EDITORIALS
- Will the next SM Breeding Protocol be BAD FOR THE BREED? -- December 24, 2011
- What do the two USA CKCS clubs have against breeding healthy cavaliers? -- October 14, 2011
- A Neurologist Answers Our August 13 Questions -- September 13, 2011
- Plucking the MVD Genes: The First Shoe Has Dropped! -- August 29, 2011
- Will the CSF-space gap predict future syringomyelia in cavaliers? -- August 18, 2011
- Okay, Syringomyelia Researchers: What Now? Where Do We Go From Here? -- August 13, 2011
- AKC Chairman Ron Menaker condemns "Pedigree Dogs Exposed" -- July 24, 2011
- How the SM Breeding Protocol could lead to the Popular Sire Syndrome -- June 13, 2011
- CKCSC,USA board admits its ignorance ... but not its stupidity! -- May 11, 2011
- Beware the Pimobendan/Vetmedin "EPIC Clinical Trial": There is no upside -- April 23, 2011
- Chiari-like malformation HAS been re-defined! -- January 30, 2011
- Maybe cavaliers don't even have Chiari-like malformation (CM)! -- January 28, 2011
- CKCSC,USA's Board reinstates a third of the REAL MVD breeding protocol -- December 28, 2010
- To CKCSC,USA Board: Reinstate the REAL MVD breeding protocol! -- October 7, 2010
- Post Script: How self-absorbed can the CKCSC,USA board be? -- September 10, 2010
- CKCSC,USA dumps MVD breeding protocol -- September 7, 2010
December 24, 2011:
Will the next SM Breeding Protocol be
BAD FOR THE BREED?
Breeding Under Age 2.5 Years Would Increase Early-Onset MVD
The
cavalier King Charles spaniel has TWO severe genetic
health disorders, NOT JUST ONE! While
syringomyelia (SM) is very
widespread in the breed, so is
mitral valve disease (MVD),
and it is MVD – not SM – that is the cavaliers’ leading killer!
While the next SM Breeding Protocol, scheduled to be released in 2012 by the British Veterinary Association and the Kennel Club (BVA/KC), still is a work-in-progress, a preliminary draft of it (see below) would permit the breeding of cavaliers as young as 12 months old! If so, this certainly would violate the MVD Breeding Protocol, which sets the MINIMUM AGE for breeding cavaliers at 2.5 years of age.*
* A September 2010 statistical report has shown that anything less than following the MVD Breeding Protocol has not worked.
Have the new BVA/KC's SM protocol drafters forgotten about MVD? Are they giving CKCS breeders a deadly choice? Is the SM protocol really going to recommend that breeders ignore the MVD Breeding Protocol and thereby produce future generations of many more cavaliers which will die early, painful deaths from congestive heart failure?
Some Background
It has been five years since the International Syringomyelia Conference issued its “Revised CKCS MRI Screening and Breeding Recommendations” in November 2006. The introduction to those breeding recommendations, also called the SM Breeding Protocol, stated:
“These breeding recommendations are made using current information and in response to CKCS breeder request for guidelines. It has yet to be proven if this guide is appropriate. The aim of these recommendations is to reduce the incidence of symptomatic syringomyelia (SM) in the breed, not to create litters of puppies guaranteed not to have SM as the chance of producing an affected dog cannot be predicted without knowing the inheritance.”
The general principle of the 2006 guidelines is that dogs graded “Code A” are more desirable to use than those graded “Code B”, and so on, but that dogs with a higher letter code may still be used in some limited circumstances.
Significantly, the protocol was predictively accurate. Statistics reported in October 2010 showed that:
• 75.9% of the offspring of matings of a Code A sire to a Code A dam were SM-clear.
• 41.9% of the offspring were SM-clear if only one parent was Code A.
• 0% of the offspring were SM-clear if neither parent was Code A.
Statistics reported a year later, October 2011, were similarly on target:
• 70% of the offspring of matings of a Code A sire to a Code A dam were SM-clear.
• 23% of the offspring were SM-clear if only one parent was Code A.
• 8% of the offspring were SM-clear if neither parent was Code A.
Still, much more has been learned about SM in the cavalier since the “current information” available to the International Syringomyelia Conference in 2006.
A June 2011 UK study of 555 cavaliers (Parker Report) showed that:
• 25% of 12 month old asymptomatic CKCSs had SM.
• 70% of asymptomatic CKCSs six years and older had SM.
These figures do not include SM-affected cavaliers which displayed symptoms, so, as the researchers concluded, “The true prevalence of syringomyelia in the general CKCS population is expected to be higher.” They also concluded that, based upon their statistics, the minimum age of the SM Breeding Protocol ought to be raised from 2.5 years to 3.0 years, although they recognized that “many breeders would consider 36 months unduly old.”*
* There is irony for you! The fact is that most cavalier breeders consider 2.0 years unduly old for initial matings.
In an October 2011 UK study (Knowler Report), the researchers go even farther. First, they concur with the Parker Report that “the optimum age for this early MRI screening is 36 months.” Then, they recommend that, if only one of the breeding pair is SM-clear, it be “five years or older”.
This is a Matter of Veterinary Ethics!
So, with those two recent reports on the table urging raising the minimum breeding age to three or even five years, how can the BVA/KC possibly – even ethically – decrease that age from 2.5 years to one year?
