I have been hearing from a few MMVD-diagnosed dog owners that their veterinarians are prescribing furosemide to the dogs even though they have not yet been diagnosed as being in congestive heart failure. In a couple of these cases, the dogs have not even been determined to have left atrium or left ventricle enlargement. In one case the loop diuretic prescribed for a Stage B1 dog was torasemide.
I would not prescribe that because B2 stage comprise a very wide range of changes and some dogs may never develop C-stage and the main reason, for me, for not prescribing diuretics prior to the onset of the CHF is that i believe there is nothing to treat yet, since there is no pulmonary edema. I think, a better way to predict the onset of CHF would be to count the respiratory rate at home and if increases, maybe then a rapid recheck for PE. Sometimes, if I have dogs with very enlarged heart and no PE that may develop CHF, I ask the owners to have some furosemide at their home in case the dog becomes dyspneic and to administer rapidly just before they can reach an emergency center.
Hello, In stages B1 - no. In stages B2 - sometimes in the absence of pulmonary edema, diuretics have to be used. It is important to have it for a very short time. If longer diuretic therapy is required, it should be accompanied by an ACE inhibitor. Sometimes this is the only way to stop coughing. Especially when corticosteroid therapy is contraindicated. Of course, these powerful drugs are only used in exceptional cases.
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