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Our dog( a miniature Schnauzer,25 lbs and 10 years old) has…

Hello Doctor Our...

Hello Doctor Our dog( a miniature Schnauzer,25 lbs and 10 years old) has been diagnosed with an enlarged heart, a leaky valve and a heart murmur. Our Vet has prescribed Vetmedin 5mg (one half tablet twice per day) and Frusemide 40mg ( one half tablet three times daily) and we are concerned about the long term effects of the medication and our research has indicated that there are natural remedies that may be just as affective. Can you please advise. Regards ***** ***** John

Veterinarian's Assistant: I'll do all I can to help. Is there anything else important you think the Veterinarian should know about the Miniature Schnauzer?

No we can't

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Answered in 49 minutes by:
2/20/2018
JACUSTOMER-2ggpt01r-
Category: Dog Veterinary
Satisfied Customers: 121
Experience: Emergency Veterinarian at Carolina Veterinary Specialists
Verified

Good evening, I'm so sorry to hear that your dog has been diagnosed with a heart condition. I know that can be very scary. Has your vet offered you a referral to see a veterinary cardiologist? That would be one way to know that your dog is being seen by someone who specializes in heart conditions. If your dog has a history of going into heart failure, there are no natural remedies by themselves that can treat this condition, although sometimes our cardiologist adds in Taurine and potassium gluconate to be used in conjunction with pimobendan, furosemide, enalalapril +/- spironolactone. Your dog should also be on a sodium restricted prescription diet such as Hill's K/D. I have added some information below about the side effects, interactions with other drugs, and concerns and cautions for both pimobendan and furosemide. Please let me know if you have any additional questions, and best of luck to your mini Schnauzer! - Dr. Cooper

Pimobendan Side Effects

Rarely, dogs taking pimobendan vomit. Call your veterinarian if your dog vomits on this drug.

Interactions with other Drugs

There are no reported drug interactions with pimobendan. However, it is not recommended for use while the dog is taking another PDE inhibitor such as theophylline.

Concerns and Cautions

Pimobendan should not be used in dogs with hypertrophic cardiomyopathy or aortic stenosis.

Furosemide Side Effects

Inherent to all diuretics, including furosemide, are the following side effects:

  • Increased thirst
  • Increased urination

Furosemide is associated with an increase in blood sugar levels. This is not a problem for most patients but a different diuretic may be a better choice for a diabetic patient.

Hearing loss has been reported, especially in cats, when large amounts of injectable Lasix have been used in a crisis.

Urination is usually seen within 30 minutes of the administration of an oral dose of furosemide. The drug peaks in strength after 1 to 2 hours after it is given orally.

Interactions with other Drugs

One of the most common drug interactions to be aware of is the interaction between furosemide and vasodilating heart medications (especially the angiotensin converting enzyme inhibitors such as enalapril, benazepril, and lisinopril). Furosemide will decrease circulating blood volume as it causes depletion in body water. This means that the kidney (and most other organs) will have a reduced blood flow to them. The patient’s kidney and electrolyte balance must stabilize before a vasodilator is added in. If the vasodilator is added too soon, it too will reduce blood flow to the kidney and the kidney will fail, possibly permanently. These two types of medications are frequently used together in heart failure patients. To avoid problems, the patient should be assessed biochemically with a blood test prior to the addition of the vasodilator. If all is normal, the vasodilator may be started and renal blood parameters should be rechecked 3 to 5 days later. If they are still normal, then the above kidney issues should not be a problem; however, should another heart failure crisis arise and large doses of injectable Lasix be required to resolve it, kidney values should again be checked 3 to 5 days later.

The airway dilator theophylline may be able to reach higher blood levels when used in conjunction with furosemide. This means that the theophylline dose may need to be reduced.

Furosemide is often used concurrently with digitalis derivatives. If furosemide leads to a significant drop in blood potassium levels, this can increase the risk of heart rhythms disturbances and other signs of digitalis toxicity.

Furosemide is often used in combination with prednisone to reduce serum calcium levels. It is possible for this combination of medication to lead to a reduction in potassium level significant enough to require potassium supplementation.

Aminoglycoside antibiotics (amikacin, gentamicin etc.) have properties that make them toxic to the ear and kidney. These properties increase with accompanying use of furosemide.

Concerns and Cautions

Obviously it is best not to use this medication in a dehydrated patient if water is being restricted.
Weakness or lethargy could be an indicator that blood potassium has dropped too low. Be sure to inform your veterinarian if your pet seems listless.

Because of the increased calcium excretion brought on by furosemide (i.e., an increase in urinary calcium levels), there could be a problem using this medication in patients with a history of calcium oxalate bladder stone formation.

It is extremely difficult to overdose with this medication. Toxic doses reported are over 100 times a typical oral dose of medication. It is important to realize that in the treatment of heart failure, which is this drug’s primary use, a crisis can arise at any time. Often giving an extra dose of oral medication can be a life-saving procedure. Be sure you understand what signs you are to watch for to determine if an extra dose or two should be administered and when you should definitely rush to the vet’s office.

The loss of water-soluble vitamins or urine can be a problem for patients receiving diuretics. Prescription diets for heart and kidney disease are vitamin-fortified with these extra losses in mind. Patients that refuse to eat such prescription diets should probably receive a vitamin supplement.

Furosemide should be used with caution in diabetic patients as they are already prone to abnormalities in electrolyte balance, which could be exacerbated by the electrolyte shifts employed by furosemide.

JACUSTOMER-2ggpt01r-
Category: Dog Veterinary
Satisfied Customers: 121
Experience: Emergency Veterinarian at Carolina Veterinary Specialists
Verified
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