"THE MORE WE
LEARN THE LESS WE KNOW":
A Progress Report to the ABC
Membership
May 7, 2001
by Kathryn M. Meurs, D.V.M.,
Ph.D.
Due to a scheduling conflict
that demanded her early return to OSU, Dr. Meurs was able to give only a brief report to a
small room of interested people during judging of the Futurity classes.
THE MORE WE LEARN THE LESS
WE KNOW
The theme of Dr. Meurs
talk was that although she has learned a great deal about Boxer Cardiomyopathy from her
research and the work of other researchers, there is still no definitive proof that would
enable her, or any other research scientist, to give us a "cutoff point"
(numbers of VPCs) for removal of dogs from our breeding programs. Dr. Meurs said much more
research was needed before we arrived at that point, and urged boxer breeders to Holter
test our breeding stock yearly, choose a course of action that seems right for our own
breeding programs, be honest and forthright with our fellow breeders, and most
importantly, remain nonjudgmental about breeders who make different choices.
WHICH TESTS ARE NECESSARY?
Dr. Meurs began her talk by
responding to a question about which heart tests she considered necessary. She said that
she considered a one-time echocardiogram at over a year of age and a yearly Holter to be
necessary for potential breeding dogs. She then posed the question of what is a
normal Holter test. In a study of 51 non-boxers, the average number of VPCs per dog was
two. The range was from 0 to 24 VPCs. For boxers, Dr. Meurs said it is probably not normal
for a dog to have 100 VPCs in 24 hours. However, as noted above, she said she cannot yet
recommend a cutoff point for removing a dog from a breeding program.
GRADING BCM
For purposes of her study, Dr.
Meurs and her associates have devised a grading scheme for Holter test results. A Holter
test that results in only single (isolated) VPCs = Grade 1; the presence of couplets and
triplets = Grade 2 or 3; the presence of runs of 4+ VPCs = Grade 4. Grades 1 and 2/3 have
NOT been proven to be connected to sudden death.
PATHOLOGY AND INHERITANCE
Dr. Meurs said that in
necropsies of all boxers that had died of BCM, a fibrous, fatty tissue infiltration in the
myocardium of the right ventricle was found. This is similar to what is seen in a human
heart disease, and may be what causes the electrical conduction disorder in boxers. Dr.
Meurs believes that BCM is definitely inherited in an autosomal dominant manner.
MEDICATION
Dr. Meurs said that medication
must lower the numbers of VPCs by 85% to be considered effective.
WHAT HAVE WE LEARNED?
1. That cardiomyopathy is
primarily an electrical disease in the boxer.
2. Therefore, the disease
should be called "Boxer Arrhythmic Cardiomyopathy."
3. Most affected boxers have
normal echocardiograms.
4. Many affected dogs have NO
symptoms.
HOW MANY NON-SYMPTOMATIC
BOXERS IN THE STUDY HAD VPCS?
Of the 188 mature boxers in
Dr. Meurs study, 157 had no clinical signs of BCM, while 31 had fainting spells
(syncope). Of the 157 dogs WITHOUT clinical signs (symptoms) of BCM:
More than 80% had at least one
VPC/24 hours.
50% had greater than 10.
More than 30% had greater than
50.
More than 30% had greater than
100.
More than 20% had greater than
500.
Only a tiny percentage of dogs
without symptoms had greater than 3000.
AORTIC/SUBAORTIC STENOSIS
(AS/SAS)
Dr. Meurs explained the OSU
grading scheme for AS/SAS:
Blood velocity of 1.7 m/s and
lower = Normal.
1.7 to 2.0 m/s = Equivocal.
2.0 to 3.0 m/s = Mildly
Affected.
4.0 and above = Severely
Affected.
Dr. Meurs said that OSU used
this grading scheme for the purposes of their research, but that no definitive research
had been done that precisely correlated those blood velocities to the OSU grading system.
Dr. Meurs closed by stressing
that we needed much more information before we could make firm recommendations about
eliminating dogs from breeding programs, and again urged us to cooperate with our fellow
breeders, make decisions only for our own breeding programs, and remain nonjudgmental
about the decisions of other breeders.
VZ - 5/31/01 |