Quote Originally Posted by Brian M View Post
....It seems to say the way to go once CHF is then to start with pimobenden which could give an extension of maybe two more years .
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.