the real world Algorithm - sava.co.za
33
Applying PROTECT in the real world Algorithm Presented by Dr. Christoph Schummer Sep 2015
Transcript of the real world Algorithm - sava.co.za
Ap
ply
ing
PR
OT
EC
T in
the
re
al w
orl
d
Alg
ori
thm
Pre
sen
ted
by
Dr.
Ch
rist
op
h S
chu
mm
er
Se
p 2
01
5
PR
OT
EC
T o
utc
om
e
Ve
tme
din
in
pre
clin
ica
l st
ag
e –
mo
re lif
e w
ith
ou
t cl
inic
al si
gn
s
JVIM
, 2
01
2
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
PR
OT
EC
T o
utc
om
e
Ve
tme
din
in
pre
clin
ica
l st
ag
e –
mo
re lif
e t
o l
ive
JVIM
, 2
01
2
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Bro
ad
er
imp
lica
tio
ns
•F
irst
pro
spe
ctiv
e b
lin
de
d s
tud
y i
n v
ete
rin
ary
card
iolo
gy
to
sh
ow
co
nv
inci
ng
be
ne
fit
in t
he
“pre
clin
ica
l” s
tag
e o
f th
e d
ise
ase
wit
h r
esp
ect
to
pri
ma
ry e
nd
po
int
(cf.
Ve
tpro
of,
SV
EP
)
•F
irst
ca
rdio
log
y s
tud
y t
o d
em
on
stra
te t
ha
t a
po
pu
lati
on
id
en
tifi
ed
th
rou
gh
scr
ee
nin
g b
en
efi
ts
fro
m a
n e
arl
y i
nte
rve
nti
on
-
> c
all
to
act
ion
to
scr
ee
n
Wo
rksh
op
wit
h K
ey
op
inio
n le
ad
er
/ p
ract
itio
ne
r (U
S/E
U)
PR
OT
EC
T -
Qu
est
ion
s a
nd
an
swe
rs
SA
specia
list
meeting |
Dr.
Christo
ph S
chum
mer
|
August/
Septe
mber
2015 |
Glo
bal M
ark
eting
- C
om
panio
n A
nim
als
Tea
chin
g b
ree
de
rs /
ow
ne
rs
Dis
ea
se p
rog
ress
ion
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Tea
chin
g b
ree
de
rs /
ow
ne
rs,
vets
D
ise
ase
aw
are
ne
ss
clin
ica
l p
ha
se
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Tea
chin
g n
urs
es
Do
gs
at
risk
fo
r D
CM
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ult
ima
tely
, a
lmo
st a
ll s
ma
ll d
og
s a
re a
t ri
sk
du
rin
g t
he
ir l
ife
tim
e7
Min
iatu
re
an
d T
oy
Po
od
le
Ch
ihu
ah
ua
Min
iatu
re
Pin
sch
er
Bo
sto
n
Terr
ier
Ca
valie
r K
ing
Ch
arl
es
Sp
an
iel
Pe
kin
ge
se
Po
me
ran
ian
Tea
chin
g n
urs
es
Do
gs
at
risk
fo
r M
VD
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ha
ve c
lie
nts
me
asu
re t
he
ir
do
g’s
bre
ath
ing
(a
t re
st o
r
sle
ep
ing
) o
ver
3–
4 d
ays
an
d
no
te a
vera
ge
re
stin
g r
esp
ira
tio
n
rate
fo
r th
eir
in
div
idu
al
do
g
Incr
ea
se in
re
stin
g r
esp
ira
tio
n
rate
(co
nsi
ste
nt
20
% i
ncr
ea
se)
sho
uld
pro
mp
t v
isit
to
cli
nic
On
ce d
iag
no
sed
wit
h h
ea
rt
fail
ure
, o
wn
ers
sh
ou
ld m
on
ito
r
bre
ath
ing
on
ce w
ee
kly
—fo
reve
r
Tea
chin
g o
wn
ers
M
on
ito
rin
g o
f b
rea
thin
g –
ea
rlie
st s
ign
an
ow
ne
r ca
n lo
ok
fo
r
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
RR
R a
pp
– B
oe
hri
ng
er
Ing
elh
eim
Tea
chin
g o
wn
ers
R
est
ing
re
pir
ato
ry r
ate
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
EC
G
Nu
rse
ed
uca
tio
n
He
art
ra
te (
pe
n m
eth
od
)
–co
un
t co
mp
lexe
s x
20
; 5
0 m
m/s
(x
10
; 2
5 m
m/s
)
P
ictu
re W
ess
, LM
U M
un
ich
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
EC
G
Qu
ick
ch
eck
po
ints
Sin
us
rhy
thm
(ye
s/n
o)?
