Blood and plasma taurine levels can be considered to see if there were a nutritional component to the condition. If the dog were being fed an unusual, protein restricted or lamb-based diet, this can be switched to a high quality senior or cardiac support diet. Taurine supplementation is also recommended at 500 mg PO BID. An abdominocentesis and thoracocentesis are recommended as clinically warranted to relieve the effusion and improve respirations. The lasix can be restarted at 75 mg PO TID for 3 to 5 days and then tapered over a few days to a maintenance therapy, perhaps 50 mg PO BID or whatever is the lowest dose that will control the clinical signs. Pimobendan is recommended at 7.5 mg PO BID. Once the dog has improved, enalapril or benazepril can be added at 10 mg PO SID and increased to 20 mg PO SID after a week if it is well tolerated. If the ventricular arrhythmia were persistent, mexiletine can be added at 150 mg PO BID to TID to suppress it.