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They fall for a Fool's Gold Standard of heart enlargement Dumbing-down diagnosing heart enlargement puts our cavaliers at high risk For the past 9 years (as of 2025), beginning with publication of the EPIC Study report in September 2016, numerous ACVIM board certified veterinary cardiologists have published articles in which they have defined left-sided cardiomegaly (heart enlargement) for any dog of any breed by two minimum echocardiograph measurements, one of the left atrium (LA/Ao = 1.6) and the other of the left ventricle (LVIDDN = 1.7)

Prescribers review patient progress at minimum every 46 weeks during dose escalation, adjusting titration speed based on gastrointestinal tolerance and weight loss velocity rather than rigidly following manufacturer protocols designed for FDA-approved branded products

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ReflexMD taps into a network of licensed compounding and mail-order pharmacies across the U.S

doi:10.1080/13803395.2014.904844CrossRefGoogle ScholarPubMed Zamzow, RM, Ferguson, BJ, Stichter, JP, et al

Primary results at 80 weeks All three doses met the primary and all key secondary endpoints of the trial