2015 ACVIM Forum Research Abstract Program

Dogs were recruited within 21 days of initial diagnosis of CHF secondary to MMVD. All dogs were clinically stable at the time of recruitment and were receiving at least 2 mg/kg furosemide per day, 0.5 mg/kg enalapril BID and 0.25 mg/kg pimobendan BID. Dogs were excluded for any of the following: more than 1 episode of CHF requiring medical therapy, receipt of diuretics prior to the onset of CHF, history of chronic kidney disease, systemic hypertension, supraventricular tachyarrhythmia or significant other disease. Dogs were examined on up to 3 occasions at 7-10 days intervals. At the first visit, blood pressure measurement, radiography, echocardiography and measurement of NT-proBNP, blood urea nitrogen (BUN) and creatinine was performed. If NT-proBNP was <1500pmol/L no adjustments to existing medications were made and only a physical examination and measurement of circulating markers was performed at the next visit (group 0). If NT-proBNP was ≥1500pmol/L and creatinine was ≤3.0 mg/dL, (group 1) therapy was escalated as follows; if the current furosemide dose was <6 mg/kg/day, this dose was increased by 50%; if the current furosemide dose was ≥6 mg/kg/ day, Aldactazide (1 mg/kg SID) was added; if the current dose of furosemide was ≥6 mg/kg/day and the dog was already receiving Aldactazide, the daily pimobendan dose was increased by 50-100%. If any dose adjustments were made, all diagnostic tests were repeated at the next visit. If creatinine was ≥3.0 mg/dL the dog was withdrawn from the study. Repeated measures mixed models were used to evaluate changes in variables over time.