Below, please find links to all of the cardiology clinical trials. The studies include a multitude of information, including (but not limited to) the study’s purpose, benefits for participating, and financial incentive information. If you have any questions, please contact the individual outlined at the end of each trial summary.
Please visit the Cardiology service webpage at the Veterinary Medical Teaching Hospital (VMTH) if you would like to learn more about the amazing things that our cardiologists can do for your animal.
Title: Coumadin versus Clopidogrel in canine aortic thrombus
Purpose of Study: Aortic thrombus is a rare condition in dogs that occurs when a thrombus (blood clot) lodges within the aorta (main arterial blood vessel of the body) and cuts off the blood supply, usually to one or both hind legs. Currently, there is very little known about the appropriate way to treat dogs with aortic thrombus and the reports of treatment are sparse and conflicting. In humans, the current recommendation is treatment with long-term Coumadin (Warfarin), which is a medication that prevents the blood from clotting. This treatment results in the clot dissolving of its own accord over time and also prevents clot recurrence. Alternatively, treatment can be targeted at preventing platelets from sticking together and forming blood clots with mediations like clopidogrel (Plavix). The purpose of this study is to compare the effectiveness of Coumadin versus clopidogrel in treating aortic thrombus in dogs as well as to evaluate the degree to which the coagulation system and platelet activity is effected dogs with aortic thrombus. Finally, we aim to evaluate the effect of Coumadin on the coagulation system and Coumadin versus clopidogrel on platelet activity, and assess whether these factors effect outcome.
- Ineligible: Dogs already being treated with Warfarin (Coumadin), Plavix or aspirin
Initial Evaluation for Participation: None
- First visit: Full workup will include abdominal ultrasound, routine bloodwork and urine analysis, blood clotting profiles including clotting tests (coagulation profile), thromboelastography (TEG, a blood clotting test) and PFA-100 (platelet clotting test), chest x-rays, and heart ultrasound. These tests represent the minimum testing for dogs presenting with aortic thrombus formation and, as such, the owner would be responsible for this cost regardless of entry into the study. Following enrollment, patients will be randomly assigned to Group 1 (Coumadin) or Group 2 (clopidogrel).
- (Group 1 ONLY): One week later, revisit, repeat physical examination and repeat clotting tests (requires blood draw for 3ml of blood) for monitoring the effect of Coumadin. Continued repeat clotting tests to be performed at 1-2 week intervals until an appropriate level of anticoagulation has been achieved.
- Second visit: One month after goal anticoagulation level achieved (group 1) or one month after initiation of therapy (group 2), revisit, physical examination, questionnaire, repeat PFA-100 (platelet clotting test, requires blood draw for 4 ml of blood) and repeat abdominal ultrasound (diagnostics funded by study).
- Third visit: Three months after goal anticoagulation level achieved (group 1) or initiation of therapy (group 2), revisit, physical examination, questionnaire, PFA-100 (platelet clotting test, blood draw for 4ml blood), and abdominal ultrasound (diagnostics funded by study).
- Fourth visit: Six months after goal anticoagulation level achieved (group 1) or initiation of therapy (group 2), revisit, physical examination, questionnaire, PFA-100 (platelet clotting test, blood draw for 4ml blood), repeat abdominal ultrasound (diagnostics funded by study).
Benefits: Regardless of the treatment, your dog will be receiving one of these 2 potentially beneficial drugs. The information gleaned from this study is critical to improving the decision making process in terms of selecting appropriate treatment for these patients and will for the first time provide information regarding benefits of therapeutic intervention for dogs with aortic thrombus.
Owner Responsibilities: The cost of the subsidized consultation and echocardiograph, 6 month treatment with the study drug, monitoring, and ultrasounds beyond the initial ultrasound will be paid for by the study (~$1500); however, the owner is responsible for paying for all costs associated with the initial diagnosis and treatment, including the initial visit, echocardiograph, x-ray, initial abdominal ultrasound and blood work ($800-1000).
Contact: Contact the Speciality Coordinators for Cardiology (530-752-4012)
Title: Effect of pimobendan on the incidence of arrhythmias
Purpose of Study: Recent studies have demonstrated that treatment with the medication, pimobendan, provides a survival benefit for dogs with heart failure. This finding has led to widespread use of pimobendan in veterinary patients. However, the optimal timing of use of pimobendan, as either an early adjunctive therapy for congestive heart failure or a rescue therapy for refractory heart failure is unknown. The aim of this study is to assess the effect of pimobendan on the frequency of arrhythmias in dogs with heart failure.
- Dogs with congestive heart failure (CHF) due to valvular degeneration (abnormally thickened heart valves)
- CHF must be controlled with conventional therapy prior to entry into the study
- Ineligible: Dogs already receiving Pimobendan
Initial Evaluation for Participation:
- Dogs must be diagnosed with congestive heart failure (CHF) due to valvular degeneration (abnormally thickened heart valves)
- First visit: Initial consultation and physical examination, baseline 24-hour ambulatory ECG (Holter), echocardiogram, blood pressure, and thoracic radiographs. Once the Holter monitor has been removed by the owner, they are to commence randomly assigned pimobendan or placebo. Both the owner and the primary investigators will be blinded as to which drug the dog is receiving.
- Second visit: Two weeks later, revisit, repeat Holter monitor, and blood pressure. This will be followed by a two-week washout period (no pimobendan or placebo). The owner will then commence the alternative drug.
- Third visit: After two weeks on alternate drug, revisit, repeat Holter monitor, and blood pressure.
Your dog will be closely monitored to see if there is a increase in presence of arrhythmia while taking the drug.
Benefits: If the patient is then deemed suitable for entry into the study, the client will receive free thoracic radiographs initially, and blood pressure monitoring and pimobendan for its duration. Hospitalization for treatment of heart failure and/or abnormal electrical activity is the responsibility of the owner.
Most dogs with CHF and mitral disease are currently put on Pimobendan, so the study is not doing anything that would not otherwise happen to your dog. The American College of Veterinary Internal Medicine (ACVIM) cardiology consensus statement actually recommends treatment of these diseases with the drug. It is possible that some dogs are particularly sensitive to this effect, and we will individualize the therapy for your dog.
We do not know when it is best to use this drug. If it does cause arrhythmia, then we would use it later in the course of heart disease than is being currently recommended. So, your dogs participation in this trial will help to clarify when to use the drug for thousands of dogs with CHF and Mitral Disease.
Owner Responsibilities: The owner is responsible for covering the initial appointment, echocardiogram, blood pressure monitoring, pimobendan costs after the trial period (4 weeks) and the costs of further follow-up and treatment.
Contact: Contact the Speciality Coordinators for Cardiology (530-752-4012)