Torasemide

RE: Torasemide

Mike Martin — Tue, 07 Jul 2015 08:59:26 GMT

We use it when we feel dogs are becoming resistant to frusemide, which is usually more than a year on at least a moderate dose frusemide, and CS are recurring despite an increase in frusemide.

Torsemide is quite potent, so monitor renal function and electrolytes frequently when switching over.

Dose on our website: http://www.martinreferrals.com/drug-formulary/

RE: Torasemide

grumpyoldman — Sun, 05 Jul 2015 09:51:41 GMT

we have it in and used it occasionally ,not seen much obvious benefit over increased frequency of lasix , I always felt the lastssixhours (lasix) was for people ,and in dogs the effect seems to end after 4 ?? so I think its better to increase the frusamide frequency to 4 hours and reassess water intake .

RE: Torasemide

Stephen Courtney — Sun, 05 Jul 2015 09:28:07 GMT

I would add in moduretic at this point. Mainly because i have it on the shelf and have used it before. bloods to check renal function and potassium a good idea too.

Sounds like the client will need a reality check as there is progression to a definite end point, and cavaliers do have a habit of sudden acute decompensation and 'waking up dead' which needs to be discussed in advance - mainly so you know what the client wants when the next crisis comes - sometimes people haven't planned ahead and when faced with a choice PTS or heroics, they don't know what to say except ' do everything' - and then have regrets.

Also +1 for injectable dimazon/ lasix - it can make a real difference, but as a top - up - you still give the oral frusemide, but train the owner to give a subcut dose of damson once a day initially

RE: Torasemide

Silvia Maldonado — Sun, 05 Jul 2015 03:09:01 GMT

My problem with torasemide was that it takes longer than furosemide to make effect. Contrary to some of the comments I've read, I used to give furosemide in emergency, and keep pets on torasemide for long term treatment (they seemed to be doing better, less side effect, specially electroytes depletion). However, I've not been in the congress, nor I've used it for years, since I came to the UK because of the cascade.

Re: Torasemide

Bob Russell — Mon, 02 Jun 2014 10:55:49 GMT

Well worth a try if frus is no longer working adequately. We have had several on it over the years. Not magic but worth a go. Amiloride/hydrochlorothiazide (Moduretic and generic) can buy some extra quality time in my experience!

Re: Torasemide

John Flynn — Mon, 02 Jun 2014 10:26:36 GMT

I've used it at about 1/10th of the dose I had the furosemide at (as replacement for the furosemide), and then titrating up to effect.

Has some theoretical advantages over furosemide I reckon, but lack of experience means I use furosemide first-line and torasemide if lack of effective diuresis in spite of increasing furosemide doses etc.

Re: Torasemide

Sarah Keir — Mon, 02 Jun 2014 10:05:28 GMT

I have used Torasemide a couple of times in the cavaliers that are bright and happy apart from persistent pulmonary oedema. These are usually end stage heart failures. Firstly check all the other doses are adequate eg pimobendan at the higher dose if appropriate. Secondly I trial frusemide by injection; they probably have some degree of gut oedema so the oral frusemide is not so well absorbed. Then I try torasemide but you must monitor kidneys, some azotaemia is likely (some people argue this the only way you can tell if a diuretic is working) but don't push them in AKF.

Sarah

Re: Torasemide

Mark Hedberg — Mon, 02 Jun 2014 09:41:56 GMT

Is it refractory to frusemide, or is the heart so worn out and damaged that the fluid buildup is simply impossible to compensate for?