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14 year old pug w respiratory distress, took to vet today,

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diagnosed w cardiomyopathy and significant...
14 year old pug w respiratory distress, took to vet today, diagnosed w cardiomyopathy and significant CHF. Given IV Lasix in office, placed on 25mg bid, enalapril 5mg qd & vermedin 5mg qd. Started the ACE & vermendin tonite, as well as 25mg PO Lasix (approx. 6 hours ago). Dog has not acted himself, seems confused, threw up, and just had major seizure lasting approx. one min w apnea and extreme muscle stiffening. Is now postictal. Looked up half life, seems first dosing of inotrope should be gone. Is he on too high of a dose? Has not had echo--small country town & vet. Was told significant cardiomegaly--but w/o echo don't know about dilated hypertrophy--maybe this med isn't appropriate for him at all? We were hoping to get him through one last summer and winter: is companion to autistic son, will be extremely hard loss. However, will not tolerate an animal in pain and will do what needs to be done. 35lbs in office today. Thanks (ps I'm a CV Nurse Practitioner).
Submitted: 6 months ago.Category: Dog Veterinary
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Answered in 9 hours by:
8/4/2017
Dog Veterinarian: Richard Rawling,
 replied 6 months ago
Richard Rawling
Category: Dog Veterinary
Satisfied Customers: 775
Experience: Veterinary Surgeon at Tameside Veterinary Clinic
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Hi, i`m Richard, a Veterinarian from the UK. Hopefully I can help today.

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Dog Veterinarian: Richard Rawling,
 replied 6 months ago

These medications are used very commonly to treat heart conditions and I have never knowingly seen a seizure as a result of the medication. The event you saw may have been due to a cardiac event if his heart is really struggling?

In advanced cases we often need to start medication on loading doses to try and get the desired effect as quickly as possible. For the drugs you have been prescribed I generally dose new patients at 1-2mg/kg lasix twice daily (so roughly 15-30mg for Charlie Brown), Vetmedin 0.2-0.3mg/kg (so approx 3-4.5mg for Charlie Brown TWICE daily rather than 4 times daily) and enalapril I use a dose of 0.5-1mg/kg twice daily (so approx 7.5 to 15mg twice daily for your dog. I do not know personally of any benefit from giving the enalapril or vetmedin more frequently than every 12 hours.

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Dog Veterinarian: Richard Rawling,
 replied 6 months ago
Hi Katherine,

I'm just following up on our conversation about Charlie Brown (He's A Clown). How is everything going?

Richard Rawling
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Richard Rawling
Richard Rawling
Richard Rawling
Category: Dog Veterinary
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Experience: Veterinary Surgeon at Tameside Veterinary Clinic

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