Efficacy of pimobendan on survival and reoccurrence of pulmonary edema in canine congestive heart failure

Abstract

The aim of this study was to evaluate the efficacy of pimobendan with conventional therapies on survival and reocurrence of pulmonary edema in dogs with congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD). Records of 197 client-owned dogs from 14 veterinary hospitals were included in this study. Dogs were administered conventional treatments with or without pimobendan. Sixty-four dogs received a standard dose of pimobendan (0.20–0.48 mg/kg every 12 hr (q12hr)), 49 dogs received a low dose of pimobendan (0.05–0.19 mg/kg q12hr), and 84 dogs received conventional therapy alone. Dogs in the standard-dose and low-dose pimobendan groups had significantly longer median survival times than dogs in the conventional group (334, 277 and 136 days, respectively; P<0.001). The reoccurrence rate of pulmonary edema in the standard-dose group was significantly lower than in the low-dose and conventional groups (43%, 59% and 62%, respectively; P<0.05). Combination of pimobendan with a conventional treatment regimen significantly prolonged survival time after an initial episode of pulmonary edema in dogs with CHF caused by MMVD. There was no difference in survival between dogs administered standard and low doses of pimobendan, but pimobendan did prevent the reoccurrence of pulmonary edema in a dose-dependent manner.

Cardiovascular effects of intravenous pimobendan in dogs with acute respiratory acidosis

“…Hypercapnia may also be associated with decreased consciousness. Addition of pimobendan to a conventional treatment regimen significantly prolongs survival time after an initial episode of pulmonary edema in dogs with congestive heart failure caused by mitral valve insufficiency 12 . However, oral administration of pimobendan is often difficult in patients with severe pulmonary edema or with disturbances of consciousness.…”

Management of Chronic Congestive Heart Failure Caused by Myxomatous Mitral Valve Disease in Dogs: A Narrative Review from 1970 to 2020

“…Studies focused on other standard therapy drugs (pimobendan or ACE inhibitors, such as the QUEST and the EPIC studies [ 370 , 371 ], respectively, which focused on symptomatic and asymptomatic dogs with cardiac remodeling) or drugs used in case of complications related to this syndrome (such as β-blockers, amlodipine, and digoxin) [ 372 , 373 , 374 , 375 , 376 , 377 , 378 , 379 , 380 , 381 , 382 , 383 , 384 ] have also been published. In the QUEST and EPIC studies, pimobendan was administered over a dose range of 0.4 to 0.6 mg/kg/daily and benazepril over a dose range of 0.25 to 1 mg/kg/daily.…”

Pimobendan: Contexto Histórico E Aplicação Clínica Em Cães

“…Nesse contexto, na busca pelo melhor tratamento farmacológico da IC, que possibilite um bom funcionamento miocárdico com redução das manifestações clínicas, surge um novo grupo de fármacos sensibilizadores dos miofilamentos ao cálcio, o pimobendan e o levosimendan (POLLESELLO et al, 2016;MIZUNO et al, 2016).…”

“…Resultados obtidos a partir de ensaios clínicos têm conferido ao pimobendan características diferenciadas, por ser um fármaco que melhora a função ventricular em curto prazo quando comparado à terapia tradicional com o uso do benazepril, pois o pimobendan permite que o coração trabalhe com valores menores de pressão sistólica final e menor dimensão diastólica final, diminuindo a regurgitação mitral e melhorando o fluxo anterógrado, resultados que conferem um melhor débito cardíaco e pressão arterial sistêmica (MIZUNO et al, 2016;BOSWOOD et al, 2018).…”

“…O pimobendan mostrou ser um fármaco que diminui a pressão atrial esquerda em pacientes com regurgitação mitral, de forma dose dependente, melhorando a qualidade de vida e aumento no tempo de sobrevivência em cães com DMVM e IC (MIZUNO et al, 2016;GORDON et al, 2017).…”