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The result for their patients - our cavalier King Charles spaniels and other breeds with MVD - is that they can end up being mis-diagnosed and therefore mis-treated

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These alternative drugs come in vials, with syringes to draw out each dose, and cost hundreds of dollars less than brand-name options

They had a baseline glycated hemoglobin (HbA1c) level between 7.5% and 10.5% (58-91 mmol/mol), a body-mass index of 25 kg/m2 or greater, and established cardiovascular disease or a high risk of cardiovascular events

They tend to affect areas that never previously troubled you

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