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25559Re: [FH] Pimobendan

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  • nala nala
    Nov 2, 2006
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      HI Renalie -

      Happy Birthday to Wolfgang!

      I am so glad that you were assertive with the
      treatment of Wolfgang and that he is on more than just
      lasix! Congratulations to you for standing up for
      your boy!

      I am sorry that he is still not thriving. According
      to my vet, the dose of lasix is anywhere from 2.2 to
      4.4 mg/kg 2x per day (although I have also read
      2-4mg/kg 3x/day). I don't know how much Wolfgang
      weighs, but you might be able to up his lasix, but I
      would check this out with my vet before doing so. (1
      kg is about 2.2 lbs so for a 10 lb cat 10/2.2=4.5 kg .
      . . 4.5 x 4.4 = 19.8 mg) You might also ask about
      spironolactone (an aldosterone receptor antagonist)
      that also has diuretic effects.

      This link is to a human study but summarizes a lot of
      more general information as well. I included a small
      excerpt.

      http://www.clinicaltrials.gov/ct/show/NCT00291720;jsessionid=39003F4BAF070BE53CC3C8672C8C2E5A?order=9


      "Plasma aldosterone concentrations are increased in
      animal models of CRF as well as in patients with even
      mild renal impairment and several lines of evidence
      point to major role of aldosterone in promoting
      progressive renal dysfunction. Observational studies
      in patients with primary hyperaldosteronism found the
      prevalence and degree of proteinuria to be greater
      than in patients with essential hypertension. Several
      experimental animal models are consistent with the
      concept that aldosterone can mediate renal injury. In
      patients with diabetic nephropathy and aldosterone
      escape despite ACE inhibitor therapy, aldosterone
      blockade significantly reduced proteinuria with no
      change in blood pressure. Little attention has been
      paid however, to the potentially beneficial effects of
      aldosterone antagonism on the cardiovascular system in
      renal failure. In a single, small uncontrolled study
      of 13 patients with diabetic nephropathy on
      established ACE inhibitor therapy, left ventricular
      mass index was significantly reduced after 24 weeks of
      treatment with spironolactone."

      ----
      Pimobendan

      There has been a little bit of discussion of this drug
      if you go back to the message board and search for
      "Pimobendan". I include some highlights below - of
      course they are contradictory, but such is the case
      with so many things. I hope they help with your
      decision:

      Susan with Roger Rags wrote previously that:

      May 2005
      "i asked her about the pimobendan that kevin spoke of
      this past
      week, and she tells me that it is absolutely
      contraindicated for hcm, as it actually speeds up the
      heart..."

      Aug 2006
      "recall reading a post about pimobendan while roger
      rags was still
      alive, and i thought perhaps that i had stumbled upon
      information about a drug
      that would solve all of our problems.....alas, both of
      his cardios burst my
      bubble by stating emphatically that it was not
      appropriate, in fact
      contraindicated, for a cat with hcm"
      --
      Jill with Puddy did have an HCM cat on Pimobendan.
      She wrote:

      Aug 2006

      "Our Puddy started taking Pimobendan last year when
      his condition was
      deteriorating and he was not able to enjoy his life as
      he had
      before. At that time the vet had given him only a few
      months to
      live. She explained that there was a small possibility
      that it
      could shorten his life and that it is a personal
      choice as to
      whether you are willing to take that risk to improve
      the quality of
      the time. In our case we decided it was worth the
      risk. Within a
      couple of days after starting the medicine he was so
      much happier.
      At the next checkup the vet said that his signs had
      improved so much
      that she could not even give an estimate as to how
      long he might
      have left. After about a year some new homeopathic
      remedies started
      to work and we were able to take him off the drug. In
      his case it
      definitely helped when he needed it."

      -Nala, Camille and Cozette

      --- renalie_ren_wren <renalie@...> wrote:

      > Hello everyone.
      >
      > I want to extend my condolences to Meredith. I am
      > pretty new here, but remember Angel
      > Monkey.
      >
      > I haven't posted in a couple of weeks, but I have
      > news.
      >
      > My cat Wolfgang has HCM and CRF. Thanks to the
      > support of this group, I stood up to
      > Wolfgangs cardiologist who only wanted to treat
      > Wolfgang with Lasix.
      >
      > I am pleased to announce that we are now working
      > together, and not fighting.
      >
      > The bad news is Wolfgang is still in CHF. His last
      > echo showed his heart to be the same
      > (moderate).
      >
      > Wolfgang started enalapril (thanks to this group)
      > and his Lasix is now up to 11mg 2x a
      > day.
      >
      > Last week he still had no appetite, and still had
      > slight labored breathing. This week he has
      > been doing a lot better. His appetite has
      > increased, and his resps have gone down. Yeah
      > Wolfgang!
      >
      > Last week Wolfgangs cardiologist checked in. He was
      > disappointed to hear that there had
      > been no real improvement. Wolfgang has been in CHF
      > since September.
      >
      > We are going to try a new drug. It is not approved
      > by the FDA for use in cats yet. The
      > research was done with dogs has been dramatic. This
      > drug is called Pimobendan. It is
      > manufactured by Vet Medin. It has recently been
      > approved for use in dogs with DCM. My
      > cardiologist has had success with his dog patients
      > on this drug. My cardiologist was the
      > first in this state to try it on a cat. Over a year
      > ago he tried it on two cats with serious
      > DCM, and both are doing well today. It has not been
      > tried on a cat with HCM. Wolfgang
      > will be the first. We are waiting for FDA approval.
      > It has not been proven that Pimobendan
      > will extend his life, but there is evidence that it
      > improves the quality. It increases appetite,
      > and kidney function (lower creatinine #). It sounds
      > too good to be true.
      >
      > Again, this drug has only been used in dogs with
      > DCM. We don't know that it will work for
      > Wolfgang.
      >
      > Has anyone heard of this drug?
      >
      > The only risk is sudden death, but that is rare. I
      > feel the risk is worth trying to improve
      > Wolfgangs quality of life.
      >
      > As I get more information, I will post it here.
      >
      > I also have a question about Q10. Wolfgang is on
      > 30mgs. Over at the Senior Cat group I
      > mentioned L-carnitine. The moderator was quite
      > interested, and had a question about
      > giving salmon oil and vitamin E with Q10. Any
      > opinions?
      >
      > Today is Wolfgangs 13th birthday. Kisses for
      > Wolfgang! Actually, everyday I have him is a
      > treasure.
      >
      > ~Renalie
      >
      >
      >
      >
      >




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