According to cardiologist Mark Oyama in a recent talk to a group of GP vets, pimo and an ACE-inhibitor and a diruetic are being combined as soon as the MVD dog enters congestive heart failure.
Using pimo at the start of CHF is relatively new, I think (at least, that is what Dr. Oyama said in his talk). In the past, the pimo was reserved for the last resort, to boost the heart when the ACE-inhibitor, diruetic, and whatever else lost their effectiveness.





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