Boxer Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

Boxer ARVC (also called Boxer Cardiomyopathy) is a hereditary disease with adult onset. The disease affects the heart muscle and can result in sudden death or the development of congestive heart failure. The average age at onset of clinical symptoms and/or abnormal Holter monitor results is about 6 years. However, some dogs may show signs earlier and others later in life.

The first mutation we identified (known as NCSU ARVC1) is a genetic deletion in a gene that functions to hold cardiac cells together. The second mutation that we just recently identified (known as NCSU ARVC2) is a single nucleotide polymorphism in a regulatory gene. In humans there are 8 different genes that can cause the development of ARVC. Each one by itself can lead to the development of ARVC. There are 141 DIFFERENT mutations in these 8 genes. The functionality of the two genes we have identified in dogs is very similar to what is currently known about the disease in human beings. Much of what we know about the disease in humans may be applicable to the dog.

ARVC is a disease of incomplete penetrance. This means that some individuals with the genetic mutation will not show the disease until they get older, and some individuals with the mutation will NEVER show the disease. In humans there are cases of IDENTICAL TWINS with a mutation, where one twin develops severe heart disease and one does not. This suggests that although the mutation affects the heart, it may require certain environmental or other genetic factors to develop the severe form of the disease. They have not been identified in people yet.

Our results in the boxer also suggest that multiple genes could work together to impact the severity of the disease in the dog, which we hope to have a better understanding of in the future.

As with any genetic information, we recommend ALWAYS using test results to guide your decisions about breeding rather than using them as an absolute recommendation for all dogs. Do not make drastic decisions. Each dog and each family line should be considered individually. The field of canine genetics is very new and the field of cardiac genetics is very complex. We are still learning how to best use these tools.

Testing Prices:

• Boxer ARVC1 = $48.00
• Boxer ARVC2 = $48.00
• Boxer ARVC Combo (ARVC1 and ARVC2) = $70.00

Findings on the Holter that suggest a diagnosis of ARVC are ventricular premature complexes (VPCs).

This is a disease that primarily affects the electrical system of the heart so the best way to test for it is a 24 hour Holter monitor. Since the disease is adult onset and can start at varying ages, we recommend that Holtering be started at 3 years of age and repeated ANNUALLY. A single Holter reading that is normal at one point in the dog’s life does not mean that it can never have ARVC. It simply means that it does not at this time.

HOWEVER, the identification of VPCs do not mean that ARVC has been diagnosed. There are many other things that can cause VPCs in dogs including inflammation of the heart muscle from certain viruses (parvovirus, etc), parasites (ex: Chagas), and tumors (including tumors in other body organs). Particularly if a Boxer is less than 3 years of age with VPCs it is less likely that his VPCS are due to ARVC.

Recommendations

Dogs that are positive for either ARVC1 or ARVC2 will not necessarily develop significant heart disease and die from the disease. Some dogs will develop a very mild form of the disease and will live quite comfortably. Others may need treatment.

Removal of a significant number of dogs from the breeding population could be very bad for the Boxer dog breed. Remember that dogs that carry this mutation also carry other important good genes that we do not want to lose from the breed.

Positive Heterozygous (1 copy of the mutated gene and 1 copy of a normal gene): Dogs that are positive heterozygous should be carefully evaluated for signs of disease (Holter monitor and possibly an echocardiogram). If an arrhythmia (VPCs) is detected, possible treatment options should be discussed with your veterinarian. Adult dogs that do not show signs of disease and that have other positive attributes could be bred to mutation negative dogs. Puppies may be screened for the mutation and over a few generations, mutation negative puppies may be selected to replace the mutation positive parent and gradually decrease the number of mutation positive dogs in the population.

Positive Homozygous (2 copies of the mutated gene): I recommend not breeding the homozygous dogs UNLESS they are exceptional members of the Boxer community and we need to be sure to maintain their positive attributes in the breed. Dogs that are homozygous for the mutation appear to have more significant disease and will certainly pass on the mutation therefore they should only be bred to a negative dog and over 2 generations of negative crosses a negative puppy could be selected as a replacement.

Positive for both genes: Dogs that are positive for both genes ideally should not be bred, as they have the highest chances of passing along a mutation resulting in affected offspring.