Total bilirubin is an independent predictor of death in dogs with degenerative valvular disease and dilated cardiomyopathy

Introduction: There is little published regarding the association between canine cardiovascular disease and the hepatic system. The objective of the study was to evaluate the relationship between hepatic parameters, survival, and disease stages of dogs with either dilated cardiomyopathy (DCM) or degenerative valvular disease (DVD). Animals, materials, and methods: Retrospective study analyzing hepatic parameters in dogs with DVD or DCM in American College of Veterinary Internal Medicine (ACVIM) stage B or C and healthy control dogs. Associations between liver parameters, type and stage of disease, and survival were investigated. Results: Ninety-nine dogs were included in the study: 61 DVD, 22 DCM, and 16 con-trols. Differences in liver parameter concentrations between DCM, DVD, and dis-ease stages were found. Univariate analysis identified alanine aminotransferase (P < 0.001), aspartate aminotransferase (P = 0.02), and total bilirubin (P = 0.005) as predictors of mortality. In the multivariate analysis, total bilirubin remained an independent predictor of mortality. Conclusions: The observed differences between DCM, DVD, and disease stages are likely consistent with disease-specific hemodynamics and progression of disease. This and the role of total bilirubin as an independent predictor for mortality indi-cate that in dogs with DVD and DCM the cardiovascular-hepatic interaction might be of relevance for disease progression and outcome, as reported for humans with cardiac disease. Further studies into the role of hepatic function in canine cardiac disease are required.