PIMOBENDAN & CHLOE —
I noticed you are again discussing
DCM on the DaDane of DaWeek. Awhile back I promised you a Pimobendan story and here goes:
Pimobendan ... then
A few years ago the veterinary
cardiologists began to recommend a new drug, Pimobendan, to our treatment of
referred DCM patients. At that time, this drug was not available
in the US and we general practitioners had little information about it. I found
myself asking many questions and finding few answers. When we attempted to get
the drug, it sometimes took weeks or months to obtain, if we could get it at
all. The general consensus of the cardiologists I talked to was that the medication
also took quite some time to begin to work. Many of our candidates were
so critical that they never even received Pimobendan before they died or were
euthanized. I had few positive thoughts about this drug.
many conferences and trying to learn more about this new "wonder
drug" I had more to wonder about than ever. Some said it was only for
dilated cardiomyopathy (DCM) patients, others said all congestive heart failure
patients; some said it worked within days, others that it took weeks or longer.
With so little information to go on, I remained skeptical.
Pimobendan ... now
Pimobendan, also known as Vetmedin,
is a drug that has been used with
success in heart failure patients in Europe and Canada for quite some time now.
It is what we veterinarians call a "positive inotrope" which
means that it improves the ability of the heart muscle to beat with greater force.
It also has some vasodilation activity which means that it enlarges the blood
vessels which in turn can improve blood pressure. It does these things by
improving the heart's ability to respond properly to calcium in the blood. Calcium
is necessary for contraction of the muscle.
Pimobendan has been shown to
be compatible with all of the other heart medicines we use and many of the other
common drugs our Great Danes might be on. One of the problems with testing this
drug here in the US is that over time it can cause a normal patient's heart
to become diseased, so it can only be tested on patients with diseased
hearts already. Such patients are sick and often die in spite of all we would
do for them, so then how do researchers know if the drug is helping or not? It
is challenging, but studies have demonstrated delayed death, improved x-ray evidence,
improved energy levels, and reduced need for other drugs.
So, does it really
work? It took my own experience with my own Dane, Chloe, to convince me. Chloe
will turn 13 on May 10, 2008. She started to slow down after
she turned 11. Around that time my friend, Dr. Grych, was studying advanced ultrasonography
in which you can take a sonogram of the heart, measure the walls, the contractility,
the valves and other items, to see if there might or might not be a problem.
He needed some big dogs to practice on. Chloe and her younger housemate, Solveig,
volunteered. Solveig was quite young and fit. While Chloe was older, I only had
a mild suspicion that there could be early trouble. I was in for a surprise:
Chloe was already well into the early stages of Dilated Cardiomyopathy and her
heart was barely contracting at all. Her blood pressure was high and she was
trouble just waiting to happen.
Dr. Grych suggested Atenolol
and Pimobendan. Again, I was skeptical. When he said I would see improvement
in DAYS rather than weeks or months, I was even more skeptical, but this was,
after all, MY Chloe. I decided to try it. The medicine had to be specially
made at a compounding pharmacy. We began right away.
I noticed improvement
in Chloe's energy levels within days and she has been on this medicine ever since.
Though she is not going to be with us much longer, I feel
that Pimobendan has given Chloe many extra months of good, quality life she would
otherwise not have had. This drug, Pimobendan, is now one I reach for early in
the treatment of DCM and other heart failures.
Thanks for the opportunity
to help other Dane owners.
— Cheryl Haugo,