Heart Medicine for Dogs: 9 Vet-Prescribed Options
Finding out your dog has heart disease is scary. It’s a big, life-changing diagnosis – there’s no denying that. Fortunately, early diagnosis, close monitoring, and veterinary-prescribed heart medicine for dogs can help your four-legged companion lead a full and comfortable life.
Featured Dog Heart Medications
*Check availability and shop your veterinarian’s online store. Prescription required.
Common Dog Heart Conditions
Heart disease is a general term for compromised heart function and there are many different types of heart disease in dogs. Some dogs are born with defects in their heart while other types of heart disease develop over time.
Understanding what type of heart condition is impacting your pet will help your veterinarian prescribe the appropriate dog heart medicine.
Some heart conditions that vets may treat with medication include:
- Dilated Cardiomyopathy (DCM)
- Hypertrophic Cardiomyopathy (HCM)
- Mitral Valve Disease (MVDD)
- Arrhythmias
- Tachycardia
- Congestive Heart Failure (CHF)
Why Your Vet Might Recommend a Dog Heart Medication
Canine heart medications can slow the progression of heart disease and make your dog feel better. Most dogs with heart disease are prescribed a combination of medications in order to maximize heart function and minimize a weakened heart’s effects on the rest of the body.
Some heart medications strengthen heartbeats while others change the rate of heartbeats. Each type of dog heart medication has a specific use. Choosing the wrong type of medication or wrong combination can actually make a dog’s heart disease worse.
In addition to medications, your veterinarian will recommend changes to your dog’s lifestyle. Strenuous activity is not appropriate for dogs with heart disease, but walks and low-impact exercises are important to keep up with until a dog develops late-stage disease. Heart-specific diets, which are low in salt and high in omega-3 fatty acids, also support heart function.
It is important to follow your veterinarian’s recommendations to give your dog the best, most comfortable life despite their weakened heart.
Types of Dog Heart Medications
Veterinarians may prescribe multiple types of heart medications as part of your dog’s treatment plan. The most common types of medications include:
Positive Inotropic Medications
Positive inotropic medications increase the strength of the muscle contractions in the heart, causing the heart to beat with more force. This helps to pump blood out of your dog’s heart and through the rest of their body.
Diuretics
Diuretics draw fluid out of the body, including the fluid that collects in the lungs and causes the acute symptoms of congestive heart failure in dogs. Inappropriate or long-term use may cause dangerous dehydration or kidney damage, so it’s important for your veterinarian to monitor your dog when on diuretic medicines.
ACE Inhibitors
ACE inhibitors are often recommended as part of combination medical therapy for managing or slowing the progression of heart disease in dogs. They have been shown to prolong longevity in dogs with CHF [1]. However, there is no evidence that ACE inhibitors delay the onset of CHF and they are not effective in treating dog heart disease on their own. The most common side effects of ACE inhibitors are nausea and a loss of appetite.
Beta-Blockers
Beta-adrenergic receptor antagonists – commonly called beta-blockers – slow down a dog’s heart rate. They are used in dogs with hearts that are beating too fast (tachycardia) or both fast and irregular (tachyarrhythmia). Beta-blockers are generally not prescribed to dogs with mitral valve disease, dilated cardiomyopathy, or conditions that cause slow heart rates.
Antiarrhythmics
These medications are used to treat heart arrhythmias in dogs. The choice of which medication to use is based on many subtle features of the arrhythmia. This is why your veterinarian will make a specific recommendation about which medication or medications are best for your dog and their specific type of heart disease.
9 Dog Heart Medications Prescribed By Vets
Here are medications that your veterinarian may prescribe if your dog has a form of heart disease or congestive heart failure.
Vetmedin (Pimobendan)
Pimobendan, known under the brand name Vetmedin, is a positive inotropic medication that increases the ability of the heart muscles to contract so they can better squeeze blood out of the heart and through the body. This oral medication also reduces blood pressure which makes it easier for a weakened heart to pump blood effectively.
Vetmedin beef-flavored tablets are chewable, making them easier to administer than traditional pills. However, the tablets are large and may be more difficult to give to smaller dogs. Pimobendan can be compounded into smaller tablets that are more manageable for little dogs.
Both Vetmedin chewable tablets and generic forms of pimobendan are generally well tolerated with minimal side effects. However, this medication should not be given to dogs with aortic stenosis or those without diagnosed heart disease.