(lo
ss o
f) s
inu
s a
rrh
yth
mia
?
QR
S c
om
ple
x
–T
ime
–M
orp
ho
log
y
He
art
rh
yth
m
–R
eg
ula
r vs
. ir
reg
ula
r
–S
up
rave
ntr
icu
lar
(no
rma
l Q
RS
) vs
. ve
ntr
icu
lar
(biz
arr
e Q
RS
)
–A
tria
l fib
rill
ati
on
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ea
sy c
he
ckp
oin
ts
Ho
me
mo
nit
ori
ng
by
ow
ne
r
EC
G d
ev
ice
– A
liv
eC
or
(ab
stra
ct A
CV
IM 2
01
3)
Giv
es
acc
ura
te h
ea
rt r
ate
as
com
pa
red
to
a r
efe
ren
ce E
CG
Re
lia
ble
EC
G‘s
ca
n b
e a
cqu
ire
d w
ith
sm
art
ph
on
e d
ev
ice
Ow
ne
r o
wn
ed
to
y (
low
str
ess
)
–V
alu
ab
le i
nfo
fo
r a
rrh
yth
mia
mg
mt:
re
-ch
eck
do
gs
wit
h A
F
–H
ea
rt r
ate
: w
ell
co
ntr
olle
d w
he
n <
14
0-1
60
bp
m
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ea
sy c
he
ckp
oin
ts
Ho
me
mo
nit
ori
ng
by
ow
ne
r
EC
G d
ev
ice
– A
liv
eC
or
(ab
stra
ct A
CV
IM 2
01
3)
Do
wn
loa
d a
pp
Sn
ap
mo
nit
or
on
to b
ack
of
iph
on
e
Pu
t o
n le
ft c
he
st -
> w
rite
EC
G
Se
t a
live
cor
acc
ou
nt
–Tr
an
smit
to
we
b,
acc
ess
, v
iew
, p
rin
t, s
av
e,
sen
d f
or
an
aly
sis
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ea
sy c
he
ckp
oin
ts
in h
ou
se E
CG
– t
ele
me
dic
ine
EC
G s
erv
ice
Tele
me
dic
ine
EC
G s
erv
ice
Lim
ite
d t
ime
, in
terp
reta
tio
n?
??
Fax,
ma
il,
on
lin
e e
valu
ati
on
(e
.g.
kard
ioko
nsu
lt.d
e,
un
ive
rsit
ies…
)
–A
na
lysi
s in
24
hrs
–D
D,
TX
–F
urt
he
r re
com
me
nd
ati
on
s
S
A s
pe
cia
list
me
eti
ng
|
Dr.
