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Vitamin D and Feline Cardiomyopathy

Background

Many tissues, including the heart, have vitamin D receptors that regulate gene transcription and expression including the renin-angiotensin system, pro-inflammatory cytokines, and endothelial dysfunction.  In 2013, a canine study showed that 25vitD levels were low with CHF and related to prognosis (1).  And in 2015, another study showed that 25vitD levels corresponded to disease severity in dogs with chronic valvular heart disease (2).

Featured Study

Most companion animal studies are small with cohorts less than 30, with the vast majority being dogs, so it was a pleasant surprise to see a relatively large (n=100) feline study looking at the relationship of vitamin D and feline cardiomyopathy (3).  This study out of JVIM studied cats with cardiomyopathy (HCM, HOCM, RCM) and examined the relationship with 25vitD and 3-epi-25vitD (the epimer of 25vitD).  Study findings showed:

  • 25vitD was lower in cardiomyopathy compared to healthy controls (p=0.07)
  • Summation 25vitD (25vitD + 3-epi-25vitD) was lower in cardiomyopathy compared to healthy controls (p=0.04)
  • 3-epi-25vitD showed no differences between groups
  • Older cats had significantly lower 25vitD levels (p=0.002)
  • Mortality was higher in cats with low 25vitD (<30ng/mL) with an odds ratio of 8.27 for death within 30 days

Conclusion

In both dogs and cats low stores of 25vitD are associated with cardiac disease, disease severity, and mortality.  Low stores of vitamin D should be considered an independent risk factor for the development and progression of heart disease.

References

  1. Kraus MS, Rassnick KM, Wakshlag JJ, Gelzer AR, Waxman AS, Struble AM, Refsal K. Relation of vitamin D status to congestive heart failure and cardiovascular events in dogs. J Vet Intern Med. 2014 Jan-Feb;28(1):109-15. doi: 10.1111/jvim.12239.
  2. Osuga T, Nakamura K, Morita T, Lim SY, Nisa K, Yokoyama N, Sasaki N, Morishita K, Ohta H, Takiguchi M. Vitamin D Status in Different Stages of Disease Severity in Dogs with Chronic Valvular Heart Disease. J Vet Intern Med. 2015 Nov-Dec;29(6):1518-23. doi: 10.1111/jvim.13606.
  3. Ware W, Freeman L, Rush J, Ward J, Makowski A, Zhang M. – Vitamin D status in cats with cardiomyopathy. J Vet Intern Med 2020, doi: 10.1111/jvim.15833.