Treatment
The recommended treatment in Stage C is to use a combination of four drugs to give the best relief from the effects of heart failure and treatment is lifelong.
Treatment
Heart failure has three main issues that develop leading to the symptoms we see develop in the dog:
• The heart failing as a pump.
• The enlarged heart taking up space in the chest.
• Fluid build-up in the lungs due to the failing heart and leaky valve plus an inappropriate retention of extra fluid in the body to try and support the blood pressure and circulation.
These drugs together:
• improve the heart’s ability to pump and reduce further damage to the heart.
• limit the accumulation of water in the body by encouraging fluid excretion as urine and relax blood vessels to reduce the accumulation of water in the lungs.
Drug tolerance
These drugs are generally well tolerated when given together and their effects complement each other to give complete support of the issues described above. Here’s a little bit more information on which drug does what:
Pimobendan
• Pimobendan improves the heart’s ability to pump, relaxes blood vessels and improves circulation.
• Helps to reduce the workload on your dog’s heart so they feel better for longer and slows the progression of their disease.
ACE inhibitors & Spironolactone
• Although these are available as two separate drugs, they are also available as a single combination tablet, meaning fewer tablets for your dog but with all the benefits of both active ingredients.
• ACE inhibitors, such as benazepril, relax blood vessels reducing the blood pressure so the heart can pump blood more easily around the body.
• Spironolactone delays progression in heart muscle damage and reduces fluid retention. It also helps prevent the kidneys from reabsorbing fluid the body does not need.
Diuretics – Torasemide or Furosemide
• Diuretics remove the fluid that has built up in the lungs by increasing fluid excretion from the kidneys. This will cause your dog to urinate more than normal initially until they are stabilised and they may also seem thirstier than usual.
• Help by removing the excess fluid build-up allowing your dog to breathe more easily and making them more comfortable.
Ceva’s cardiology treatment range for Mitral Valve Disease is designed with your pet in mind. All our tablets are flavoured and easy to divide so your dog will think it is receiving a treat each time it has a tablet! This can be helpful as not all the medications can be given with your dogs meal (see table below).
There are two commonly used diuretic drugs available for your pet – one is given twice daily the other only once daily. Ask your vet which is the best choice for your dog.
Top Tips
The doses of each drug are not fixed. Sometimes they need to be increased or decreased depending on how your pet is coping. That’s why regular check ups with your vet are important.
Ask your vet how regularly they would like to see your pet now that heart failure has developed.
Top Tip for diuretics
Diuretics are very effective at relieving the signs of heart failure especially improving your dogs breathing by removing the fluid build-up in their lungs. However, there are some top tips to help you and your dog cope with the extra drinking and urination:
Always allow free access to water as without this dogs on diuretics can become dehydrated.
Give your dog access to urinate often – diuretics make your dog produce more urine than normal and it can be harder for them to hold on.
Once your dog is well controlled ask your vet to see if you can reduce the diuretic dose. This must be done gradually so only do this under the guidance of your vet, otherwise heart failure can recur.
Your dog may need to urinate 2-6 hours after each diuretic tablet, so try and ensure they have access to outdoors at this time. Don’t give diuretics too late at night, give early morning and early evening instead.