Ch
rist
op
h S
chu
mm
er
|
Au
gu
st/S
ep
tem
be
r 2
01
5
|
Glo
ba
l Ma
rke
tin
g
-
Co
mp
an
ion
An
ima
ls
PR
OT
EC
T
Ext
rap
ola
tio
n t
o o
the
r la
rge
bre
ed
s –
Vo
llm
ar
pa
pe
r (A
CV
IM 2
01
2)
PR
OT
EC
T
Ext
rap
ola
tio
n t
o o
the
r la
rge
bre
ed
s (1
/4)
Sim
ila
riti
es
in p
he
no
typ
e,
pa
tho
log
y, a
nd
pa
tho
ph
ysi
olo
gy
Oth
er
bre
ed
s d
eve
lop
sy
sto
lic
dy
sfu
nct
ion
as
a c
on
seq
ue
nce
of
dil
ate
d c
ard
iom
yop
ath
y w
hic
h is
sim
ila
r in
ap
pe
ara
nce
to
th
at
ma
nif
est
ed
by
Do
be
rma
n P
insc
he
rs.
Sim
ila
riti
es
in d
ise
ase
pro
gre
ssio
n -
occ
ult
vs.
cli
nic
al
Th
ey
als
o h
ave
pe
rio
ds
wh
en
th
e d
ise
ase
is
de
tect
ab
le t
hro
ug
h t
he
pe
rfo
rma
nce
of
dia
gn
ost
ic t
est
s b
ut
the
do
g d
em
on
stra
tes
no
ou
twa
rd s
ign
s o
f d
ise
ase
; d
uri
ng
th
is p
ha
se t
he
dis
ea
se i
s
de
scri
be
d a
s “p
re-c
lin
ica
l”.
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
PR
OT
EC
T
Ext
rap
ola
tio
n t
o o
the
r la
rge
bre
ed
s (2
/4)
Co
mm
on
pre
dic
tors
: LV
en
larg
em
en
t /
arr
hy
thim
a f
req
ue
ncy
Do
be
rma
n P
insc
he
rs a
s a
bre
ed
we
re n
ot
sho
wn
to
be
ha
ve s
ign
ific
an
tly
dif
fere
ntl
y t
o o
the
r b
ree
ds
wit
h d
ila
ted
ca
rdio
myo
pa
thy.
In a
la
rge
stu
dy
of
fact
ors
in
flu
en
cin
g s
urv
iva
l, t
he
ext
en
t to
wh
ich
th
e
left
ve
ntr
icle
wa
s e
nla
rge
d a
nd
th
e p
rese
nce
of
a v
en
tric
ula
r rh
yth
m
dis
turb
an
ce w
ere
ass
oci
ate
d w
ith
a w
ors
e o
utc
om
e (
Ma
rtin
an
d o
the
rs
20
10
).
Th
e o
nly
bre
ed
th
at
did
exc
ep
tio
na
lly
ba
dly
wa
s th
e G
rea
t D
an
e.
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
PR
OT
EC
T
Ext
rap
ola
tio
n t
o o
the
r la
rge
bre
ed
s (3
/4)
Sim
ila
r p
ath
op
hy
sio
log
y –
sim
ila
r M
oA
Th
e m
ech
an
ism
th
rou
gh
wh
ich
pim
ob
en
da
n i
s th
ou
gh
t to
act
– a
s
an
in
od
ila
tin
g d
rug
im
pro
vin
g c
on
tra
ctil
ity
an
d r
ed
uci
ng
aft
erl
oa
d
– s
ho
uld
be
of
valu
e t
o a
ny
do
g w
ith
sim
ila
r le
vels
of
syst
oli
c
dys
fun
ctio
n i
rre
spe
ctiv
e o
f th
eir
bre
ed
.
No
oth
er
dru
g w
ide
ly u
sed
fo
r th
e t
rea
tme
nt
of
card
iac
dis
ea
se i
n
do
gs
is k
no
wn
or
be
lie
ved
to
ha
ve a
bre
ed
-sp
eci
fic
eff
ect
.
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
He
art
siz
e r
ed
uct
ion
in
oth
er
bre
ed
s ~
be
ne
fici
al
ou
tco
me
It is
ev
ide
nt
fro
m t
he
re
sult
s o
f th
e P
RO
TE
CT
stu
dy
th
at
the
be
ne
fit
con
ferr
ed
by
th
e t
rea
tme
nt
ap
pe
ars
pro
po
rtio
na
l to
th
e d
eg
ree
to
wh
ich
th
e l
eft
ve
ntr
icu
lar
syst
oli
c d
iam
ete
r re
du
ces
aft
er
the
init
iati
on
of
tre
atm
en
t (S
um
me
rfie
ld a
nd
oth
ers
20
12
).
Th
is r
ed
uct
ion
in
he
art
siz
e h
as
als
o b
ee
n s
ho
wn
to
occ
ur
in m
ore
he
tero
ge
ne
ou
s g
rou
ps
of
do
gs
wit
h h
ea
rt d
ise
ase
tre
ate
d w
ith
pim
ob
en
da
n (
Hä
gg
strö
m a
nd
oth
ers
20
13
, W
oo
lle
y a
nd
oth
ers
20
07
) a
nd
is
the
refo
re u
nli
kely
to
be
a b
ree
d s
pe
cifi
c b
en
efi
t.
PR
OT
EC
T
Ext
rap
ola
tio
n t
o o
the
r la
rge
bre
ed
s (4
/4)
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Alg
ori
thm
Ech
o:
go
ld s
tan
da
rd ,
bu
t h
igh
co
sts
(ow
ne
r),
eq
uip
me
nt,
exp
ert
ise
,
imp
ract
ica
l fo
r e
very
at
risk
do
g
Go
al:
En
cou
rag
e t
o d
ete
ct a
nd
sta
ge
DC
M b
y a
n e
asy
to
ol
wit
h r
ea
son
ab
le c
ost
s
Pre
pa
red
wit
h e
xpe
rt p
an
el
of
card
iolo
gis
ts a
nd
ge
ne
ral p
ract
itio
ne
rs
Ris
k s
tra
tifi
cati
on
(li
keli
ho
od
, p
red
icto
rs)
–W
ha
t is
th
e l
ike
lih
oo
d o
f th
is d
og
/po
pu
lati
on
to
de
velo
p D
CM
–P
red
icto
rs:
bre
ed
, fa
mil
ial h
isto
ry,
HR
, R
R,
VP
C,
incr
ea
sed
VH
S/B
NP
/LV
ID…
•O
the
r e
xam
ple
s: w
ea
the
r fo
reca
st
Alg
ori
thm
P
rin
cip
le o
f ri
sk s
tra
tifi
cati
on
Sa
tell
ite
pic
ture
s/ca
lcu
lati
on
s: g
old
sta
nd
ard
, b
ut
hig
h c
ost
s, e
qu
ipm
en
t,
exp
ert
ise
, im
pra
ctic
al
for
eve
ry a
t ri
sk a
rea
Alg
ori
thm
P
rin
cip
le o
f ri
sk s
tra
tifi
cati
on
– e
xam
ple
of
we
ath
er
fore
cast
Fo
reca
st h
isto
ry
Ch
eck
th
e s
ky
: cl
ou
ds,
th
un
de
r li
gh
tnin
g?
Ad
dit
ion
al te
sts:
hu
mid
ity
(h
ygro
me
ter)
, a
ir p
ress
ure
(b
aro
me
ter)
PR
OT
EC
T
Alg
ori
thm
– L
eve
l 1
- P
hys
ica
l e
xam
s
No
te s
ub
tle
cli
nic
al
sig
ns:
-O
wn
er
ma
y r
ece
ive
th
em
as
no
rma
l
-S
ign
s d
ue
to
fa
ct t
ha
t d
og
is
ge
ttin
g o
lde
r
-M
ay
be
no
t sp
eci
fic
(->
ad
dit
ion
al
test
s)
->
ask
qu
est
ion
s!!!
