welcomes Professor Marisa Ames, Board-certified veterinary cardiologist and expert on the RAAS in dogs and cats.Please check out https://www.trigdocs.com/ to find out more about The Translational RAAS Interest Group, Dr Ames' collective of interested clinicians and researchers from the fields of veterinary and human medicine.

Message our hosts, Kieran and Jose.Over the last year, research data has indicated some potential hope for anti-hypertrophic drug use in feline hypertrophic cardiomyopathy. In this episode, Prof Joshua Stern, Associate Dean of Research at NC State University and current President of the ACVIM Cardiology Specialty, joins Jose and Kieran to review our most recent understanding of some exciting approaches which may completely change how we think about feline cardiomyopathy in the coming 5-years.

Message our hosts, Kieran and Jose.What do you understand by clinical research? What makes a good research study, and what limitations are common in veterinary publications? How should clinical research work impact what we do as clinicians? In this episode, hosts Kieran and Jose interview Professor Adrian Boswood, Vice Principal at the Royal Veterinary College and active clinician-researcher in cardiology. Adrian has spearheaded a  number of game-changing clinical works over the last three decades, and has trained and inspired generations of undergraduate and post-graduate vets in the UK. He has lectured all over the world, and is known for his engaging and relatable explanations of complex topics.In this episode, we discuss aspects pertinent to all subspecialties in veterinary medicine, not just cardiology research, and we consider how things could be refined to get the most out of future clinical research.

Message our hosts, Kieran and Jose.Welcome to Season 2 of The Animal Heartbeat! It's great to be back. Join our hosts, Kieran and Jose, as they facilitate a panel discussion featuring world-renowned experts from the canine and human cardiology world. This fascinating special episode covers a range of topics centred around mitral and aortic surgery in dogs and humans, and compares the human and canine perspectives. This live event was made possible by the kind support of Ceva Animal Health.Our panel:Dr Ravi De Silva: Consultant Cardiothoracic Surgeon, Royal Papworth Hospital; Training Programme Director for Cardiothoracic Surgery, East of England DeaneryDr Anne Kurosawa: ACVIM Veterinary Cardiology Diplomate; Cardiology and Cardiothoracic Surgery Team, Dick White ReferralsDr Rohin Francis: Consultant Interventional Cardiologist, Essex Cardiothoracic Centre; UCL Clinical Research Fellow; Science Communicator (Youtube @medlifecrisis)Dr Claudio Bussadori: ECVIM Veterinary Cardiology Diplomate; Clinic Director, Clinica Veterinaria Gran Sasso, Milan; human cardiologist and researcher at San Donato Hospital, MilanNote - although the sound from St John's College, Cambridge, allows us to soak up the ambience of The Old Divinity School Lecture Theatre (1877), listening with earbuds may help to make the most of the audio experience.