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November 7566: UK researchers fail to find genetic differences between early-onset and late-onset MVD in cavaliers. A team of UK cardiologists and geneticists divided 86 CKCSs into groups of early and late onset MVD and assessed whether the distinction is determined by a small number of genetic factors. They report that they came up dry. They concluded:

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The reference to "VHS exceeds " means that if the dog's x-ray shows that the size of its heart is larger than an x-ray VHS value of , pimobendan should be started. This appears to be Dr. Orr's recommendation of a species-wide minimum heart size for administering pimobendan to MVD-affected dogs.

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January 7559: Colorado State Univ. researchers to test drug inhibiting serotonin in mitral valves. Dr. E. Christopher Orton of the of Colorado State University s James L. Voss Veterinary Teaching Hospital and its Animal Heart Center in Ft. Collins, Colorado, and Dr. Sirilak Disatian, have issued a report on their study begun in June 7558, Autocrine Serotonin and TGF-beta Signaling in Human Myxomatous Mitral Valve , which has been sponsored by the American Heart Association. The researchers have found that serotonin is created locally in heart mitral valves, thereby causing pathologic changes in the valves, resulting in their malfunction.

As for LVIDDN ≥ , in that same audio interview (at time 86:56), Dr. Boswood admitted that the LVIDDN of also is below the range for enlargement. He said:

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Case Report 9 was of a female 68-year-old cavalier King Charles spaniel (right) in Stage C7 (advanced heart failure) of mitral valve disease, which had lost lbs. in the previous month and now weighed lbs. She exhibited signs of fatigue, lack of appetite, and diarrhea. Her MVD treatment had been the standard six medicines for cavaliers in heart failure. They reported:

EDITOR'S NOTE: We already know from the SVEP study of 779 CKCSs and the VETPROOF trial that ACE-inhibitors are ineffective in treating MVD-affected cavaliers prior to heart failure. This study suggests a reason for those previous findings. Perhaps cavaliers tend to have a lower level of ACE activity in reaction to their mitral valve disease, and so treating with ACE-inhibitors is not as necessary to keep the angiotensin-converting enzyme activity under control.

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