Degenerative mitral valve disease – differentiating stable and progressive cases

This PhD project is suitable for a veterinary graduate competent in small animal veterinary practice who is interested and motivated to further knowledge in the area of canine degenerative mitral valve disease (DMVD).

DMVD is the most common cardiac disorder of dogs and is easily identified in the pre-clinical stages by cardiac auscultation. Differentiating progressive cases destined to develop heart failure (stage B2) from those that are stable (B1) with low likelihood of developing heart failure within the subsequent two years is currently dependent on determining cardiac chamber size by echocardiography and therefore requires specialist skills in veterinary cardiology.

We hypothesise that cardiac biomarkers and clinical observations can be used to make this distinction without the need for specialist imaging. Furthermore, we propose that interventions shown to prolong the pre-clinical phase of DMVD will reduce the rate of change of circulating biomarker concentrations when monitored longitudinally in DMVD cases undergoing treatment.

This project will test this hypothesis using clinical cases presenting to first opinion practices and archived samples and associated case records to: (i) devise a diagnostic algorithm that sensitively and specifically differentiates stage B1 and B2 cases based on cardiac biomarkers and clinical data (retrospective analysis); (ii) validate this algorithm in a separate population of dogs with DMVD; (iii) design a randomised controlled clinical trial to determine the effect of drug treatment on cardiac biomarkers in dogs predicted to have progressive disease based on the diagnostic algorithm.

Training will be provided in epidemiology and statistics, clinical trial design and monitoring and laboratory diagnostic immunoassays.

Interviews will be held at the RVC Hawkshead Campus on 6th December. Start date is anticipated to be January 2017, or as soon as the preferred candidate is available.