Echocardiographic changes in dogs undergoing chemotherapy protocols with doxorubicin

Echocardiographic changes in dogs undergoing chemotherapy protocols with doxorubicin | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Echocardiographic changes in dogs undergoing chemotherapy protocols with doxorubicin GUSTAVO CAVINATO HERRERA, MATHEUS MATIOLI MANTOVANI, JACQUELINE RIBEIRO DE CASTRO, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7795024/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 15 You are reading this latest preprint version Abstract Background Doxorubicin is a widely used drug in veterinary oncology protocols due to its antineoplastic efficacy and cost-effectiveness. However, its cardiotoxic effects are not well documented, necessitating the development of strategies for its safe use. Objectives This study aimed to assess whether echocardiography can effectively detect and quantify the cardiotoxic effects of doxorubicin, alone or in combination with other chemotherapeutics. Animals This study monitored 33 dogs undergoing different chemotherapy protocols at the Veterinary Hospital of the Federal University of Uberlândia and its affiliated clinics using echocardiography. Methods In this prospective study, examinations were performed at three time points (T0 - before chemotherapy and after each application - to T3) to measure ejection fraction (Teicholz and Simpson methods), fractional shortening (FS), and left ventricular dimensions in diastole and systole. A linear mixed-effects model was used for statistical analysis, considering time, doxorubicin use, the presence of preexisting heart disease, and their interactions. Results Statistically significant reductions in echocardiographic parameters were observed in dogs treated with doxorubicin, either alone or in combination with other chemotherapeutics. These reductions remained within the physiological reference ranges of the species, with no clinical evidence of cardiac dysfunction. Chronic myxomatous degeneration of the mitral valve intensified the cardiotoxic response, as indicated by the estimated marginal means, suggesting the need for close monitoring in such cases. Age also influenced the magnitude of the changes, with adult dogs showing greater susceptibility than older dogs. These findings suggest a cumulative cardiotoxic pattern associated with doxorubicin, which can be detected early through serial echocardiographic monitoring, even when values remain within reference limits. Conclusion and Clinical Importance It was concluded that doxorubicin is safe when used under rigorous cardiovascular monitoring, and routine echocardiographic surveillance is recommended throughout treatment, even in the absence of overt clinical signs of cardiopathy. dogs doxorubicin echocardiography cardiotoxicity Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 Mar, 2026 Reviews received at journal 15 Mar, 2026 Reviews received at journal 06 Mar, 2026 Reviewers agreed at journal 03 Mar, 2026 Reviewers agreed at journal 02 Mar, 2026 Reviews received at journal 28 Dec, 2025 Reviews received at journal 02 Nov, 2025 Reviewers agreed at journal 26 Oct, 2025 Reviewers agreed at journal 24 Oct, 2025 Reviewers agreed at journal 22 Oct, 2025 Reviewers invited by journal 21 Oct, 2025 Editor assigned by journal 10 Oct, 2025 Editor invited by journal 09 Oct, 2025 Submission checks completed at journal 09 Oct, 2025 First submitted to journal 09 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7795024","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":536458495,"identity":"ee21a866-8f88-4a8f-a98a-3961c74f12a1","order_by":0,"name":"GUSTAVO CAVINATO HERRERA","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYDADAygtx8B8gIGZgGLGBmQtxgxsCSRqSWwgpEU+Iv35g59tNvLm7L3PPnzcY5e+4RiPAXPhHtxaDG/kGDb2tqUZ7uw5bjxzxrPkXLCWGc/waJmRw9jAc+ZwgsGNNGZmngPMuRvu9xgAGfi0pD9s/APScv8ZM/OfA/XpBiBb8GmRl0gwbOapANnCxszMcADIIKTFgOeN4WyZijTDDWfSmBl7Dhw3nHmMreDwDHy2tKc/+PjGwEbe4PgxZoYfB6rl+Y4xb3xcgM8WrHJ4NABtacAnOwpGwSgYBaMABAC9XlPlYphJvAAAAABJRU5ErkJggg==","orcid":"","institution":"Federal University of Uberlândia","correspondingAuthor":true,"prefix":"","firstName":"GUSTAVO","middleName":"CAVINATO","lastName":"HERRERA","suffix":""},{"id":536458496,"identity":"1c14039e-af29-4451-a9cb-c6cdb8ebc1c1","order_by":1,"name":"MATHEUS MATIOLI MANTOVANI","email":"","orcid":"","institution":"Federal University of Uberlândia","correspondingAuthor":false,"prefix":"","firstName":"MATHEUS","middleName":"MATIOLI","lastName":"MANTOVANI","suffix":""},{"id":536458497,"identity":"882fb3eb-5708-48e8-976d-79911f55f070","order_by":2,"name":"JACQUELINE RIBEIRO DE CASTRO","email":"","orcid":"","institution":"Federal University of Uberlândia","correspondingAuthor":false,"prefix":"","firstName":"JACQUELINE","middleName":"RIBEIRO","lastName":"DE CASTRO","suffix":""},{"id":536458498,"identity":"712d1c79-b0fb-4100-a723-291b09f388b7","order_by":3,"name":"ANDRESA DOS SANTOS VERAS","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"ANDRESA","middleName":"DOS SANTOS","lastName":"VERAS","suffix":""},{"id":536458499,"identity":"8712284f-6362-411b-8be8-72b21f6c3101","order_by":4,"name":"MARCELO JOSÉ BARBOSA SILVA","email":"","orcid":"","institution":"Federal University of Uberlândia","correspondingAuthor":false,"prefix":"","firstName":"MARCELO","middleName":"JOSÉ BARBOSA","lastName":"SILVA","suffix":""}],"badges":[],"createdAt":"2025-10-07 02:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7795024/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7795024/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":94814234,"identity":"04f1c12d-64a7-4b6c-b2e1-cfe0f2ca44cb","added_by":"auto","created_at":"2025-10-31 04:04:23","extension":"json","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7465,"visible":true,"origin":"","legend":"","description":"","filename":"cee5fc7137ab412da028c30518934295.json","url":"https://assets-eu.researchsquare.com/files/rs-7795024/v1/382162dcfde7ce225a4251ab.json"},{"id":94826304,"identity":"ae76b782-6e57-48fb-9315-a793d9ead612","added_by":"auto","created_at":"2025-10-31 06:51:23","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1387206,"visible":true,"origin":"","legend":"","description":"","filename":"PaperGustavoBMC4.