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View Full Version : Beware the Pimobendan/Vetmedin "EPIC Clinical Trial": There Is No Upside



RodRussell
24th April 2011, 07:13 AM
Read this take on the current EPIC clinical trial study of giving cavaliers pimobendan before they are in congestive heart failure. http://bit.ly/evrxg9

Karlin
24th April 2011, 11:25 AM
Thanks for that perspective, Rod -- a lot of vets seem now to prescribe this earlier as well based on some studies and owners definitely need to be aware of all these considerations.

RodRussell
10th May 2011, 02:11 AM
Some interesting quotes and summaries have been added to the article at http://bit.ly/evrxg9 about why cavalier owners should not volunteer their dogs for the pimobendan/Vetmedin EPIC clinical trial:

"There is evidence that treatment with a positive inotropic agent such as pimobendan prior to the development of systolic myocardial failure can have deleterious effects. ... Pimobendan...should be reserved for use when systolic myocardial failure is detected or suspected."-- Dr. Amara Estrada, Board Certified Veterinary Cardiologist.

"Most dogs with chronic valvular heart disease do not have decreased contractility and do not need positive inotropic support." -- Dr. George A. Kramer, Board Certified Veterinary Cardiologist.

"One study in dogs with early mitral valve disease suggested an increase in valve damage in the dogs given pimobendan." -- Dr. Mark Rishniw, Board Certified Veterinary Cardiologist.

Research Report Summaries:

In "Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study", published in 2007 in the Journal of Veterinary Internal Medicine, the researchers found that "PIMO has adverse cardiac functional and morphologic effects in dogs with asymptomatic MVD."

In "Increased Mitral Valve Regurgitation and Myocardial Hypertrophy in Two Dogs With Long-Term Pimobendan Therapy", published in 2005 in Cardiovascular Toxicology, the researchers concluded "This is the first report to describe an increase in mitral regurgitation under clinical conditions in dogs treated with pimobendan. We also suggest that pimobendan may induce ventricular hypertrophy."

In the U.S. Food and Drug Administrationís (FDA) 2007 report approving the use of pimobendan for dogs, it stated this conclusion in a four week toxicity study of pimobendan administered to 30 previously healthy lab Beagles: "Conclusions: Pimobendan administered IV daily to healthy Beagles caused dose dependent increases in heart rate, mitral valve myxomatous thickening, left ventricular outflow tract endocardial thickening, and ventricular muscle ischemic lesions (multifocal subendocardial necrosis and scarring). The cardiac pathology seen in these dogs is typical of positive inotropic drug toxicity in normal dog hearts, and is related to the physiologic effect of the drug on contractility and exaggerated hemodynamic response."

Wagtails
10th May 2011, 09:18 AM
Thank you so much for alerting us to all these studies, Rod. I certainly feel that more and more vets are tending to want to start medication earlier and earlier these days, so this gives us ammunition against such pressure if we need it.

MurphysMummy
8th July 2011, 02:10 PM
OMG! - Cant believe I've only just read this. Murphy is part of the EPIC study. I am taking Murphy of the tablets either if there the vetmedin or the placebo!!