The clear answer is that they should not! If the final, approved version of the new BVA/KC SM Breeding Protocol allows breeding any cavalier under the age of 2.5 years, then it will undercut the MVD Breeding Protocol, and it will be encouraging rampant early-onset MVD in the breed!
At the very least, the final version of the BVA/KC guidelines chart should change Age from "1-3" to "<3".
October 14, 2011:
What Do the Two USA CKCS Clubs Have Against
Breeding
Healthy Cavalier King Charles Spaniels?
The
syringomyelia (SM) breeding protocol works! (See the
October 2011 statistical report.) And, anything less than the
mitral valve
(MVD) breeding protocol has not worked! (See the
September 2010 statistical report.)
BUT ... STILL ... neither of the USA cavalier King Charles spaniel clubs will recommend that their members follow either of these breeding guidelines.
Why
don't these two breed clubs, the American Cavalier King Charles Spaniel
Club (ACKCSC), and the Cavalier King Charles Spaniel Club, USA (CKCSC,USA),
oppose SM and early-onset MVD in future generations of CKCSs?
Why don't they endorse the MVD and SM breeding guidelines?
Ask their presidents. Call and email them.
The president of the ACKCSC is Patricia Kanan, telephone 805-688-7830, email torlundy@comcast.net
The president of the CKCSC,USA is Bruce Henry, telephone 214-691-0062, email ShirmontCavs@aol.com
September 13, 2011:
A Neurologist Answers Our August 13 Questions:
"Okay Syringomyelia Researchers:
What Now? Where Do We Go From Here?"
Lo and behold! For a moment there, I thought we might have had a definitive
answer to the query: "So, where do we go from here ...? Yo, researchers, do
you have any suggestions?" in our August 13
editorial.
In the September 10, 2011 issue of the Veterinary Record, UK veterinary neurologist Rita Gonçalves wrote an editorial titled, "Understanding Chiari-like malformation: where are we now?"
"Ah ha", I thought! What wisdom does she have to impart? Well, not much, actually. After a brief but thorough and concise review of CM research in the cavalier King Charles spaniel, up through mid-2011, along with comparisons to the research of human Chiari malformation, Dr. Gonçalves reaches this painfully disappointing but quite obvious conclusion:
"Chiari-like malformation has for a decade now been widely identified in the CKCS population but despite its high prevalence, little is still known about its pathogenesis. Further studies are necessary to increase our understanding of this condition in order to allow the development of new treatment options and improve the welfare of the CKCS affected."
So, the answer essentially is that we need more money to continue the research, so that we can close in on the mysteries of the causes and solutions to CM and SM in our precious breed.
August 29, 2011:
Plucking the MVD Genes:
The First Shoe Has Dropped!
The
headline of the September 2011 Journal of Heredity article says it all:
"Identification of 2 Loci associated with development of myxomatous mitral valve
disease in cavalier King Charles spaniels." Translation? It means that the
first step towards finding a DNA test for early-onset MVD genes has been taken.
The first shoe has dropped.
Soon there should be a second shoe heard hitting the floor, when the researchers announce they've identified the actual genes themselves. In their report, they state:
"We will initiate studies of the most promising candidate genes in the 2 candidate regions which hopefully will lead us to the mutations affecting the development of mitral valve disease."
And then the thud of a third shoe (yes, we are talking about a triped here) will be felt when the researchers offer the DNA test to determine which cavaliers do or do not carry the offending genes.
That will be when the shoes hit the fan! For it has been well over a dozen years since the MVD breeding protocol was offered to cavalier breeders in the USA as the means of eliminating early-onset MVD in the breed. Since that announcement in 1998, nearly all of those "reputable", "responsible" cavalier breeders have declined, claiming that they would prefer to wait until the MVD genes are identified. Instead of trying to reduce MVD in their breeding stock, they chose to hide behind that excuse, and they continued to produce generation after generation of cavaliers with worse and worse early-onset MVD.
But now, those breeders' big bluff is about to be called. Soon enough, they will have what they claimed they've been waiting for. They claimed that they would not risk following the MVD breeding protocol because they feared that it would eliminate too much of their breeding stock. If they thought the MVD breeding protocol would have that much of an effect, just imagine what the DNA test will do to their bloodlines! It may wipe out entire kennels of breeding cavaliers!
So, it looks like they're going to have to come up with a new excuse for ignoring the DNA test. Start thinking hard now, you "reputable", "responsible" breeders. You don't have much time left!
August 18, 2011:
Will the CSF-Space Gap Predict
Future Syringomyelia in Cavaliers?
In
a recent research study of cavalier King Charles spaniels with
Chiari-like malformation (CM) and some with both CM and syringomyelia (SM),
the researchers reported:
"When [cerebrospinal fluid] CSF space between the cerebellum and brainstem was compared in CKCS with and without SM, there was a significant increase in CSF space in CKCS with CM alone compared to those with CM/SM when head position was flexed. In their cine MR imaging study of CSF flow dynamics in CKCS with CM or CM/SM, Cerda-Gonzalez and others (2009a) found that turbulent CSF flow and jets are associated with SM presence and severity and CSF flow velocity at C2/3 is inversely related to the presence of SM. The reduced CSF space in CM/SM dogs reported in this study could explain this jet like CSF flow in dogs with CM/SM compared to those with CM alone."
Translation? We THINK it means that there is more space for cerebrospinal fluid (CSF) between the cerebellum and the brainstem of cavaliers with just CM than there is of cavaliers with both CM and SM.
Now, one of the current issues about CKCSs is that those younger ones with only CM still may develop SM as they age. Another recent study found that most cavaliers do not develop SM until after their third birthday and as late as age 6 years. Most all cavalier breeders believe that it is unreasonable to have to wait until their breeding stock is over 3 years old before being bred for the first time.
It would be a very valuable piece of information for any breeding program to be able to predict if a young cavalier (say, at age 18 or 24 months) will or will not ever develop syringomyelia.
This study may lead to the answer to the question: Can an MRI at an early age, showing the amount of CSF space between the cerebellum and the brainstem, predict whether the cavalier will or will not end up with SM?
August 13, 2011:
Okay, Syringomyelia Researchers:
What Now? Where Do We Go From Here?
HERE IS THE SITUATION: In June, a team of veterinary
neurologists issued
a
devastating report. They examined the MRI scans of 555 cavalier King Charles
spaniels, and found that at age 12 months, 25% had syringomyelia (SM), and by
age six years, 70% had SM. And, all 555 of these were cavaliers which reportedly
had no symptoms of SM.
THINK OF IT: Not only did 25% of these cavaliers already have SM by their first birthday, but in the five years between age 1 and age 6, 45% of the rest of the cavaliers acquired SM.
Previously, these neurologists thought that most dogs afflicted with SM would start to show symptoms before age 3 years. When the International Syringomyelia Conference issued its revised CKCS MRI screening and breeding recommendations in 2006, the panel of researchers stated:
“The age cut off at 2.5 years has been decided so as to tie in with MVD recommendations and because most dogs with symptomatic SM will show signs before 3 years of age.”
That cut off age meant that cavaliers at least 2.5 years old without SM would be classified as Code “A” and could be mated with any other cavaliers over 2.5 years, even if they had asymptomatic SM.
Now, we find, most cavaliers do not even contract SM until after they are 3 years old, much less also become symptomatic.
The authors of the June 2011 report, J. E. Parker, S. P. Knowler, C. Rusbridge, E. Noorman, and N. D. Jeffery, carefully worded the serious impact of these findings upon the current SM breeding protocol:
“The evidence for a lower prevalence in younger animals is more reliable ... and this effect lasts until dogs are at least three years of age. This finding has important implications for the design of a screening test procedure and may conflict with the current recommendations that the optimum age for screening should be 30 months. These data would imply that it is probable that dogs aged up to three years may yet have reduced odds for the diagnosis of syringomyelia. However, there is a need for the dogs to be screened when they are reasonably young so that breeders can decide at an early stage whether their animals are suitable for breeding; many breeders would consider 36 months unduly old.”
GET IT? This means that more cavaliers develop SM after age 2.5 years than before that age. So, the current SM breeding protocol is ineffective. But, they also observe that breeders would not consider waiting until their MRI-clear cavaliers are 3 years old (“unduly old”). Thus the dilemma in which we CKCS fanciers find ourselves.
WHAT TO DO? WHAT TO DO? Well, the researchers don’t give us much hope. They go on:
“The high lifetime prevalence of syringomyelia raises concerns for the welfare of the CKCS breed and also suggests that eliminating the genetic risk factors for the disease by selective breeding may be difficult, because the heritability has previously been shown to be complex ... and the prevalence of the determinant genes within the population is therefore likely to be high. The true prevalence of syringomyelia in the general CKCS population is expected to be higher than that found in this sample population because symptomatic dogs were specifically excluded.”
RAISES CONCERNS!!! To say the least! MAY BE DIFFICULT!!! What an understatement! We now know that SM is far more widespread in the breed than anyone, even the experts, ever thought. We now know that the 2.5 year cut off in the SM breeding protocol is way too early, but that many breeders would not stand for extending that age by even another six months.
(Actually, the dirty little secret is that nearly all US cavalier breeders always have been ignoring the current SM breeding protocol. Neither of the two CKCS national clubs in the US will even acknowledge that the breeding protocol exists, much less recommend that breeders follow it.)
So, where do we go from here, cavalier fanciers? Yo, researchers, do you have any suggestions?
July 24, 2011:
AKC's Chairman Ron Menaker Condemns
"Pedigree Dogs Exposed"
Then Reinserts His Head Firmly Back Underground
Is
this any way to lead the American Kennel Club through the genetic morass it is
facing? On July 19, the chairman of the board of the American Kennel Club, Ron Menaker, signed a petition to the UK's Parliament to prevent the
British Broadcasting Company from broadcasting a sequel to
"Pedigree Dogs Exposed" (PDE), the 2008 BBC documentary which has turned the
British purebred dog world upside-down.
Chairman Menaker did not stop at just adding his name to the petition to Parliament. He also wrote:
"Responsible dog owners, the dog loving public and responsible dog breeders should not be subjected to another piece of sensationalist fiction and tabloid journalism masquerading as a documentary. Any investigation of dogs, breeding or health matters should be balanced and fair. If the BBC insists on repeating this exercise in media sensationalism, why not present the truth about the progress that has been made as a result of responsible dog breeding and scientific research projects funded by organizations that truly care about dogs. For the BBC's next installment, how about 'Jemima Harrison Exposed'?"
Thus, the AKC chairman wants UK's Parliament to both ban the BBC from broadcasting its upcoming PDE-2, and to force the BBC to present an exposé of PDE's producer, Jemima Harrison. Putting aside all of the anti-Freedoms of Speech and Press and censorship aspects of AKC Chairman Menaker's comments, it is jaw-dropping that the highest ranking officer of the American Kennel Club would wage so public and vicious an attack against PDE and its producer, just as that same producer is putting together the sequel which Mr. Menaker so desperately seems to want to prevent.
Hullo, Mr. Menaker? Can you spell "Good Public Relations"?
One of the reasons PDE has had such a dramatic impact upon the British pedigree dog world since 2008 is that the UK Kennel Club and its breed clubs, including the UK's cavalier King Charles spaniel club, refused to substantively cooperate during its production. CKCS club members literally turned their backs on PDE's cameraman. But even those UK clubs had enough savvy to not publicly and personally lash out at Ms. Harrison, its producer.
On the one hand, AKC Chairman Menaker attacks PDE and it’s producer for not being "balanced and fair", and yet on the other hand, instead of offering information to help make PDE-2 more balanced and fair, he wants the British government to ban it! And investigate its producer, to boot! His head-in-the-sand approach is not going to work for the AKC, and if Chairman Menaker is not careful, soon Ms. Harrison may cross the pond to produce PDE-3, and re-pay him for his courtesies.
June 13, 2011:
How the Syringomyelia Breeding Protocol
Could Lead to the Popular Sire Syndrome
Many "D" Bitches Mated With the Same "A" Stud =
Another
Genetic Crisis for the CKCS
For corner-cutting breeders of cavalier King Charles spaniels, trying to
follow the syringomyelia (SM) breeding protocol could lead to a uprising of the
dreaded Popular Sire Syndrome*.
*A Popular Sire has been defined in canine research papers as having produced more than 100 offspring.
The current SM breeding protocol, introduced to the cavalier King Charles spaniel community in 2006 by the International Syringomyelia Conference, only requires that one of a breeding pair of cavaliers not have syringomyelia. The other cavalier of that pair may either have syringomyelia but without any symptoms – according to its magnetic resonance imaging (MRI) scan – or it may not even have been MRI scanned at all.
Specifically, the protocol provides that a dog classified as an "A" must be over 2.5 years of age and that SM is "absent or less than 2mm central canal dilatation in the C2-C4 region only". A "D" cavalier is one which is over 2.5 years and diagnosed by MRI to have "asymptomatic" SM, meaning that the dog has the disease but does not act like it does. That is one way a cavalier may be classified as a "D". The other way is to be over 2.5 years but to not be MRI scanned at all. So, as long as the dog is over 2.5 years and does not behave like it is suffering from SM, it is a "D" dog. This is known as a "default D" dog.
Most cavalier breeders have more female breeding stock than males. Having too many – in some cases even just one – intact males around can cause more problems than the males are worth. So, most cavalier breeders who do not rely much upon line breeding, will hire other breeders’ studs for mating, rather than keep the dogs in their own households with all those bitches around.
When a financially-challenged CKCS breeder with, say, a half dozen bitches as her breeding stock, considers the SM breeding protocol, she finds that MRI scanning can be quite costly. One thorough scan for just one bitch can cost thousands of dollars, when the ancillary procedures are taken into account, such as blood tests, anesthesia, radiologist and neurologist fees, transportation, etc. Multiply that cost by the number of bitches in the breeder’s kennel, and then maybe double that figure, since more than one MRI scan could be necessary during the breeding years for each bitch. Dealing with just this one protocol for this one genetic disorder could wipe out any hopes of the breeder breaking even on the litters all of her bitches could be hoped to produce.
An apparent solution to this breeder’s dilemma is the option under the SM protocol to not scan her breeding stock at all. If they don’t have symptoms of SM, then she can call all of them "D"s, hence the term, "default D". And if she can find a sire which has been MRI scanned and classified an "A", she could use that sire on all of her "default D"s and still satisfy the SM protocol.
But what about using that one "A" sire on so many "D" bitches? And what about all the other cavalier breeders who decide to take the same approach and also use that "A" male on all of their "D" bitches?
That would be a classic case of Popular Sire Syndrome (PSS). Yes, the current SM breeding protocol encourages corner-cutting breeders, with "default D" bitches, to use the same limited pool of sires, called "Popular Sires", in this case "popular" because they are among a very limited number of "A" dogs.
The PSS is believed to be one of the main causes for the spread of genetic disorders in any breed. As a result, geneticists have urged all breeders to avoid using the same dog for mating all or most of their own breeding stock, and also to avoid using the same sires that several other breeders have been using. Even the owners of the sires themselves have been urged to limit the usage of their dogs by breeders.
Cavalier breeders should not take the short-cut of calling their unscanned bitches "D" (for default), and then breeding them to the same "A" male, to satisfy the SM breeding protocol. But, if past history is a guide, many of corner-cutting cavalier breeders will do just that, and the CKCS community will face another genetic crisis soon enough, thanks to another round of the Popular Sire Syndrome.
May 11, 2011:
CKCSC,USA Board Admits Its Ignorance
...
But Not Its Stupidity!
