Pimobendan (Vetmedin) in Dogs and Cats With Heart Failure

Mixed race veterinarian listening to Pomeranian dog's heartbeat
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Pimobendan (Vetmedin) is a heart medication that is becoming a frequently used drug for dogs with heart disease. It is approved for use in the United States for dogs with congestive heart failure (CHF) caused by either dilated cardiomyopathy or mitral valve disease.

Though pimobendan is only approved for use in dogs, it is sometimes used off-label in cats as well to treat congestive heart failure, especially in cases where improvement of the ability of the heart muscle to contract is beneficial. Its use in cats is still somewhat controversial, though.

Congestive Heart Failure

Congestive heart failure is a disorder that occurs in both pets and in human beings. Over time, the valves of the heart become less effective; as a result, blood pumps more slowly and less efficiently. Pets can be born with congestive heart failure or develop the disorder over time as a result of age, lack of exercise, or poor diet.

Since it develops slowly, symptoms can be hard to spot. Your pet may be short of breath, easily tired, or anxious. Over time, other symptoms can include a swollen belly, fainting, or weight loss. To determine whether congestive heart failure is present, your vet may conduct tests including an EKG, chest X-rays, or an ultrasound.

If congestive heart failure is found, your vet will want to take action quickly. Treatment will usually include a change in your pet's diet, a recommendation for increased exercise, and medication. Pimobendan is one of several medications approved for pets with congestive heart failure.

How Pimobendan Works

Pimobendan has two different methods of improving the heart's function. It acts on the heart muscle itself to improve its ability to contract normally. This is referred to as an inotropic function. It also dilates the blood vessels throughout the rest of the body, which provides less resistance to blood flow and makes it easier for the heart to pump the blood to where it needs to go.

When Pimobendan Should Be Used

Most veterinarians prefer to administer pimobendan only to dogs that are suffering from congestive heart failure. Some vets recommend giving the medication once heart disease is detected but before congestive heart failure has occurred. This use is still controversial and may or may not be effective in slowing the progress of the disease.

Pimobendan is not currently labeled for use in cats, its use is controversial. Some veterinarians have used it successfully, but it is contraindicated in some types of heart disease that are common in cats (such as hypertrophic cardiomyopathy or HCM.)

When Pimobendan Should Not Be Used

In addition to HCM, Pimobendan is contraindicated in aortic stenosis and other types of heart disease in which it's dangerous to increase the amount of blood that has to be pumped by the ventricles of the pet's heart.

Pimobendan should also be used with caution in animals with cardiac arrhythmias, especially if the arrhythmias are not well-controlled. If your pet is sensitive to the medication, he should not receive pimobendan.

According to the label for pimobendan, it has not been fully evaluated "in dogs younger than 6 months of age, dogs with congenital heart defects, diabetes mellitus or other serious metabolic diseases, dogs used for breeding, or pregnant or lactating bitches."

Potential Side Effects of Pimobendan

It is important to note that some of these "adverse reactions" may actually be due to heart disease rather than a result of giving the pimobendan.

Potential health hazards have been documented in dogs taking pimobendan for heart disease, including sudden death. Other observed side effects of pets in this condition include:

  • Lack of appetite
  • Depression
  • Diarrhea
  • Difficulty breathing
  • Weakness
  • Incoordination
  • Azotemia (an increase in nitrogen-based waste products in the bloodstream)
  • Fluid build-up in the chest cavity
  • Fainting
  • Coughing
  • A heart murmur 

There is some concern that pimobendan may also increase the risk of arrhythmias. Since heart disease can cause arrhythmias as well, it is difficult to determine whether the arrhythmia is a direct result of the pimobendan or simply a manifestation of the dog's heart disease.

Pimobendan (Vetmedin) is a drug that is approved for use in dogs with congestive heart failure due to dilated cardiomyopathy or mitral valve disease.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.