Vetmedin             [back to Radiograph of the Month]

Boehringer Ingelheim Canada Ltd., sponsor of the radiograph of the month, presents the following reference information for those readers wanting more information about Vetmedin® 
 

Active ingredient: pimobendan

Drug class: inodilator

Mode of action: pimobendan has a dual mode of action on the cardiovascular system - positive inotropy via myocardial calcium sensitization and balanced peripheral vasodilation (both venous and arterial) through PDE III inhibition

Label indication: For the treatment of congestive heart failure originating from dilated cardiomyopathy or valvular insufficiency. It is recommended that the diagnosis of congestive heart failure be confirmed by radiographs or diuretic responsiveness. Treatment should be initiated only in symptomatic cases which will benefit from increased myocardial contractility (positive inotropy).

Dose: Vetmedin® capsules should be administered orally at a dose range of 0.2 mg to 0.6 mg pimobendan/kg body weight per day. The preferable daily dose is 0.5 mg pimobendan/kg body weight. The dose should be divided into two administrations (0.25 mg/kg each), one half of the dose in the morning and the other half approximately 12 hours later. Each dose should be given approximately one hour before feeding.

Package insert: Vetmedin Package Insert (pdf file)

Frequently asked questions: Vetmedin FAQ (pdf file)

Consensus statement on treating uncomplicated CHF: Consensus Statement

Recent Radiograph of the Month cases employing Vetmedin® treatment

VetGo.com information relevant to Vetmedin® use:

    • Section 10: List positive inotropes used to treat heart failure and outline their advantages and disadvantages.
    • Section 13: What have we learned from the veterinary clinical heart failure trials?
    • Section 14: What is the trend in therapy for heart failure due to systolic dysfunction?
    • Section 15: How should heart failure in the dog be treated?
    • Section 16: How should I treat CHF?
    • Section 17: How should I treat the patient with fulminate pulmonary edema?
    • Section 18: How would the authors treat the patient with severe chronic heart failure on an out-patient basis?

 

  • Acquired heart disease http://www.vetgo.com/cardio/concepts/concsect.php?conceptkey=72#72
    • Sections 2-4: Chronic valvular disease (CVD) what is it? How does it present? How is it diagnosed?
    • Section 5: How is chronic valvular disease treated?
    • Section 7, 11, & 12: What is cardiomyopathy? How does it present? How is it diagnosed?
    • Section 13: How is canine DCM treated?

Vetmedin® Reference List

Peer–reviewed veterinary literature:

  1. Fuentes VL, Corcoran B, French A, et al. A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy. J Vet Intern Med 2002;16:255-261.

http://www.jvetintmed.org/perlserv/?request=get-abstract&doi=10.1892%2F0891-6640%282002%29016%3C0255%3AADRPSO%3E2.3.CO%3B2

  1. Smith PJ, et al. Efficacy and safety of pimobendan in canine heart failure caused by myxomatous mitral valve disease. J Sm Anim Pract 2005;46:121-130.

http://www.blackwell-synergy.com/loi/JSAP?open=2005#year2005

  1. Tissier R, Chetboul V, Moraillon R, et al. Increased Mitral Valve Regurgitation and Myocardial Hypertrophy in Two Dogs With Long-Term Pimobendan Therapy. Cardiovasc Tox 2005;5:43-51.

http://humanapress.com/index.php?option=com_journalshome&task=articledetails&category=journals&article_code=CT:5:1:43

  1. Gordon SG, Miller MW, Saunders AB.Pimobendan in Heart Failure – A Silver Bullet? J Am Anim Hosp Assoc 2006;42:90-93.

http://www.jaaha.org/cgi/content/abstract/42/2/90

  1. Lombard, CW; Jöns, O; Bussadori, CM: Clinical efficacy of pimobendan versus benazepril for the treatment of acquired atrioventricular valvular disease in dogs. J Am Anim Hosp Assoc 2006;42:249-261.

http://www.jaaha.org/cgi/content/abstract/42/4/249

  1. Kanno N, et al. Effects of pimobendan for mitral valve regurgitation in dogs. J Vet Med Sci 2007;69(4):373-377.

http://www.jstage.jst.go.jp/article/jvms/69/4/69_373/_article

  1. Chetboul V, Levebvre HP, Sampedrano CC, et al. Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: A prospective, controlled, blinded, and randomized study. J Vet Intern Med 2007;21:742-753.

http://www.jvetintmed.org/perlserv/?request=get-abstract&doi=10.1892%2F0891-6640%282007%2921%5B742%3ACACEOP%5D2.0.CO%3B2

