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Greetings, I'm Dr. Peck, hopefully I may be of some help, one moment while I reply.
I would suggest you trust the cardiologist in their recommendations. The vetmedin is to help the "pump function" of the heart, i.e. help blood move in the forward direction better. The diuretic was for the heart failure: when blood goes backwards to some degree it results in fluid build up in the lungs, or left-sided heart failure (or right sided heart failure if it ends up in the abdomen). It sounds like your local vet had a concern for fluid in your dogs lungs on the x-rays, and thus started the diuretic. The cardiologist I'm assuming did some type of workup on their own - repeated x-rays? echo / ultrasound of the heart? blood pressure? EKG? etc. They also have a much better eye for assessing x-rays than a general practitioner in terms of these concerns. They may have recommended discontinuing the diuretic as the heart failure had resolved (no more fluid in the lungs), because of the concerns with the kidney values, because a difference in opinion of the initial x-rays, or some combination thereof. But I would trust them. The viagra is likely for pulmonary hypertension, which may be related to your dogs heart condition. Most dogs tolerate viagra well.
If I sent one of my patients to a cardiologist on referral and they recommended something different than what I'd previously suggested, I will support their recomendations with my client - they are specialists in their field, it's why you were referred to them.
Hopefully my response is helpful to you. It's always very concerning when our little ones are not doing well. It sounds like you are at a point of focusing on quality of life and quantity of time left. By trusting the specialist and following up with them as they direct you'll be doing the best possible for your pet.
Please, kindly rate using the stars as this is the only way in which I receive credit for helping with your question today. If you have further questions, kindly just write me back. - Dr. Peck