After repeated denials, the CKCSC,USA's current board of directors finally
admitted that its 1998 predecessor board really did endorse
the real MVD Breeding Protocol. In the official minutes of the board's October 14, 2010 meeting, it
says:
"In response to numerous inquiries and comments regarding the guidelines adopted by the CKCSC-USA, David Frederick clarified that guidelines are not medical protocols. The protocol suggested by a cardiology symposium held in conjunction with the 1997 [really was in 1998] National Specialty specified 2.5 years as the minimum age for first time breeding of dogs and bitches. This protocol was endorsed by an earlier Board." (Emphasis added, of course.)
So, there you have it. The current CKCSC,USA board admits that it was wrong when it claimed that its April 2010 breeding recommendations were "historic" and that "none had existed before"*. Unfortunately, what it did not do at its October 2010 meeting is re-instate the real, one-and-only MVD Breeding Protocol, which this current board un-ceremoniously dumped at its April 2010 meeting. Read "CKCSC,USA Dumps MVD Breeding Protocol" for those details.
The current CKCSC,USA board still endorses only a worthless breeding guideline which no cardiologist or geneticist researcher has ever recommended, and which, they have told us, has not worked and would not work! Stupidity and callous disregard for the hearts of future generations of cavaliers still reign at the Cavalier King Charles Spaniel Club, USA!
*Interestingly, one of the current board members was also on the 1998 board which unanimously endorsed the real MVD protocol. Notwithstanding her inexplicable memory lapse, she now can say that she voted for it before she voted against it!
April 23, 2011:
Beware The Pimobendan/Vetmedin "EPIC Clinical Trial":
There Is No Upside
There comes a time when owners of cavalier King Charles spaniels must say
“NO!” to participating in a pharmaceutical company’s study of its proprietary
brand wonder drug. The on-going “EPIC Clinical Trial” of pimobendan is a prime
example. EPIC is being sponsored by its developer, Boehringer Ingelheim GmbH, a
German pharmaceutical company, which markets the drug under the registered brand
name “Vetmedin”.
Background of Pimobendan
Cavalier King Charles spaniels suffering from mitral valve disease (MVD) and in the late stage of congestive heart failure (CHF), often are prescribed pimobendan. This drug has been shown to improve the quality of life for dogs suffering from CHF due to MVD. It can be very effective at increasing the strength of the heart muscle contractions, thereby improving the heart’s efficiency to function as a pump, and increasing the blood flow to major organs. It even has been shown, in some studies, to actually reduce the amount of backflow of blood through the mitral valve and reverse the enlargement of the heart chambers.
But, there also can be negative aspects to pimobendan. It can have life-threatening (or worse) side-effects when prescribed for asymptomatic dogs or to dogs which, even though they have enlarged hearts and are in CHF, also still have strong heart muscles and good contractility. For those dogs, pimobendan has over-increased their hearts’ pumping ability and contractility to the extent that their mitral valves’ major chordae tendineae have been overworked and, in some cases, have actually ruptured, causing immediate death. (Click here for summary of three disturbing research reports about the inappropriate administration of pimobendan to dogs not in CHF.)
Cautionary Statements About
Pimobendan
by Board Certified Veterinary Cardiologists:
"There is evidence that treatment with a positive inotropic
agent such as pimobendan prior to the development of systolic myocardial failure
can have deleterious effects. ... Pimobendan...should be reserved for use when systolic myocardial
failure is detected or suspected."
--
Dr. Amara Estrada, Board Certified Veterinary Cardiologist.
"Most dogs with chronic valvular heart disease do not have decreased
contractility and do not need positive inotropic support."
--
Dr. George A. Kramer, Board Certified Veterinary Cardiologist.
"One study in dogs with early mitral valve disease suggested an
increase in valve damage in the dogs given pimobendan." --
Dr. Mark Rishniw, Board Certified Veterinary Cardiologist.
111
The U.S. Food and Drug Administration’s (FDA) 2007 report approving the use of pimobendan for dogs also contained the warning that the drug not be prescribed by dogs which are not in congestive heart failure. On each container of Vetmedin is the warning that “Vetmedin should not be given in cases ... where an augmentation of cardiac output is inappropriate for functional or anatomical reasons. Warnings: Only for use in dogs with clinical evidence of heart failure.” (Click here to read more about pimobendan and its downsides.)
The Bad News EPIC Trial
Pimobendan’s manufacturer’s EPIC Clinical Trial has no upside for cavaliers. The trial’s criteria are that cavaliers with some heart enlargement due to MVD but which do not have any clinical signs and are not in CHF, are to be given twice-daily doses of either pimobendan or a worthless placebo and nothing else. This daily medication (or placebo) is intended to go on until the dog develops heart failure.
We already know, from the extensive studies relied upon by the FDA in its approval report, that pimobendan should not be prescribed to dogs if they are not in CHF. Boehringer Ingelheim’s exclusive marketing rights for Vetmedin, as currently approved by the FDA, expires a year from now. So the manufacturer has a strong motivation to find other applications for this powerful drug and perhaps thereby extend its exclusivity rights.
We also know that treating a progressive disorder like MVD with only a worthless placebo -- and nothing but a worthless placebo -- until heart failure results, can be an extremely risky protocol for any cavalier. It would be irresponsible of the cavalier’s owner and its cardiologist.
So, much like Hobson’s choice, you can allow your cavalier to risk pre-mature death due to being given pimobendan when it could do more harm than good, or you can allow your cavalier to not be treated with anything at all until it develops heart failure.
