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Pimobendan to Prevent Dilated Cardiomyopathy

Clinician's Brief (Capsule)

Cardiology

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March 2014

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The purpose of this study was to determine if pimobendan can delay the onset of congestive heart failure (CHF) or sudden death and improve survival in preclinical Doberman pinschers diagnosed with dilated cardiomyopathy (DCM). Pimobendan has previously been considered effective for DCM in Doberman pinschers that have already developed CHF. Dogs >35.1 kg received two 5-mg pimobendan capsules PO q12h; dogs <35 kg received one 5-mg pimobendan capsule PO q12h. Pimobendan treatment prolonged time to CHF onset or sudden death and increased median survival time. Arrhythmias (eg, ventricular premature complexes, high median heart rate) were associated with a shortened time to onset of CHF or sudden death.

The Doberman pinschers came from an apparently healthy population diagnosed with DCM from an echocardiogram and showed no signs of DCM at study start. There was no significant difference in suspected adverse drug reactions between the preclinical patients with DCM that received pimobendan and the placebo group, thus demonstrating the safety of pimobendan when used in preclinical Doberman pinschers diagnosed with DCM.

Commentary

Giving pimobendan before onset of signs can delay progression of heart disease and prolong overall life in Doberman pinchers with occult DCM but without significant ventricular arrhythmias. The median survival time of Doberman pinschers receiving pimobendan (vs placebo) increased by 15 months. Pimobendan administration did not increase the frequency or complexity of ventricular arrhythmias determined by pre- and posttreatment Holter monitors. Although this news is exciting, we should continue to use caution administering pimobendan in other breeds with occult DCM and those preclinical DCM dogs that have significant ventricular arrhythmias.—Teresa DeFrancesco, DVM, DACVIM (Cardiology), DACVECC

Source

Efficacy of pimobendan in the prevention of congestive heart failure or sudden death in Doberman pinschers with preclinical dilated cardiomyopathy (the PROTECT Study). Summerfield NJ, Boswood A, O’Grady MR, et al. JVIM 26:1337-1349, 2012.

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