New Drug Class For Heart Failure?

Hello Summarians!

Three very different topics to check out today. That is the beauty of the world of animal medicine. We never run out of topics to discuss.

I hope that you enjoy these.

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End Of Life Assessment In Dogs

The Dog Aging Project (DAP) is a large, prospective longitudinal study of more than 50,000 companion dogs across the United States designed to better understand the biological and environmental factors that influence aging. Because dogs share many genetic, environmental, and disease similarities with humans—and age more rapidly—they offer a powerful model for studying aging within a shorter time frame. A critical component of the DAP is the End of Life Survey (EOLS), an owner-completed questionnaire developed to capture detailed information about dogs’ deaths, including cause of death (CoD), reason for euthanasia (RFE), quality of life (QoL), and perimortem experiences. 

This report summarizes 646 completed surveys from dogs that died between December 2019 and March 2021. The mean age at death was 13 years, and most dogs were in the senior life stage. Euthanasia was the most common manner of death, accounting for 83% of cases, typically performed in a veterinary clinic, though nearly one-quarter occurred at home. Veterinary care had been sought within two weeks of death for over 80% of dogs. 

Pain and/or suffering was the most frequently cited primary reason for euthanasia, followed by poor quality of life and poor prognosis. Owners reported that quality of life declined more noticeably in older dogs, and unfavorable QoL ratings increased with advancing age. The most common primary causes of death were cancer (29.7%), old age (29.4%), and organ system disease (22.3%), with cancer often involving the spleen, liver, or lymph nodes. 

Although the study relies on owner-reported data without mandatory diagnostic confirmation, it provides valuable insight into end-of-life experiences in companion dogs. These findings highlight the importance of veterinary education on pain recognition, quality-of-life assessment, and geriatric care to better support dogs and their owners during the aging process. 

McNulty, K. E., Ruple, A., Fitzpatrick, A., Wilkins, V., Dog Aging Project Consortium, & Creevy, K. E. (2026). The Dog Aging Project End of Life Survey reveals owners’ perceptions of canine death and highlights areas to improve client education. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.25.12.0863

Bottom line — Helpful to remember.

New Class Of Heart Medications For Dogs

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are widely used in human medicine to reduce morbidity and mortality in patients with type 2 diabetes and heart disease. These drugs lower blood glucose by blocking glucose and sodium reabsorption in the proximal renal tubules, leading to increased urinary glucose excretion. Beyond glycemic control, SGLT2i provide cardiovascular and renal protection through mechanisms that likely extend beyond simple diuresis or natriuresis. Their role in veterinary patients, particularly dogs with heart disease, remains under investigation. 

This study evaluated the short-term tolerability and physiologic effects of oral dapagliflozin in dogs with heart disease. The primary findings were marked increases in urinary glucose concentration and fractional excretion of glucose without clinically meaningful changes in serum glucose, sodium, ketones, blood urea nitrogen, or creatinine. These results indicate that dapagliflozin induces substantial glucosuria in dogs without causing hypoglycemia or ketonemia, mirroring findings in humans and other animal studies. Contrary to expectations, urinary sodium excretion and fractional sodium excretion did not increase, suggesting that compensatory renal mechanisms may limit sustained natriuresis. This supports the concept that SGLT2i benefits are not solely due to diuretic effects and that these drugs likely complement rather than replace traditional loop diuretics. 

Biomarker analysis revealed increases in haptoglobin and total thiol concentrations, suggesting potential antioxidative and anti-inflammatory effects. Given the recognized role of oxidative stress and inflammation in heart disease progression, these findings highlight possible pleiotropic benefits of SGLT2 inhibition in dogs. Blood ketone concentrations remained unchanged, and no cases of euglycemic ketoacidosis were observed. 

Overall, short-term dapagliflozin administration was well tolerated, with minimal adverse effects. Although limited by a small sample size and short duration, the findings support further investigation into the multifaceted mechanisms and long-term clinical benefits of SGLT2 inhibitors in canine heart disease. 

Laura K Massey, Jessica L Ward, Alexandra V Crooks, Emilie Guillot, Jose Ceron, Camilla Rubio, Victoria Convey, Melissa Tropf, Mei-Jyun Ciou, Jonathan P Mochel, Mark A Oyama, Effect of the sodium glucose transporter-2 inhibitor dapagliflozin on urine and blood biomarkers in dogs with heart disease, Journal of Veterinary Internal Medicine, Volume 40, Issue 2, March-April 2026, aalag036, https://doi.org/10.1093/jvimsj/aalag036 

Bottom line — Seems safe. Now we need to determine clinical benefit.

Shockwave Therapy

Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment modality that uses high-energy acoustic pressure waves generated outside the body to deliver mechanical energy to targeted tissues. First introduced in the early 1980s for lithotripsy to break down kidney stones, shock wave technology was later adapted for therapeutic applications in musculoskeletal medicine. Shock waves are characterized by a rapid rise in pressure followed by a rapid decline. The initial positive pressure produces direct mechanical forces on tissues, while the subsequent negative phase creates indirect forces through cavitation bubble formation. These combined effects are believed to induce controlled microtrauma at the cellular level, stimulating the release of anti-inflammatory cytokines and growth factors that promote angiogenesis, osteogenesis, and tissue repair. ESWT also provides significant analgesia, often lasting at least 48 hours, though its precise pain-relieving mechanism remains incompletely understood. 

There are four primary types of shock wave generators: electrohydraulic, electromagnetic, piezoelectric, and radial (ballistic). Focused systems—electrohydraulic, electromagnetic, and piezoelectric—concentrate energy at a specific depth, whereas radial devices produce unfocused pressure waves that dissipate superficially. Electrohydraulic units generate shock waves via a high-voltage spark gap, producing high peak pressure and a large focal zone. Piezoelectric units use crystals to create more narrowly focused waves, requiring precise targeting. Machine selection influences tissue penetration, patient comfort, and sedation needs. 

Clinically, ESWT is commonly used for tendon and ligament injuries, osteoarthritis, bone healing, thoracolumbar pain, and wound healing in horses and dogs. Treatment parameters include depth, energy flux density (mJ/mm²), and pulse number, with total energy determined by pulses multiplied by energy per pulse. Side effects are typically mild and transient but may include swelling or bruising. Contraindications include neoplasia, open growth plates, bleeding disorders, and caution near major nerves and vessels. Proper technique, patient preparation, and post-treatment exercise restriction are essential to maximize therapeutic benefit and minimize risk. 

Horne, C. R., & Schnabel, L. V. (2026). Extracorporeal shock wave therapy in equine and canine practice. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.25.12.0827 

Bottom line — another potential mobility tool.

Just putting things in perspective …