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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 30295
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Cavalier Kong with an enlarged heart moderate after Dino

Customer Question

Cavalier Kong Charles with an enlarged heart moderate after Dino decided to either prescribe
Enalapril or pinodi.n
Want to make sure which is the safer drug
JA: I'm sorry to hear that. What is the dog's name and age?
Customer: Charlie 8 years old
JA: Is there anything else the Veterinarian should be aware of about Charlie?
Customer: Both have side effects but want to make sure he is given the one that will be safer
Submitted: 1 year ago.
Category: Dog Veterinary
Customer: replied 1 year ago.
Actually Charlie is 9 years old huge appetite
But as we all know this breed is predisposed to heart issues
They said it was mild to moderate
Customer: replied 1 year ago.
I have read about side effects with the
Pimobendan. Vetmedin and was wondering if enalapril was safer
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this with Charlie. Please clarify "after Dino decided to either prescribe..." A diuretic such as furosemide + an ACE inhibitor such as enalapril + the heart drug pimobendan is the usual triumverate of drugs prescribed to dogs such as Charlie. The combination of those drugs has given the best results.

To answer you directly, it's important to note that enalapril and pimobendan have different effects and one may be more important than the other depending upon an individual's particular condition. The use of enalapril in the adjunctive treatment of heart failure (CHF/congestive heart failure) in dogs is somewhat controversial. Despite concerns about the studies involving this drug in dogs with CHF it continues to be used by many veterinary cardiologists for CHF in dogs secondary to myxomatous mitral valve disease as would be expected in Charlie. As long as Charlie's BUN and creatinine (renal values) are checked within a week of enalapril being prescribed, there shouldn't be a significant risk of his being administered it.

There's no question that pimobendan can improve survival times and quality of life when compared with standard treatment consisting of an ACE inhibitor and furosemide. This drug's primary adverse effects are gastrointestinal effects. If I had to choose between enalapril and pimobendan in a dog such as Charlie, pimobendan would be my drug of choice. Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thank you this is what our vet prescribed
As well so the side affects are gastro issue
I'm guessing what will this entail
Expert:  Dr. Michael Salkin replied 1 year ago.

Most cardiologists recommend 0.5 mg/kg of enalapril twice daily. Pimobendan is also dosed at 0.5 mg/kg but the dose is divided into two portions given twice daily as well. A diuretic such as furosemide may or may not be needed.

So you're looking at two medications given twice daily. Both drugs can upset the tummy but in general are well-tolerated by my patients. Doses of either drug may be altered as Charlie's condition changes. Please continue our conversation if you wish.

Customer: replied 1 year ago.
Have you ever seen in your practice a cavalier that has lived a long life after these treatments given his situation
Expert:  Dr. Michael Salkin replied 1 year ago.

His longevity would be predicated upon the severity of his condition when first diagnosed. My knowing only that he has a mild to moderately enlarged heart isn't enough to prognosticate accurately for you. To better understand how well Charlie's heart is functioning, an echocardiogram (ultrasound of his heart) is needed. The ultrasound, then, should give you a good idea of his expected longevity. Once again, the use of pimobendan is expected to prolong his life span. Please continue our conversation if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin