Anaesthetic management of dogs with myxomatous mitral valve disease: results of a questionnaire survey of veterinary anaesthesiologists.

MMVD severity should guide drug selection, with opioid premedication, conservative fluids, and dobutamine readiness in advanced cases.

This cross-sectional questionnaire survey examined the anaesthetic management preferences of 21 American board-certified veterinary anaesthesiologists for dogs with myxomatous mitral valve disease (MMVD) across increasing disease severities (stages B1, B2, and C). Using seven standardized clinical scenarios involving nervous and potentially aggressive dogs, respondents indicated preferences via a 5-point Likert scale covering ASA physical status classification, premedication choices, ketamine use, intraoperative fluid rates, and dobutamine likelihood. Key findings demonstrated a progressive shift toward higher ASA classifications and greater cardiovascular support as disease severity advanced. Opioid-based premedication was broadly favored, while acepromazine and alpha-2 agonists were increasingly avoided in advanced stages due to hemodynamic concerns. Ketamine was more acceptable in early disease stages (B1/B2) but less endorsed in stage C cases, likely reflecting concerns over increased heart rate and sympathomimetic effects in decompensated patients. Conservative intraoperative fluid rates of 2–3 mL/kg/hour were preferred across all scenarios, with particular emphasis in advanced MMVD to avoid volume overload. Dobutamine use became increasingly likely as disease severity progressed, reflecting the need for positive inotropic support in compromised patients. The study highlights substantial expert consensus despite the absence of formal evidence-based guidelines, providing clinicians with a practical framework for anaesthetic decision-making in MMVD dogs. Limitations include the small sample size and subjective nature of survey-based methodology.

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