Just Say NO!
Occasionally, or perhaps even more often than that, pharmaceutical companies’ motivations to sell their products tend to outweigh the ethical prudence they should display to not encourage inappropriate marketing. We are not suggesting that this manufacturer’s current EPIC Clinical Trial is such a marketing ploy. But knowing what we do know about the lethal dangers of prescribing pimobendan to cavaliers too early in the progression of their MVD, or to cavaliers even in congestive heart failure but still with strong contractility, this is a potentially terribly flawed study, and cavalier owners should not allow their dogs to participate in it.
Research Report Summaries:
In "Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study", published in 2007 in the Journal of Veterinary Internal Medicine, the researchers found that "PIMO has adverse cardiac functional and morphologic effects in dogs with asymptomatic MVD."
In "Increased Mitral Valve Regurgitation and Myocardial Hypertrophy in Two Dogs With Long-Term Pimobendan Therapy", published in 2005 in Cardiovascular Toxicology, the researchers concluded "This is the first report to describe an increase in mitral regurgitation under clinical conditions in dogs treated with pimobendan. We also suggest that pimobendan may induce ventricular hypertrophy."
In the U.S. Food and Drug Administration’s (FDA) 2007 report approving the use of pimobendan for dogs, it stated this conclusion in a four week toxicity study of pimobendan administered to 30 previously healthy lab Beagles: "Conclusions: Pimobendan administered IV daily to healthy Beagles caused dose dependent increases in heart rate, mitral valve myxomatous thickening, left ventricular outflow tract endocardial thickening, and ventricular muscle ischemic lesions (multifocal subendocardial necrosis and scarring). The cardiac pathology seen in these dogs is typical of positive inotropic drug toxicity in normal dog hearts, and is related to the physiologic effect of the drug on contractility and exaggerated hemodynamic response."
January 30, 2011:
Chiari-Like Malformation HAS Been Re-Defined!
Our
January 28, 2011 editorial, "Maybe Cavaliers Don’t
Even Have Chiari-Like Malformation (CM)!", pointed out that, in
view of recent research reports, either cavalier King Charles spaniels do not
have CM ("decreased caudal fossa volume") or CM needs to be re-defined to fit
within these current research findings.
Well, apparently CM has been re-defined! On the website of syringomyelia researcher Dr. Clare Rusbridge, CM now is defined as "a condition characterized by a mismatch in size between the brain (too big) and the skull (too small). There is not enough room for the brain and the back part (cerebellum and medulla) is pushed out the foramen magnum." The foramen magnum is a hole in the back of the skull -- in the occipital bone -- leading to the spinal cord. Dr. Rusbridge goes on to explain that the cavalier appears to have a brain more appropriate for a bigger dog.
This new definition of Chiari-like malformation pretty much neutralizes the point of our January 28 editorial, so in the inimitable words of Saturday Night Live’s Gilda Radner’s character, Emily Litella, "Never mind!"
January 28, 2011:
Maybe Cavaliers Don't Even Have
Chiari-like Malformation (CM)!
It may be time to let Chiari-like malformation (CM) off the hook! For many
moons, CM has been tagged as the "usual suspect" in the blame-game for a cause
of syringomyelia (SM) in the cavalier King Charles spaniel (CKCS). But based
upon recent studies, it looks like cavaliers do not even have CM!
CM is defined as, "decreased caudal fossa volume with caudal descent of the cerebellum, and often the brainstem, into or though the foramen magnum." The caudal fossa is the cavity within the hind portion of the skull, also known as the occipital bone. The occipital bone contains the foramen magnum, which is the hole at the base of the skull.
The implication has been that the smaller caudal fossa volume within the occipital bone would force the cerebellum (the hindbrain) to squeeze through that hole, the foramen magnum, causing excessive pressure on the cerebrospinal fluid (CSF) and resulting in the production of a syrinx. The conclusion was that it was the smaller size of the hind-skull that was to blame for that squeeze play and the consequent syrinxes.
However, three veterinary research journal articles published in 2009 and 2010 point to evidence that cavaliers’ hind-skull volumes are not different from other small breeds, particularly those with short muzzles, and that the percentage of the volume of the caudal fossa to the volume of the total cranial cavity did not differ significantly between CKCSs with and without SM.
Instead, the oversized cerebellum may be the culprit. These studies also found that the volume of hindbrain was significantly greater for young -- 2-years and younger -- cavaliers with SM than older dogs -- 5 years and older -- without SM. They also found that increased hindbrain volume in CKCSs with SM, compared to that of the hind-skull, was directly correlated with the size of the dogs’ syrinxes.
If the 2009 and 2010 studies are on the right track, then we may have to either re-define "Chiari-like malformation" or use another term to describe the disorder, since the "malformation" may not be of the skull, but of the brain. A re-definition could be "increased cerebellar parenchyma volume with caudal descent of the cerebellum, and often the brainstem, into or though the foramen magnum." But then, would that really be "Chiari-like", or just some other type of malformation?
So, indeed, the SM cavalier’s brain may be too large for its skull!
December 28, 2010:
CKCSC,USA's Board Reinstates A Third Of
The REAL MVD Breeding Protocol
In our October 7 Editorial, we
called upon the CKCSC,USA's board of directors to reinstate the REAL
mitral valve disease breeding protocol at their October meeting. Well,
apparently they did a third of that. Recall, if you will, that at their
April 2010 meeting, they dumped the real protocol, which their
predecessors had unanimously approved in May 1998 when the protocol was
introduced. See our September 7 Editorial
("CKCSC,USA Dumps MVD Breeding Protocol") politely pointing out their act of
virtual insanity.
