Background – Right-sided heart disease (RHD) results in systemic venous hypertension. The clinical impact of elevated venous pressures on gastrointestinal health is unknown. Hypothesis – Measures of gastrointestinal dysfunction increase with increasing severity of RHD. Animals – Eighteen dogs with RHD: compensated RHD without hepatic venous dilation (Group 1), compensated RHD with hepatic venous dilation (Group 2), and decompensated RHD with ascites (Group 3). Methods – Prospective clinical trial. All dogs had a comprehensive echocardiogram performed, including evaluation of hepatic/caval vein distension and collapsibility. Beyond conventional hematologic, fecal, and urine testing, thromboelastography, N-terminal pro-B-type natriuretic peptide (NT-proBNP), c-reactive protein (CRP), cobalamin, folate, methylmalonic acid (MMA), and serum intestinal fatty acid-binding protein (I-FABP) were measured. Differences between groups were compared by one-way analysis of variance. Results – There were no differences between groups for cobalamin or folate. Three of 6 dogs in both Groups 1 and 2 showed hypercoagulability while 5 of 6 dogs in Group 3 showed hypocoagulability. Two Group 3 dogs had elevated CRP; CRP was normal in all other dogs. Both MMA (P=0.04) and I-FABP (P=0.03) differed between groups, with values increasing from Group 1 to 3. NT-proBNP progressively increased between groups (P<0.001) with mean (range) of 1,168 pmol/L (493-3,016), 2,918 (1,125-8,117), and 5,864 (3,492-10,000) respectively. Conclusions – Gastrointestinal health is altered in RHD, with greater dysfunction present in decompensated heart failure. These findings may impact nutritional management of RHD. The impact of gastrointestinal health on absorption of nutrients or medications in dogs with RHD deserves further study.