MA
Y
Wh
o:
- D
x o
f a
du
lt d
og
s
- A
t ri
sk b
ree
ds
(h
igh
pre
vale
nce
)
- Fa
mil
ial h
isto
ry
(f
am
ilia
l d
ise
ase
)
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ph
ysi
cal
exa
min
ati
on
:
-A
usc
ult
ati
on
+ p
alp
ati
on
(p
rem
atu
re c
on
tra
ctio
n)
-Li
ste
n l
on
g e
no
ug
h f
or
arr
yth
mia
s/V
PC
s
-3
rd h
ea
rt s
ou
nd
-5
0%
of
DC
M d
og
s h
ave
a h
ea
rt m
urm
ur!
PR
OT
EC
T
Alg
ori
thm
– L
eve
l 2
– A
dd
itio
na
l te
sts
Ad
dit
ion
al t
ets
:
-N
o s
tan
d a
lon
e t
oo
ls (
com
bin
ed
wit
h le
vel
1 o
r ru
n a
s co
mb
ina
tio
n)
-5
min
EC
G v
alu
ab
le t
oo
l (f
ind
ing
: h
igh
ly s
usp
icio
us)
: ch
eck
ele
ctri
cal
cha
ng
es
(arr
hy
thm
ia/V
PC
/AF
: b
ig w
arn
ing
)
-C
ave
: D
ob
i a
nd
Bo
xer:
arr
hy
thm
ic f
orm
s! (
Ho
lte
r re
com
me
nd
ed
)
-If
EC
G s
ho
ws
fin
din
g:
hig
hly
su
spic
iou
s
-X
-ra
y:
mo
rph
olo
gic
al ch
an
ge
s; c
he
ck l
un
g p
ath
olo
gy,
ru
le o
ut
cau
se a
nd
se
veri
ty,
exc
lud
e n
on
-ca
rdia
c ca
use
s
-B
NP
: c
he
ap
, se
nsi
tive
bio
ma
rke
r
sho
rtcu
t
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
PR
OT
EC
T
Alg
ori
thm
– L
eve
l 3
– R
e-e
xam
ina
tio
ns/
Ech
o
Ech
o:
-O
bta
in d
iag
no
sis
+ s
tag
e d
ise
ase
(cl
inic
al
pro
gre
ssio
n i
s co
nti
no
us!
)
-D
iscu
ss o
pti
ma
l tr
ea
tme
nt
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Re
-exa
ms:
-D
CM
is
no
t a
co
nti
no
us
dis
ea
se
-S
cre
en
ing
do
es
no
t te
ll t
o b
e f
ree
for
life
-N
ee
d t
o d
ete
ct l
ike
lih
oo
d t
o
be
ha
ve g
oo
d o
r b
ad
-C
lose
mo
nit
ori
ng
(e
.g.
imp
ort
an
t
wh
en
on
ly a
rrh
yth
mo
ge
nic
:
Do
be
rma
n/B
oxe
r!)
Alg
ori
thm
P
red
icto
rs a
s p
uzz
le p
iece
s –
n=
1
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Alg
ori
thm
P
red
icto
rs a
s p
uzz
le p
iece
s –
n=
2
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Alg
ori
thm
P
red
icto
rs a
s p
uzz
le p
iece
s –
n=
3
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Alg
ori
thm
P
red
icto
rs a
s p
uzz
le p
iece
s –
n=
4
Take
ho
me
me
ssa
ge
s
Ed
uca
tio
n i
s ke
y (
ow
ne
r, b
ree
de
r, n
urs
e,
vets
)
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
Ea
rly
de
tect
ion
ma
tte
rs (
ea
sy a
vail
ab
le p
red
icto
rs)
Do
n`t
wa
it:
Scr
ee
n in
ord
er
to s
tart
pre
clin
ica
lly
It is
in y
ou
r h
an
ds
to c
ha
ng
e t
he
liv
es
of
you
r p
ati
en
ts (
ow
ne
rs)
–G
ive
th
em
a h
ap
pie
r, h
ea
lth
ier
an
d lo
ng
er
life
Re
fere
nce
s
1. A
tkin
s C
, B
on
ag
ura
J, E
ttin
ger
S,
et al. G
uid
elin
es fo
r th
e d
iag
no
sis
an
d tre
atm
en
t of can
ine
chro
nic
valv
ula
r he
art
dis
ea
se. J V
et
Inte
rn M
ed
. 20
09
;23(6
):
11
42–
11
50
.
