C11 - Evaluating the Safety and Efficacy of Clevidipine in Dogs with Congestive Heart Failure

Abstract: Background – Congestive heart failure (CHF) secondary to canine myxomatous mitral valve disease (MMVD) is common and adjunct therapies for acute decompensation are lacking. Afterload reduction enhances cardiac output, but vasodilator options are limited. Clevidipine is a novel intravenous dihydropyridine calcium channel blocker that may aid in canine CHF management.

Hypothesis/Objectives – Clevidipine, compared to standard of care (SOC), will result in a 20% reduction in mean arterial pressure (MAP) in a dose-dependent manner without adverse effects when used for afterload reduction in CHF secondary to MMVD. A secondary objective was to determine whether oscillometric blood pressure measurement (OSC) provides a reliable assessment of MAP in treated patients.

Animals – Ten client-owned dogs in acute decompensated CHF secondary to MMVD.

Methods – Prospective, randomized, open-label, clinical trial. Dogs enrolled received SOC alone or with clevidipine (CLEV) with continuous direct arterial (ART) and OSC monitoring throughout treatment.

Results – Target MAP was achieved in all CLEV patients and MAP was significantly decreased compared to SOC (p = 0.0005) at doses 4.5-16.5 mcg/kg/min (5.25, IQR 4.50-9.75 mcg/kg/min). Comparison of ART and OSC methods demonstrated overestimation of MAP in both SOC and CLEV groups (bias -13.99, -15.45). There was no significant difference in BUN or creatinine following treatment in either group and no notable hypotension was appreciated.

Conclusions and clinical importance – Clevidipine was well-tolerated and resulted in a dose-dependent reduction of MAP in dogs with MMVD and CHF. Direct arterial blood pressure monitoring is recommended for monitoring response to clevidipine therapy.