Sonopath Forum

Pimobendan in subclinical dogs with MVD

Hello

We recently heard of a study that was being conducted on subclinical dogs with MVD and the benifits of pimobendan. An associate mentioned that a cardiologist referenced it to them but I have not been able to find the study.

Has it been published?

Is there a downside to starting pimobendan in non-clinical patients?

Thanks. Brent

Hello

Has it been published?

Is there a downside to starting pimobendan in non-clinical patients?

Thanks. Brent

Comments

Pankatz

November 29, 2016 at 7:31 pm -

Hi Brent – that is the EPIC

Hi Brent – that is the EPIC study and it is now available in the Journal Of Veterinary Medicine which is open access.

Pankatz

November 29, 2016 at 7:31 pm -

Hi Brent – that is the EPIC

Hi Brent – that is the EPIC study and it is now available in the Journal Of Veterinary Medicine which is open access.

tosullivan

November 29, 2016 at 10:30 pm -

Thanks you I will go read it

Thanks you I will go read it now! Hopefully has a great ending!

Peter

November 30, 2016 at 6:23 pm -

Hi!

It’s basically very

Hi!

It’s basically very simple to explain:

Dogs with DMVD and without congestive heart disease should be treated wth Pimo if:

they are small breed (up to 15 kg)
they have a systolic heart murmur 3/6 or louder
if the VHS is > 10.5
If the LA:Ao ratio is 1.6 or larger
If the left ventricular end-diastolic cornell index (diameter in cm divided by (BM raised by 0.294)) is 1.7 or larger

The mean median time to the primary endpoint was 15 months longer in the Pimo group

Consequence:

Asymptomatic DMVD needs clinical exam, radiographs, and an ultrasound for decision making
You will have to calculate the Cornell Index

Regards!

Peter

Pankatz

November 30, 2016 at 11:52 pm -

Good reason to do more

Good reason to do more echocardiograms!

tosullivan

November 30, 2016 at 6:30 pm -

Fantastic information! I am

Fantastic information! I am guessing that they have to meet all the criteria to start pimobendan? Or is there some parameters that are more important?

What is the draw back starting pimobendan if these criteria are not present?

Thanks Brent

November 30, 2016 at 7:31 pm -

Thanks for the summary peter

Thanks for the summary peter !

Peter

December 1, 2016 at 6:18 pm -

Hi!

You’re welcome – this

Hi!

You’re welcome – this is what I’m here for 🙂

@tosullivan:

From the GP’s standpoint, as long as a small breed (<15 kg) patient with known DMVD has a VHS of 10.5 or smaller, Pimobendan is not an option.

From the sonographer’s standpoint: Yes, all criteria should be fulfilled.

Even though this is not scientifically correct, I would personally extrapolate the data to large breed dogs as well, even though the LV-Cornell-Index cut-off of 1.7 could be too low in large breeds. Means, if I have a large breed dog with DMVD and left sided volume overload, I would likely start with Pimo.

Best regards!

Peter

tosullivan

December 1, 2016 at 7:44 pm -

Thanks again!

Thanks again!

randyhermandvm

December 2, 2016 at 4:48 am -

Peter,
Can you show us how to

Peter,

Can you show us how to calculate the left ventricular end-diastolic cornell index?

Thanks

randyhermandvm

December 2, 2016 at 5:13 am -

I believe I have found out

I believe I have found out how to calculate.

Please confirm:

LVDd (cm)/ Weight kg raised to 0.29

Use a calculator to calculate.

Peter

December 9, 2016 at 2:46 pm -

Hi
Its LVd (cm)/(KM raised to

Its LVd (cm)/(KM raised to 0.294)

(I mentioned this on my first posting)

sorry for the delay!

Peter

December 9, 2016 at 2:46 pm -

KM is BM 🙂

KM is BM 🙂