Abstract
PICO question
 In adult dogs with aortic stenosis does treatment with beta blockers compared with surgical intervention show a longer survival time with improved clinical parameters?
 
 Clinical bottom line
 Category of research question
 Treatment
 The number and type of study designs reviewed
 Eight studies were reviewed. One was a randomised controlled study, three were cohort studies, one was a case series and three were case reports
 Strength of evidence
 Moderate to weak
 Outcomes reported
 Intervention appeared to improve survival times ± physiological parameters when compared to no treatment at all. The severity of clinical signs was reduced, but the risk of sudden cardiac-related death was not diminished according to a number of papers. The direct comparison of surgical treatment with the use of beta blockers showed no significant difference in survival times or physiological parameters across all papers. There is not enough evidence available comparing the different beta blockers used for treatment to draw a meaningful conclusion as to which is more effective
 Conclusion
 Treatment of some form should be given to a dog diagnosed with aortic stenosis. This will improve clinical signs and there is evidence to say that it will prolong survival as well as improve quality of life.More research into this area is essential. Controlled, randomised clinical trials should be carried out in order to find a reliable and strong recommendation for treatment. Ethical implications need to be considered when going forward with this, which is why the evidence pool is likely to be so limited currently
 
 How to apply this evidence in practice
 The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
 Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
 
Highlights
Of the 27 dogs in the treatment group, 25 received atenolol
A high pressure gradient (PG) (>130 mmHg) at diagnosis (20/50 dogs) in both analyses was associated with a reduced survival time of 2.8 years, compared with 8.3 years for ≤130 mmHg (30/50 dogs)
Population: A 3 month old Golden Retriever diagnosed with subvalvular aortic stenosis
Summary
Julia Thomas Student 1* Sophie Marshall Student 1 Georgia Conway Student 1 Karin Gormley Student 1 Kieran Borgeat BSc BVSc MVetMed CertVC MRCVS DipACVIM DipECVIM-CA 1. PICO question In adult dogs with aortic stenosis does treatment with beta blockers compared with surgical intervention show a longer survival time with improved clinical parameters?. There is not enough evidence available comparing the different beta blockers used for treatment to draw a meaningful conclusion as to which is more effective Conclusion Treatment of some form should be given to a dog diagnosed with aortic stenosis. This will improve clinical signs and there is evidence to say that it will prolong survival as well as improve quality of life.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
