Update/Question

Hey, my boys bloods came back and there’s no concern for his kidneys. His MCH is slightly low 21.1, his reticulocyte haemoglobin is slightly low 21.9 and his creatinine levels are slight high 146.0 but his vets don’t seem overly concerned by that. I have read a page that suggests if a dogs NT-proBNP is elevated above 1500 that they are at high risk of developing heart failure within 3-6 months. Obviously things aren’t guaranteed or predicted but is there enough evidence to suggest that it is likely? His NT-proBNP is 2380 but no changes to his echocardiograph. I know NT-proBNP can fluctuate but this has more than doubled since 6 months ago when he was in the 900 range so I’m just wondering if there is a high risk to heart failure in the upcoming few months or if there’s no definitive way of knowing? Just to add, he is stage B2 MMVD and has been for 2 years. Thank you

Hello!  There was a study done by Jang, Yoon and Choi, published in the Irish Veterinary journal last year, which concluded that high blood pressure increases the Pro-BNP by placing pressure on the left ventricle.  I quote "Stress on the left ventricle is greater and NT-proBNP concentrations are higher in systemic hypertensive dogs with MMVD stage B than in normotensive dogs with MMVD stage B. Therefore, clinicians should be aware that NT-proBNPcould be elevated in the presence of systemic hypertension."  I do not know whether this is relevant to your boys' case, but your vet might.  High blood pressure can occur in connection with or independently of, known heart disease.  If this might be the cause, are they doing everything they can to control the blood pressure?  This might be a useful question to ask. I'm afraid that I am not a cardiologist and in no better position to understand this case than your own vets.  However, it is important to ask them questions like this in order that you feel in control and confident in your pets' medical care.   I would argue that it might merit an extra consultation; if you make sure that your vets know what you are wanting to talk about in advance, they will hopefully have chance to prepare good explanations. I wish you the very best in finding some peace; please will you let us know how you get on?

I am just wondering if there is a high risk of heart failure in the coming months or there is know was of knowing?    To be clear, I beleive that an  elevantion in Pro-BNP does increase a dogs' risk significantly, but of course risk is usually a percentage e.g. 80% or 20% or 60% or 2%, and as any gambling person would tell you, does not definitively dictate which group your dog is going to end up falling into.  It does, however, make a lot of sense to try to reduce the risk when the means are available.  Your vet and cardiology team are the best people to ask about this. I hope that this makes sense.