 

Abstracts:

  1. Ripken A, et al. A clinical trial about the efficacy of pimobendan in comparison to enalapril in dogs with mitral valve endocardiosis. WSAVA Congress Granada 2002 (Abstract).
  2. O'Grady MR, Minors SL, O'Sullivan LM, Horne R. Evaluation of the efficacy of pimobendan to reduce mortality and morbidity in Doberman pinchers with congestive heart failure due to dilated cardiomyopathy. Abstract 248. Proceeding 21st ACVIM Forum 2003:1011.
  3. O’Grady MR, Minors SL, O’Sullivan LM, Horne R. Evaluation of the efficacy of pimobendan to reduce morbidity and mortality in dogs with congestive heart failure due to chronic mitral valve insufficiency. Abstract 123, Proceedings 21st ACVIM 2003:968.
  4. O'Grady MR, Minors SL, O'Sullivan LM. Evaluation of the efficacy of pimobendan to reduce mortality and morbidity in Doberman pinschers with congestive heart failure due to dilated cardiomyopathy. Abstract 248: Proceedings 21st Annual ACVIM Forum; 2003:1011.
  5. O’Grady MR, Minors SL, O'Sullivan ML, et al. Assessment of the ability of pimobendan to increase the frequency of ventricular ectopy in dogs with congestive heart failure due to dilated cardiomyopathy or mitral valve insufficiency. In: Proceed Am Coll Vet Intern Med Forum, Minneapolis. 2004;22 (Abstract).
  6. O’Grady MR, et al. Assessment of the Chronic Hemodynamic Response to Pimobendan in Doberman Pinschers with CHF due to Dilated Cardiomyopathy. Abstract ACVIM 2004.
  7. O’Grady MR, et al. Comparison of the Chronic Hemodynamic Response of Pimobendan versus Benazepril in Dogs with CHF due to Chronic Mitral Valve Insufficiency. Abstract ACVIM 2004.
  8. Roland RM, et al. Acute cardiovascular effects of pimobendan in dogs with stable congestive heart failure (CHF) due to chronic degenerative atrioventricular valve disease. In Porceed Am Coll Vet Intern Med Forum, Louisville. 2006 (Abstract).
  9. Rosenthal SL, et al. Association of pimobendnan with ventricular arrhythmias in dogs with congestive heart failure. Abstract ACVIM 2006
  10. Ouellet M, et al. Evaluation of pimobendan in the treatment of early mitral valve disease. J Vet Intern Med 2007;21(3):610 (Abstract).
  11. Booth, MA, et al. The effect of pimobendan on the rennin-angiotensin-aldosterone system and arrhytmogenesis in dogs. Abstract ACVIM 2007.
  12. O’Sullivan ML, et al. Frequency of Ventricular Ectopy in Dogs with Chronic Mitral Valve Disease and Congestive Heart Failure Treated with Pimobendan or Benazepril. Abstract ACVIM 2007

 

Veterinary proceedings lectures:

  1. Lombard CW. Clinical experience with pimobendan. BCVS Meeting; 2000:11-12.
  2. O'Grady M, Gordon SG, Braz-Ruivo L. Pimobendan: The North American experience. Proceedings 20th Annual ACVIM Forum; 2002:80-82
  3. Lombard CW. Pimobendan in congestive heart failure. In: Proceed Am Coll Vet Intern Med Forum, Charlotte, 2003;21.
  4. Lombard CW. Pimobendan in mitral regurgitation vs dilated cardiomyopathy. In: Proceed Am Coll Vet Intern Med Forum, Minneapolis. 2004;22.
  5. Gordon SG. Pimobendan & chronic valvular disease: A retrospective study. In: Proceed Am Coll Vet Intern Med Forum, Minneapolis, 2004;22.
  6. Haggstrom J, Kvart C. New and old treatment modalities of myxomatous mitral valve disease in dogs. Proceedings 21st Annual ACVIM Forum; 2003: 113-114.
  7. Vollmar AC, Trotschel C, Kleeman R, Keene BW. Cardiomyopathy in Irish Wolfhounds. Proceedings 23rd ACVIM Forum 2005.
  8. Lombard CW. Promising Cardiovascular Drugs – Pimobendan. Proc WSAVA Congress 2006.
  9. Therapy of Congestive Heart Failure in Dogs with Inodilators. Proc WSAVA Congress 2006.
  10. Gordon SG. Incorporating Pimobendan in Practice. Proc 25th ACVIM Forum 2007.

 

Additional resources:

 

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