Furosemide
Furosemide is a widely prescribed diuretic medication for dogs with symptomatic heart disease or congestive heart failure. It is used in both emergency situations to help a suffering dog breathe easier and as an at-home medication to prevent the build-up of lung fluid.
When used appropriately furosemide is a life-saving drug. However, long-term use can lead to kidney damage, changes in electrolyte balance, and severe dehydration. Inappropriate use can cause low blood pressure, kidney failure, and worsen heart disease. This is why it is important that dogs on furosemide have regular check-ups and bloodwork with their veterinarian.
Enalapril and Benazepril
Enalapril and benazepril are two very similar ACE inhibitors that are often recommended as part of combination medical therapy for dogs with heart disease. ACE inhibitors dilate blood vessels, reducing blood pressure and making it easier for the heart to pump blood. There is no data to prefer the use of one drug over the other. The choice is often based on ease of appropriate dosing, cost, and availability. The most common side effects of enalapril and benazepril are nausea and a loss of appetite.
Cardalis (Spironolactone, Benazepril)
Cardalis combines two medications: spironolactone, which is a mild diuretic, and benazepril, which is an ACE inhibitor. The benefit of a combination prescription is that it is one pill instead of two. The most recent guidelines for the treatment of heart disease in dogs recommends using both of the active ingredients in Cardalis for advanced (symptomatic) heart disease. So even if your veterinarian does not recommend this medicine initially, it may be added to your dog’s treatment plan later.
With Cardalis, your veterinarian cannot titrate each medication individually to best suit the needs of your dog. Furthermore, both of the agents in Cardalis are not considered effective in delaying the onset of congestive heart failure.
Sotalol
Sotalol is the most commonly prescribed beta-blocker in veterinary medicine that is used to treat ventricular tachyarrhythmias (abnormal heart rhythms with a ventricular rate of 100) in pets. It slows the rate of electrical signaling in the heart muscle cells, helping keep the heart in a normal rhythm. Sotalol may be used in combination with other heart medications including pimobendan or mexiletine.
Diltiazem
Diltiazem is a commonly prescribed anti-arrhythmic medication for dogs. It is used to treat tachyarrhythmia – either alone or in combination with other medications on this list. Diltiazem is available as both an injection for use in emergency situations in veterinary clinics and as a capsule to give at home. Diltiazem should never be given with a beta-blocker. It interacts with many types of other prescription medications so it is important that your veterinary cardiologist knows about all of the medications your dog takes before prescribing this medication.
Digoxin
Digoxin is another commonly used medication for treating heart arrhythmia in dogs. Digoxin is a cardiac glycoside that occurs naturally in the Foxglove flower. It causes the heart rate to slow while also increasing the heart muscle’s ability to contract.
Side effects are mostly gastrointestinal upset such as nausea and diarrhea but dizziness or weakness can result as well. Dogs with kidney disease should not be prescribed digoxin or should be prescribed a lower dose.
Dogs taking digoxin are closely monitored and it is important not to change your dog’s dose without instructions from your veterinarian. An overdose of digoxin could be lethal.
Mexiletine
Mexiletine is a less commonly prescribed anti-arrhythmic medication. It is used to treat arrhythmias that originate in the ventricles of the heart. It is often prescribed with sotalol. Side effects may include nausea, lethargy, loss of appetite, and seizures. It used to be more easily available but it is no longer used in human medicine and so may be difficult to find at standard pharmacies.
Dog Heart Medications: Tips and Safety
With medications used to treat heart disease in dogs it is very important to follow your veterinarian’s recommendations closely. When used appropriately these drugs are effective and safe. However, that efficacy also means that altering the dose or frequency can be dangerous.
If you accidentally skip a dose or accidentally double the dose of a medication, call your veterinarian or a local emergency veterinary clinic right away. Always ask your veterinarian about any other medications, supplements, or natural products you give your dog to make sure there are no harmful interactions.
When your dog is prescribed a heart medication, your veterinarian will recommend specific followup timelines and tests. These are important in determining if the medicine is working or if other medications may be more effective.
Throughout treatment, you and your veterinarian will develop a close relationship that will allow you to ask questions and address issues as the disease progresses. If you’re worried about how your dog is responding to medication, make sure to discuss those concerns directly with your veterinarian.
References:
- Lefebvre, H P et al. “Angiotensin-converting enzyme inhibitors in veterinary medicine.” Current pharmaceutical design vol. 13,13 (2007): 1347-61. doi:10.2174/138161207780618830