In April, the current board replaced the REAL protocol with an odious, worthless version, in which they stated: "The CKCSC,USA recommends that prior to breeding any Cavalier, the dog have a clear rating at two years of age from an auscultation by a board certified veterinary cardiologist."
In the face of an onslaught of justifiable criticism, the board met in October and tweaked their bogus breeding recommendation thusly:
"The CKCSC,USA recommends that prior to breeding any Cavalier, the dog should have a heart clearance from an auscultation by a board certified veterinary cardiologist that is consistent with prevailing cardiology protocols; however, the CKCSC,USA recommends a minimum of a cardiology clearance at age 2.5 years by a board certified cardiologist."
Say what??? I suppose we should be grateful for whatever crumbs the board chooses to throw our way, but really!!! This October revision is only a miniscule improvement over their April abomination, and the bottom line is that, according to the researchers, it is still worthless. After all, whatever the CKCSC,USA board "recommends" is toothless at best. No breeders are bound by it, so why doesn't the board go all the way and actually reinstate the REAL MVD protocol that the Club stood by for the past twelve years until this board came along?
Why not add the other two-thirds of the REAL protocol?
• Do not breed any Cavalier under the age of 5 years, unless its parents' hearts were free of MVD murmurs by age 5 years.
• Do not breed any Cavalier who is diagnosed with an MVD murmur under the age of 5 years.
Come On, CKCSC,USA Board: MAN UP!!! Show the world that your Club really does take early-onset MVD seriously, instead of showing your incredible pride and your heinous contempt for future generations of Cavalier King Charles spaniels.
October 7, 2010:
To CKCSC,USA Board:
Reinstate the REAL MVD Breeding Protocol!
Dear CKCSC,USA board of directors: Your next board meeting on
October 14 is your chance to redeem yourselves. Reinstate the
REAL
MVD Breeding Protocol!
The Club’s 1998 board wisely endorsed the REAL protocol which the international research panel of heart specialists and geneticist drew up and urged all cavalier King Charles spaniel breeders to follow, at a minimum! They told us at the Club’s MVD Symposium in May 1998 that we could eliminate early-onset MVD in just a few generations if enough breeders faithfully followed it. Since then, we know that only a handful of cavalier breeders ever paid any attention to it, so twelve years after 1998, there has been no progress in ridding the breed of young cavaliers with bad hearts, suffering and dying all too soon. But that was no excuse for you to dump the REAL protocol at your April 2010 meeting!
In April, you had your chance to re-new the endorsement and urge all club members to follow the REAL protocol. Instead, you replaced it with a worthless recommendation to breed cavaliers "clear at 24 months", which no cardiologist or geneticist researcher has ever recommended. In fact, they told us in 1998 that breeding "clear-to-clear" has not worked and would not work!
You have ignored the research experts’ conclusions that, at a minimum:
(A) All four parents of the breeding pair be MVD-clear as of
their 5th birthday;
(B) The breeding pair be at least 30 months old and MVD-clear at the
time of breeding; and
(C) No cavalier be bred if diagnosed with an MVD murmur before its fifth
birthday.
Just last month, Sweden’s Dr. Clarence Kvart reported that the Swedish CKCS club’s "clear at 24 months" protocol has not reduced the percentage of cavaliers having MVD, and as a result, the Swedish club is considering making the REAL protocol mandatory!
Whatever your purpose in rejecting the REAL protocol, now is your opportunity to redeem yourselves. You owe it to the future generations of cavaliers. Remember, the next edition of Pedigreed Dogs Exposed is focusing on you!
September 10, 2010:
Post Script:
How Self-Absorbed Can The CKCSC,USA Board Be?
Now, after the editorial
CKCSC,USA dumps MVD breeding protocol first appeared
on September 7, the CKCSC,USA has added to its website an introduction to the
announcement of the board's April 29, 2010 decision to reject its 1998
endorsement of the
MVD breeding protocol. The introduction falsely
states:
"The Board took a historic step and established minimal recommendations for conducting health tests ... where none had existed before."
This is a very odd attempt to revise the club's history. The club's 1998 endorsement of the MVD breeding protocol was indeed "historic". The only thing which is historic about the board's April 2010 decision is that it has replaced the MVD breeding protocol with a worthless "clear at 24 months" recommendation, which the research experts told the club back in 1998 would not work.
In the face of the laser now shining brightly and critically upon the cavalier King Charles spaniel, beginning with the broadcast of Pedigree Dogs Exposed, one would expect the CKCSC,USA's board to take a giant step forward and, at the very least, re-new its recommendation of the MVD breeding protocol, if not make it mandatory for registering litters. Instead, the board in April of this year has pretended that it never had recommended the protocol at all, and then replaced it with nonsense. Why does the board now deny that it approved the MVD breeding protocol in 1998?
September 7, 2010:
CKCSC,USA dumps MVD breeding protocol
Taking a giant step backwards from its May 1998 decision endorsing the
MVD breeding protocol, the board of directors of
the Cavalier King Charles Spaniel Club, USA rejected that protocol at its April
2010 meeting. Instead, its board approved a watered down, proven worthless "recommended guideline",
calling for the breeding pair to have MVD-murmur-clear hearts at only 24 months.
