Effects of Vetmedin on a healthy(?) Cavalier KCS

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Mike Nikolaou — Sat, 03 Jul 2010 12:21:17 GMT

2 months down the line the dog is still fine and the owner is having her hair done more frequently I noticed. All the lovely vetmedin money is being spent on highlights!!!

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Andrew Henfrey — Fri, 30 Apr 2010 21:26:19 GMT

I suspect the article the clients have found is this one in JVIM.

Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study.

Chetboul V, Lefebvre HP, Sampedrano CC, Gouni V, Saponaro V, Serres F, Concordet D, Nicolle AP, Pouchelon JL.

J Vet Intern Med. 2007 Jul-Aug;21(4):742-53.

It seems to suggest that pimobendan rapidly increase mitral regurgitation in early symptomatic mitral valve disease.

Hope this article is helpful

Andrew

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Rob Loxley — Tue, 27 Apr 2010 23:32:24 GMT

[quote user="mike nikolaou"]would I be justiied to wean the dog off it since I see no CHF symptoms?[/quote]

Given that furosemide use will activate RAAS, then giving it without CHF present (especially without an ACEi, aldosterone receptor blocker or angiotensin receptor blocker) may be deleterious to the dog.
Haven't heard of pimobendan use without CHF present being actively harmful, but as others have said trying to save the owner's money for when you definitely will help the dog by medicating it seems like a good plan regardless.

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Mike Nikolaou — Tue, 27 Apr 2010 22:01:21 GMT

There were no clinical signs from what the owner describes. Xrays were taken because the dog had "neck pain" and the owner was told that it was fine, the dog didn't have syringomyelia...

I have already stopped the frus and told owner to start slowly reducing the vetmedin and keep an eye on her.

David do you know anything about this L atrial/auricular enlargement on a healthy dog that's on vetmedin?

Thanks for all the input guys, it's very much appreciated! And the owner is very appreciative as well, considering she's been paying for drugs that the dog didnt need for 2 years...

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

David Mackenzie — Tue, 27 Apr 2010 17:26:01 GMT

Hi Mike

What clinical signs was the dog showing that prompted the previous vet to take chest xrays? Was there any change in clinical signs upon starting the furosemide and pimobendan? There is currently no evidence that medicating dogs prior to the onset of congestive heart failure is of any benefit.

I think if you can't hear a murmur then it's likely this dog doesn't have one, or else a very low grade one (ie 1/6). This all makes the chance of it being in heart failure unlikely. I suggest you gradually withdraw the furosemide, monitor, then gradually withdraw the pimobendan. As long as the owner monitors resp rate etc carefully then nothing suddenly drastic will happen. You may be able to save the owner a lot of money on cardiac drugs (and being a CKCS - she may well need the money for later in the dog's life).

Hope this helps

David (CertVC)

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Hannah Wynne Richards — Tue, 27 Apr 2010 17:06:37 GMT

You may think it healthy, but that could be the effect of treatment !!!!!!!!!!!!!

At least get a 2nd opinion within the practice, and check it's pro BNP b4 taking off medication-or if it deteriorates it will be your fault !!!!!!!!!!!!!!

Wynne

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Mark Frost — Tue, 27 Apr 2010 14:25:19 GMT

True, but I believe they class left atrial enlargement as a clinical sign. There is no evidence that treating a dog with a murmur prior to signs of congestive heart failure developing, including as an early sign left atrial enlargement. These trials I believe were all based on myxomatous mitral valve disease, therefore if the dog doesn't have a murmur its less relevant. On balance it sounds as if the dog probably shouldn't be on the medication but I'd seek the advice of a cardiologist prior to doing anything that may cause a problem in future!

Re: Effects of Vetmedin on a healthy(?) Cavalier KCS

Ian Mostyn — Tue, 27 Apr 2010 12:44:16 GMT

Boehringer have previously told me that there is no advantage in treating a dog with sub-clinical heart disease and that it doesn't improve life expectancy. They did a big trial last year I think so should have the data on file. Vetmedin is meant to be able to reduce the size of the heart to a degree so maybe it worked? If you try stopping you could always put the dog back on Vetmedin if there is a deterioration.

Ian