Targeted Therapy in Canine Pulmonary Hypertension: Clinical Application of Beraprost

Pulmonary hypertension (PH) in dogs remains a complex and difficult condition to manage, particularly in patients that continue to exhibit clinically significant signs such as syncope and exercise intolerance despite standard therapy. Although phosphodiesterase-5 inhibitors, most notably sildenafil, are widely used as first-line treatment, a subset of dogs demonstrate an incomplete or suboptimal clinical response, highlighting the need for additional mechanism-based therapeutic strategies.

This session will explore the concept of targeted therapy in canine PH, with an emphasis on the three principal pathophysiologic pathways currently recognized in human and veterinary medicine: the endothelin, nitric oxide, and prostacyclin pathways. An overview of these pathways will be provided to establish the rationale for multimodal treatment approaches and to contextualize the role of prostacyclin analogues in PH management.

The second part of the session will focus on the clinical application of beraprost, an oral prostacyclin analogue, used as an adjunctive therapy in dogs with PH. Clinical findings from a cohort of at least 20 dogs treated with beraprost in combination with standard therapy will be presented. When used as an add-on to conventional treatment, beraprost was associated with improvement in clinical signs, particularly reductions in syncopal episodes and improvements in exercise tolerance.

Through a case-based discussion, this session will provide practical guidance on patient selection, dosing strategies, and monitoring considerations for beraprost therapy in canine PH. The goal of this presentation is to offer clinicians a structured, mechanism-oriented framework for incorporating prostacyclin pathway modulation into the multimodal management of dogs with pulmonary hypertension, while also highlighting areas where further prospective research is needed.