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Use of pimobendan in cats: a practical evidence-based review
Sonya G Gordon1, Ashley B Saunders1, Sonya Wesselowski1
1Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, Texas, USA.
Insights
Pimobendan offers potential benefits for feline cardiomyopathies, improving heart function and reducing clot risk. This review explores its use, dosage, and safety in cats, providing guidance for veterinarians.
Area of Science:
- Veterinary Cardiology
- Pharmacology
Background:
- Cardiomyopathies are a leading cause of congestive heart failure (CHF) in cats, with limited therapeutic options.
- Current treatments like diuretics and antithrombotics do not directly improve myocardial function.
- Pimobendan, a phosphodiesterase III inhibitor and calcium sensitizer, is reviewed for its potential in feline cardiomyopathies.
Purpose of the Study:
- To summarize the evidence for pimobendan's use in feline cardiomyopathies.
- To provide primary care veterinarians with practical information and case examples.
- To discuss potential benefits, dosage, administration, and adverse events of pimobendan in cats.
Main Methods:
- Review of existing evidence on pimobendan in feline cardiomyopathy.
- Discussion of pimobendan's mechanism of action and potential cardiovascular effects.
- Analysis of reported adverse events and contraindications.
Main Results:
- Pimobendan may improve left ventricular systolic and diastolic function in cats.
- Potential benefits include reduced platelet aggregation and improved atrial function.
- A dosage of 0.25 mg/kg PO q12h is generally well-tolerated, with an oral solution available in several countries.
Conclusions:
- Pimobendan shows promise as a therapeutic option for feline cardiomyopathies, addressing systolic dysfunction.
- While not licensed for cats, it is increasingly used off-label with generally favorable safety.
- Veterinarians should consider potential benefits against contraindications like outflow tract obstruction.
Practical Relevance:
Cardiomyopathies are a common condition and the leading cause of congestive heart failure (CHF) in cats; however, to date there have been limited therapeutic options available. Commonly used therapeutics include diuretics for CHF and antithrombotics 2 to reduce the risk of arterial thromboembolism (ATE), which do not directly affect myocardial function. This review summarizes the evidence for the use of pimobendan, a phosphodiesterase III inhibitor and calcium channel sensitizer, in feline cardiomyopathies. Potential benefits of pimobendan in cats include improved left ventricular systolic and diastolic function, reduced platelet aggregation, reduction in left atrial size, and improved left atrial and auricular systolic function.Drug details:Pimobendan is indicated for the treatment of CHF in conditions associated with systolic dysfunction (including dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and some cases with non-specific phenotypes) and has been used in the treatment of CHF secondary to hypertrophic cardiomyopathy. A dosage of pimobendan of 0.25 mg/kg PO q12h is generally well tolerated, and an approved oral solution is now available in the UK, EU, USA, Japan and Australia, which may facilitate administration in some cats; it should be noted, however, that pimobendan is not licensed for use in cats and marketing authorizations may vary between countries. Adverse events are uncommon with pimobendan but include gastrointestinal upset (anorexia, vomiting), transient changes in heart rate and possible worsening arrhythmias at higher doses. The use of pimobendan is contraindicated in cats with fixed obstructions of the left or right ventricular outflow tract (ie, congenital heart disease - pulmonic or aortic valvular stenosis).
Audience:
This article reviews the use of pimobendan in cats for primary care veterinarians and includes practical case examples that reflect the typical use and recommendations for usage of pimobendan by the authors.