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7795024/v1_covered_3d84877b-61b8-4f34-b7b1-8f311d2380a1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Echocardiographic changes in dogs undergoing\nchemotherapy protocols with doxorubicin","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"dogs, doxorubicin, echocardiography, cardiotoxicity","lastPublishedDoi":"10.21203/rs.3.rs-7795024/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7795024/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eDoxorubicin is a widely used drug in veterinary oncology protocols due to its antineoplastic efficacy and cost-effectiveness. However, its cardiotoxic effects are not well documented, necessitating the development of strategies for its safe use.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives \u003c/strong\u003eThis study aimed to assess whether echocardiography can effectively detect and quantify the cardiotoxic effects of doxorubicin, alone or in combination with other chemotherapeutics. Animals This study monitored 33 dogs undergoing different chemotherapy protocols at the Veterinary Hospital of the Federal University of Uberlândia and its affiliated clinics using echocardiography.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eIn this prospective study, examinations were performed at three time points (T0 - before chemotherapy and after each application - to T3) to measure ejection fraction (Teicholz and Simpson methods), fractional shortening (FS), and left ventricular dimensions in diastole and systole. A linear mixed-effects model was used for statistical analysis, considering time, doxorubicin use, the presence of preexisting heart disease, and their interactions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eStatistically significant reductions in echocardiographic parameters were observed in dogs treated with doxorubicin, either alone or in combination with other chemotherapeutics. These reductions remained within the physiological reference ranges of the species, with no clinical evidence of cardiac dysfunction. Chronic myxomatous degeneration of the mitral valve intensified the cardiotoxic response, as indicated by the estimated marginal means, suggesting the need for close monitoring in such cases. Age also influenced the magnitude of the changes, with adult dogs showing greater susceptibility than older dogs. These findings suggest a cumulative cardiotoxic pattern associated with doxorubicin, which can be detected early through serial echocardiographic monitoring, even when values remain within reference limits.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and Clinical Importance\u003c/strong\u003e It was concluded that doxorubicin is safe when used under rigorous cardiovascular monitoring, and routine echocardiographic surveillance is recommended throughout treatment, even in the absence of overt clinical signs of cardiopathy.\u003c/p\u003e","manuscriptTitle":"Echocardiographic changes in dogs undergoing\nchemotherapy protocols with doxorubicin","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-31 04:04:18","doi":"10.21203/rs.3.rs-7795024/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-24T18:12:53+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-15T13:43:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-06T18:35:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236982087963369884115899252042674735390","date":"2026-03-03T08:16:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"291994203569511447035801386510789417960","date":"2026-03-02T14:45:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-29T01:40:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-02T14:57:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15448695706430389142556195021623968924","date":"2025-10-26T14:45:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130568775121219933154753783036431586874","date":"2025-10-24T08:31:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"35112072694103752507067955491345135138","date":"2025-10-22T08:40:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-21T13:52:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-10T05:46:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-10T03:41:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-09T16:44:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Veterinary Research","date":"2025-10-09T16:42:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a068641c-00e7-41e1-acd1-eb3496bf56ae","owner":[],"postedDate":"October 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-30T09:00:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-31 04:04:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7795024","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7795024","identity":"rs-7795024","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}