It has been twelve years since the CKCSC,USA sponsored the "International Symposium on Chronic Cardiac Valve Disease (CVD) in the Cavalier King Charles Spaniel" in Atlanta, Georgia in May 1998. The club invited a panel of veterinary cardiologists from the USA and the UK -- Drs. Andrew Beardow, James Buchanan, Virginia Luis Fuentes, and Bruce Keene -- and the renowned canine geneticist, Lennart Swenson from Sweden. Before a packed theater of club members, the panel reported on the severity of the disease and its pervasiveness throughout the breed. They stated these conclusions:
• MVD is the leading cause of death in Cavaliers;
• It is a hereditary, genetic disorder;
• There has been no statistical improvement in Cavaliers' mitral valves in the eleven years since the first studies; and
• The disease can be decreased and the age of onset delayed by following guidelines of only breeding Cavaliers who are over the age of 2.5 years, have hearts free from MVD murmurs, and have parents whose hearts were MVD murmur-free at age 5 years. No Cavaliers should be bred which have murmurs before age 5 years.
The panelists then introduced:
The MVD Breeding Protocol:
4Every breeding Cavalier King Charles Spaniel should be examined annually by a board certified veterinary cardiologist.
4Do not breed any Cavalier who is diagnosed with an MVD murmur under the age of 5 years.
4Do not breed any CKCS before age 2.5 years.
4Do not breed any Cavalier under the age of 5 years, unless its parents' hearts were free of MVD murmurs by age 5 years.
That same weekend in May 1998, the CKCSC,USA's board endorsed the protocol and then sent a verbatim transcript of the symposium to all club members, with this statement:
"In this 'Year of the Heart' in which the CKCSC,USA is instituting a number of programs geared toward the study and control of chronic cardiac valve disease, this symposium was organized to bring together international experts to present data and provide guidelines for breeders.
"We urge our members to follow their recommendations, and hope that we will attain our goal of bringing the prevalence, the age of onset, and the severity of the disease to the levels seen in other breeds of dogs."
The Club also mailed to its members annually, beginning in 1998, a Health Registry booklet, which included this set of MVD breeding guidelines:
Guidelines To Reduce The Incidence Of Mitral Valve Disease
Raising the age of onset of mitral valve disease
(MVD) should be a breeder's immediate aim. The best way to approach
this is to select breeding stock with good heart records behind
them. It is strongly recommended that ALL Cavaliers be auscultated
by a Board Certified Veterinary Cardiologist at two and a half years
of age or older and on several occasions during their lifetime,
especially within a year of being bred.
Ideally, Cavaliers should be five years of age or older with a clear
heart when they are first bred. However, recognizing the problems
associated with breeding females for the first time at five years of
age, the following is suggested as a secondary approach to reducing
the incidence of MVD:
Minimum Recommendations
4The Brood Bitch should be a minimum of two and a half years old with a clear heart and with parents with clear heart certificates issued at five years of age or older.
4The Stud Dog should be a minimum of two and a half years old with a clear heart and with parents with clear heart certificates issued at five years of age or older.
4All clear heart certificates must be by a Board Certified Veterinary Cardiologist.
To use an older stud dog with a clear heart certificate issued as late in life as possible is highly desirable. However, an older dog with a slight murmur should not be ignored. It is strongly advised that breeding stock under five years old be limited to those with clear heart certificates.
These guidelines are based on the current recommendations of geneticists and cardiologists and may be updated and reissued by the Cavalier King Charles Spaniel Club, USA when further research becomes available.
Even with these strong endorsements, only a handful of cavalier breeders have faithfully followed the MVD breeding protocol. As evidence of that lack of participation, in March 2009, eleven years after the protocol was introduced, cardiologist Simon Swift stated: "In the UK and the USA, about ½ of all cavaliers [still] have a murmur by the time they are 5 years old."
Purebred breed clubs -- of which indeed the CKCSC,USA is one -- are obliged to educate breed owners on the nuances of the breed and oversee the breed’s health and welfare. The leadership of breed clubs owe a fiduciary duty, not to the club's breeders, but to the breed, to assure that the dogs are protected from irresponsible breeding practices and from the creation of future litters of genetically damaged puppies. Since most all cavalier breeders in the club have failed to faithfully follow the MVD breeding protocol these past twelve years, the responsible thing for its board to do, to protect the breed, would be to re-affirm the importance that its breeders comply with the protocol.
But now we find, twelve years after endorsing the MVD breeding protocol, that instead doing that responsible thing, the CKCSC,USA board has dumped it and instead has contrived this totally bogus guideline which has been proven to be a failure:
"The CKCSC,USA recommends that prior to breeding any Cavalier, the dog have 1) a clear rating at two years of age from an auscultation by a board certified veterinary cardiologist; ..."
This new worthless guideline ignores the research experts' conclusions that: (A) All four parents of the breeding pair be MVD-clear as of their 5th birthday; (B) The breeding pair be at least 30 months old and MVD-clear at the time of breeding; and (C) No cavalier be bred if diagnosed with an MVD murmur before its fifth birthday.
Sadly, the Club's board has effectively thumbed its collective nose at the heart-health of all future generations of CKCSC,USA cavalier King Charles spaniels.
