Cardiac failure and renal disease

Re: Cardiac failure and renal disease

Bob Russell — Fri, 01 Jul 2011 11:07:08 GMT

[quote user="robloxley"]

If you need more diuresis I'd consider adding moduretic into the mix

[/quote]

Never underestimate the value of moduret/moduretic. it can improve a dogs comfort significantly without any obvious problems with the kidneys. I have seen several patients over the years that other vets have said are at the limit of medication. Moduret has shown them to be wrong!

Re: Cardiac failure and renal disease

Rob Loxley — Thu, 30 Jun 2011 18:16:19 GMT

If you need more diuresis I'd consider adding moduretic into the mix

Re: Cardiac failure and renal disease

Thomas Johnson — Thu, 30 Jun 2011 15:19:03 GMT

Thank you all for your comments, having had further discussions with the owner we are not changing any of the dog's drug doses at the moment, partly because the dog does not appear to be suffering any adverse effects from its pulmonary oedema, and partly because the owner is at the limit of what she can afford to spend on medication.

Re: Cardiac failure and renal disease

mariette asselbergs — Thu, 30 Jun 2011 13:52:56 GMT

Coughing in these cases, especially in advanced stages, is often caused by pressure on the airways from the enlarged atrium rather than from lungedema. You can suspect that from x ray or ultrasound, and if the cough is not a productive cough, then you may calm it down with codeine syryp which is very effective.

Mariette

Re: Cardiac failure and renal disease

Julian Earl — Wed, 29 Jun 2011 22:04:46 GMT

If you have a dog with renal disease then presumably the dog is polyuric/polydipsic so there should be less of a requirement for the diuretics anyway. So my answer is to tailor the dose to the dog's needs but that the frusemide probably could be reduced and you would still have enough diuresis to prevent drowning.

Re: Cardiac failure and renal disease

Mark Hedberg — Wed, 29 Jun 2011 20:15:03 GMT

Also, spironolactone is 2-4mg/kg, and from what I see you're on the lower end of that dose range too. There's space to play with here.

Re: Cardiac failure and renal disease

Clive Ansell — Wed, 29 Jun 2011 19:27:07 GMT

it is also possible to double the uid dose of Benazepril too, as per the data sheet.

In human patients with chronic renal disease an improvement of urea and creatinine levels has been observed with the use of Benazepril.

Re: Cardiac failure and renal disease

Thomas Johnson — Wed, 29 Jun 2011 17:47:45 GMT

[quote user="Mark Hedberg"]Also, there, no reason you can't up the pimobendan to 2.5mg twice daily; might help with the crackling, and you have lower client costs as only 1 type of pimo pill instead of 2.

[/quote]

That sounds like a better idea, I wasn't entirely happy with increasing the furosemide dose (hence asking the question).

Re: Cardiac failure and renal disease

Mark Hedberg — Wed, 29 Jun 2011 16:20:02 GMT

Also, there, no reason you can't up the pimobendan to 2.5mg twice daily; might help with the crackling, and you have lower client costs as only 1 type of pimo pill instead of 2.

Re: Cardiac failure and renal disease

Mark Holmes — Wed, 29 Jun 2011 11:13:50 GMT

Yes but then Craig Devine says that dogs should die of renal failure not cardiac disease. Its likely you will have to increase the frusemide eventually but do you need to do it right now? If she is bright and relatively active is she worried about the crackles and cough?