2. S
isso
n D
. V
alv
ula
r h
ea
rt d
ise
ase
in
do
gs. P
roce
ed
ing
s fro
m th
e W
SA
VA
20
02
Con
gre
ss; O
cto
be
r 3–
6, 2
00
2; G
ran
ad
a, S
pa
in.
htt
p:/
/ww
w.v
in.c
om
/pro
ce
ed
ing
s/P
roce
edin
gs.p
lx?
CID
=W
SA
VA
200
2&
PID
=2
532
. A
cce
sse
d S
ep
tem
be
r 2
0, 2
01
2.
3. G
ug
lielm
ini C
. C
ard
iova
scu
lar
dis
ea
se
s in
th
e a
gin
g d
og
: D
iag
no
stic a
nd
th
era
pe
utic p
rob
lem
s.
Ve
t R
es C
om
mu
n.
20
03
;27
(Su
pp
l 1):
55
5–
56
0.
4. B
uch
an
an
JW
. P
reva
len
ce
of
ca
rdio
va
scu
lar
dis
ord
ers
. In
: F
ox P
R,
Sis
so
n D
, M
ois
e N
S,
ed
s. T
extb
oo
k o
f C
an
ine
an
d F
elin
e C
ard
iolo
gy. P
hila
de
lph
ia, P
A:
WB
Sa
un
de
rs; 1
99
8:4
57–
47
0.
5. O
yam
a M
. C
on
ge
nita
l he
art
dis
ea
se. In
: E
ttin
ger
SJ, F
eld
man
EC
, e
ds.
Te
xtb
oo
k o
f V
ete
rina
ry In
tern
al M
ed
icin
e.
7th
ed
. S
t. L
ouis
, M
O:
Saun
de
rs E
lsevie
r;
20
10
:12
50–
12
98.
6. O
lse
n L
H, H
äg
gstr
öm
J, P
ete
rse
n H
D.
Acq
uir
ed
va
lvu
lar
he
art
dis
ea
se
. In
: E
ttin
ge
r S
J, F
eld
ma
n E
C, e
ds.
Te
xtb
oo
k o
f V
ete
rin
ary
In
tern
al M
ed
icin
e.
7th
ed
.
St.
Lo
uis
, M
O:
Sa
un
de
rs E
lse
vie
r; 2
01
0:1
29
9–
13
19.
7. B
org
are
lli M
, B
uch
an
on
JW
. H
isto
rica
l re
vie
w,
ep
ide
mio
log
y a
nd
na
tura
l h
isto
ry o
f d
eg
en
era
tive
mitra
l va
lve
dis
ea
se
. J V
et C
ard
iol. 2
01
2;1
4:9
3–
101
.
8. O’G
rad
y M
R,
Min
ors
SL
, O’S
ulli
va
n M
L,
Horn
e R
. E
ffe
ct o
f p
imo
be
nd
an o
n c
ase
fa
talit
y r
ate
in
Dob
erm
an
pin
sch
ers
with
co
ng
estive
he
art
fa
ilure
ca
use
d b
y
dila
ted
ca
rdio
myo
pa
thy. J V
et In
tern
Me
d.
20
08
;22
(4):
89
7–9
04.
9. S
um
me
rfie
ld N
J, B
osw
oo
d A
, O
Gra
dy M
R,
et
al. P
imo
be
nd
an
imp
rove
s s
urv
iva
l in
Do
be
rma
n P
insch
ers
with
pre
clin
ical D
CM
: th
e r
esu
lts o
f P
RO
TE
CT
,
a d
ou
ble
-blin
d, p
lace
bo
-co
ntr
olle
d, ra
nd
om
ize
d c
linic
al t
ria
l. J
Ve
t In
tern
Me
d.
