Peer-reviewed veterinary case report
How ACE inhibitor doses affect survival in dogs with heart disease
By Ward, Jessica L et al.·Published in Journal of veterinary internal medicine·2021·Department of Veterinary Clinical Sciences, United States·View original on PubMed →
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Original publication title: Retrospective evaluation of a dose-dependent effect of angiotensin-converting enzyme inhibitors on long-term outcome in dogs with cardiac disease.
- Species:
- dog
Plain-English summary
A group of 144 dogs with heart disease were treated with angiotensin-converting enzyme inhibitors (ACEIs) to see how the dosage affected their long-term survival. The study found that dogs receiving higher doses of ACEIs had better survival rates, especially those with congestive heart failure at the start of treatment. Most dogs tolerated the medication well, with very few needing a dose reduction due to side effects. The findings suggest that giving ACEIs twice a day could provide better heart protection for these dogs.
People also search for: dog heart disease treatment · ACEI dosage for dogs · congestive heart failure in dogs
Abstract
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly prescribed in dogs, but the ideal dosage is unknown. HYPOTHESIS/OBJECTIVES: In dogs with cardiac disease, a dose-response relationship exists for ACEIs with respect to long-term outcome. ANIMALS: One hundred forty-four dogs with cardiac disease, 63 with current or prior congestive heart failure. METHODS: Retrospective medical record review. Cox proportional hazards models were used to determine variables associated with 2-year survival or survival from first-onset congestive heart failure (CHF). RESULTS: Median initial ACEI dosage was 0.84 (interquartile range [IQR], 0.56-0.98) mg/kg/day, and 108/144 (75%) of dogs received q12h dosing. No clinically relevant changes in renal function test results, serum electrolyte concentrations, or blood pressure occurred between initial prescription of ACEI and first reevaluation (median, 14 days later). In univariable analysis, higher ACEI dose was associated with increased survival from first-onset CHF (P = .005), and within the subgroup of dogs in CHF at the time of ACEI prescription, higher ACEI dose was associated with improved survival at 2 years (P = .04). In multivariable analysis, q12h dose frequency of ACEI (hazard ratio [HR], 0.30; 95% CI, 0.10-0.88; P = .03) and higher serum potassium concentration at visit 1 (HR, 0.39; 95% CI, 0.16-0.97; P = .04) were predictive of 2-year survival. The ACEIs were well-tolerated, with only 8/144 (5.6%) dogs having ACEI dose decreased or discontinued because of adverse effects. CONCLUSIONS AND CLINICAL IMPORTANCE: Twice daily dose frequency might optimize the cardioprotective benefit of ACEIs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34387901/