Vetmedin

[frecklesmom]

Just received this as an alert re: Vetmedin and German study. Not sure what to pull out as quote so will list the url.

http://www.itnews.it/news/2008/09040...-for-dogs.html

Easier to read here I think
http://www.prnewswire.com/mnr/boehri...gelheim/34774/

[Cathy Moon]

Hey, great post!

There is one thing I would caution against, based on what our vet cardiologist told us. A veterinary cardiologist needs to be the one who determines whether or not your dog is in congestive heart failure. If Vetmedin is prescribed before it is actually needed, it could shorten your dog's life by overworking his/her heart.

The study describes symptoms of congestive heart failure:

Symptoms of this form of heart failure that dog owners should look for include coughing, reduced tolerance for exercise, anxiety and restlessness during the night, and laboured breathing.(3) If these symptoms are present, it is important that dog owners take their pets to their veterinarians for assessment and treatment.

Our experience with Geordie's MVD was that he became restless at night, and then developed a cough. When he developed a cough, we rushed him to our regular vet, where he was x-rayed, and they diagnosed the beginning of congestive heart failure. Fortunately the vet prescribed Enalapril (an ACE inhibitor) rather than Vetmedin. We scheduled an appointment with the cardiologist, and he did an ultrasound of Geordie's heart, took new x-rays, and viewed Geordie's x-rays from the vet. Three specialists agreed that Geordie is not in congestive heart failure yet. So he will remain on Enalapril until he shows early signs of respiratory changes. Then he'll be rushed to the cardiologist, and if he is diagnosed with congestive heart failure, he will immediately be prescribed Vetmedin and 3 other drugs.

In most cases, you will want to see a cardiologist before allowing your dog to take Vetmedin, just to be on the safe side.

[Pat]

Then he'll be rushed to the cardiologist, and if he is diagnosed with congestive heart failure, he will immediately be prescribed Vetmedin and 3 other drugs.
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Cathy,

I'm curious about your post. What are the three other drugs? You are saying that four drugs will be started at the same time? That this is the course for ALL dogs as soon as they go into CHF -- a "one size fits all" treatment plan rather than a drug regime geared to the particular dog's cardiac functioning as determined by an echo?

My experience has been far different - over a 15 year period with 10 elderly Cavaliers, a Peke, and a Shih Tzu. The treatment protocols were quite varied depending on the individual dog; there were different combinations of meds depending on the results from the echos and other tests, the symptoms in the particular dogs, etc. (I have had the same cardiologist for 15 yrs or so, but my regular vet and I can diagnose CHF. I then take x-rays and blood chemistry to cardiologist for an echo, more complete diagnosis and treatment plan. My dogs have had routine work-ups by cardio long before going into CHF.) Drugs were generally added one at a time to monitor whether or not symptoms improved and to monitor any side effects (either observed side effects or changes in blood chemistry). The idea is to use the least amount of drugs at the lowest dosages needed to control symptoms so that the dog is in "compensated" heart failure.

Pimobendan (vetmedin) was not started when CHF first began. All of my dogs began enalapril generally when there were changes in heart size and significant regurg on echo (before CHF ensued); lasix was generally added either when CHF first began or was "imminent," sildenafil (viagra) was used in some that had pulmonary hypertension; spironolactone sometimes added if increased diuresis needed; pimobendan added when CHF became refractory to other drugs and only when contractility was diminished, etc. Other drugs can be used such as hydralazine, hydrochlorthiazide, anti-arrhythmia drugs, etc., but I never had to use those. Only one of my Cavaliers and a Shih Tzu ever took pimobendan. Of the 11 that are gone, only two died of heart failure - one Cavalier of acute CHF (died 30 minutes after onset of symptoms) and the Peke died in his sleep of a fatal arrhythmia at age 16. The Shih Tzu died of pulmonary hypertension at 15. The others lived to be 13-16 and died of other causes (4 from cancer, 2 from kidney failure, 2 euthanized due to quality of life issues - senile/blind/deaf). The point of all that is to say that they were so well compensated on their heart meds that all but one Cavalier died from reasons other than CHF. Several were only ever on enalapril.

I've just never heard of such a "cut and dried" absolute drug regime before. I know that some cardios do start pimobendan earlier in the course of the disease (Dr. Gordon's paper discusses that); mine tends to wait later. (And my cardio studied at OSU under your cardio, assuming that yours is Dr. Bonagura!)

Pat
Atlanta

[lucylue]

My boy spot has been on vetmedin for about 2years he is doing really well on them hes not in congestive heart failure hes graded at about 6 out of 10 which has been like that for a while i take him for a scan every 3 months or before if i feel he needs to.Spots mum she was only 7 years when i lost her she was on vetmedin as well but her heart was so enlarged it pushed her wind pipe up she lived a year on meds she died in her sleep.And i had her daughter as well she had MVD and she died at 8 years and now spot so when the vet said he wanted to put spot on the vetmedin i thought he must be bad to put him on meds now but the cardiologist who i see said they were trying out something if they stared vetmedin before congestive heart failure started to see if it was any better so i said ok i am so pleased i did cos as i say spot has been on them 2 years now hes 11 full of life still likes hes walks he sometimes has a play and he looks well so i am very happy i started the meds early.

[EddyAnne]

Each of my MVD Cavaliers had drugs and dosages depending on examination and how each presented at that particular time, and where each dog was somewhat different. My specialist believes in starting drug regimes somewhat earlier than some others would, this to counteract even the early stresses and strains that do occur, and which over the long term may reflect a better quality of life over a longer period.

To add, studies may show Vetmedin does provide better results to most, BUT keep in mind that some dogs may respond better to other medications, and based on examination on how the dog is presenting at that time it's then a matter of trying medications and dosages then seeing how each particular dog responds. Be aware that over time there maybe changes in dosages and maybe even changes in what medications are prescribed.
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