In p
ress.
10
. B
uch
an
an
JW
, Bű
ch
ele
r J. V
ert
eb
ral sca
le s
yste
m to
me
asu
re c
an
ine
he
art
siz
e in
ra
dio
gra
ph
s.
J A
m V
et M
ed
Asso
c. 1
99
5;2
06
(2):
194–
19
9.
11
. L
am
b C
R,
Wik
ele
y H
, B
osw
oo
d A
, P
feiffe
r D
U.
Use
of b
ree
d-s
pe
cific
ra
ng
es fo
r th
e v
ert
eb
ral h
ea
rt s
ca
le a
s a
n a
id in
th
e r
ad
iog
rap
hic
dia
gn
osis
of ca
rdia
c
dis
ea
se
in d
og
s. V
et
Rec. 2
00
1;1
48
(23
):70
7–7
11.
12
. P
ag
el P
S,
Hett
rick D
A,
Warl
tier
DC
. In
flu
en
ce
of
levo
sim
en
dan
, p
imo
be
nd
an, a
nd
milr
ino
ne
on
th
e r
eg
ion
al d
istr
ibu
tio
n o
f ca
rdia
c o
utp
ut in
an
ae
sth
estize
d
do
gs. B
r J P
ha
rma
co
l. 1
99
6;1
19
:60
9–6
15.
13
. G
ord
on
SG
, M
ille
r M
W, S
au
nd
ers
AB
. P
imo
be
nd
an
in h
ea
rt fa
ilure—
a s
ilve
r b
ulle
t? J
Am
An
im H
osp
Asso
c. 2
00
6;4
2(2
):9
0–9
3.
14
. F
itto
n A
, B
rog
de
n R
N.
Pim
ob
en
da
n: A
re
vie
w o
f its p
ha
rma
co
log
y a
nd
th
era
pe
utic p
ote
ntia
l in
co
ng
estive
he
art
fa
ilure
. D
rug
s A
gin
g. 1
99
4;4
:41
7–4
41.
15
. V
an
Me
el JC
A,
Die
de
ren
W. H
em
od
yn
am
ic p
rofile
of
the
ca
rdio
ton
ic a
ge
nt p
imo
be
nd
an
. J C
ard
iova
sc P
ha
rm. 1
98
9;1
4(S
up
pl 2
9):
S1–
S6
.
16
. L
om
ba
rd C
W, Jö
ns O
, B
ussa
do
ri C
M;
for
the
Ve
tSC
OP
E S
tud
y.
Clin
ica
l eff
ica
cy o
f p
imo
be
nd
an
ve
rsu
s b
en
aze
pri
l fo
r th
e tre
atm
en
t o
f a
cq
uir
ed
atr
iove
ntr
icu
lar
va
lvu
lar
dis
ea
se
in d
og
s.
J A
m A
nim
Ho
sp
Asso
c. 2
00
6;4
2:2
49–
26
1.
17
. H
äg
gstr
öm
J,
Bo
sw
oo
d A
, O
Gra
dy M
, e
t a
l. E
ffe
ct o
f p
imo
be
nd
an o
r b
en
aze
pri
l hyd
roch
lori
de
on
su
rviv
al tim
es in
do
gs w
ith
co
ng
estive
he
art
fa
ilure
ca
use
d b
y n
atu
rally
occu
rrin
g m
yxo
ma
tou
s m
itra
l va
lve
dis
ea
se
: th
e Q
UE
ST
stu
dy.
J V
et In
tern
Me
d.
20
08
;22
(5):
11
24–
113
5.
SA
sp
eci
ali
st m
ee
tin
g |
D
r. C
hri
sto
ph
Sch
um
me
r |
A
ug
ust
/Se
pte
mb
er
20
15
|
G
lob
al M
ark
eti
ng
-
C
om
pa
nio
n A
nim
als
