Tell me the dose rate of pimobendin in cat and dog from different books
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pimobendan dose rate cats dogs veterinary cardiology guidelines mg/kg
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pimobendan dosing cats dogs heart failure
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pimobendan dogs canine myxomatous mitral valve disease ACVIM
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pimobendan 0.25 mg/kg dogs cats cardiac treatment
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ACVIM consensus guidelines pimobendan myxomatous mitral valve disease dogs 2019
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ACVIM consensus heart disease cats feline 2020
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Excellent! Found the cat dosing: 0.625–1.25 mg per cat q12h PO. Now I have all the key data. Let me compile the comprehensive answer from all the sources gathered.
Pimobendan Dose Rates in Dogs and Cats — From Multiple Sources
Dogs
| Source | Dose | Frequency | Indication |
|---|---|---|---|
| EPIC Study (Boswood et al., 2016 — RCT, PMID 27678080) | 0.4–0.6 mg/kg/day in divided doses | q12h (i.e., ~0.2–0.3 mg/kg per dose) | Preclinical MMVD with cardiomegaly (Stage B2) |
| ACVIM Consensus Guidelines 2019 (Keene et al.) | 0.25–0.3 mg/kg q12h | Twice daily | All stages of MMVD with cardiac enlargement (Stage B2, C, D); total daily dose ~0.4–0.6 mg/kg/day |
| ACVIM Stage C / Acute CHF | 0.25–0.3 mg/kg q8–12h | Can be given q8h in refractory cases | Stage C (overt CHF) |
| Vetmedin (licensed product insert — Boehringer Ingelheim) | 0.5 mg/kg/day divided | q12h (0.25 mg/kg per dose), given ~1 hour before food | MMVD and dilated cardiomyopathy (DCM) |
Key points for dogs:
- The total daily dose is consistently 0.4–0.6 mg/kg/day, most commonly rounded to 0.5 mg/kg/day, split into two equal doses of 0.25 mg/kg q12h.
- Given on an empty stomach (~1 hour before feeding), as food significantly reduces bioavailability.
- The EPIC trial (PMID 27678080) demonstrated that pimobendan extended the preclinical period by a median of ~15 months in Stage B2 dogs (LA:Ao ≥1.6, Nlvid-d ≥1.7).
- Pharmacokinetic data (McManamey et al., 2023 — PMID 37776546) confirmed t½ ~1–1.4 hours for pimobendan and its active metabolite (O-desmethyl-pimobendan, ODMP), with high inter-individual variability.
Cats
| Source | Dose | Frequency | Indication |
|---|---|---|---|
| ACVIM Consensus Statement 2020 (Luis Fuentes et al., PMID 32243654) | 0.625–1.25 mg per cat | q12h PO | Stage C cardiomyopathy (CHF); cats with global LV systolic dysfunction |
| Oldach et al., 2021 (PMID 33622315) — pharmacodynamic study | 1.25 mg per cat (flat dose) | Single oral dose | Subclinical HCM study; acute dose well tolerated |
| General clinical use | ~1.25 mg per cat (or 0.625 mg for small cats) | q12h PO | Cats with systolic dysfunction or refractory CHF |
Key points for cats:
- Pimobendan is dosed as a flat dose in cats (not per-kg), typically 1.25 mg/cat q12h (~0.25–0.3 mg/kg for an average 4–5 kg cat), with 0.625 mg/cat q12h for smaller cats.
- The 2020 ACVIM feline consensus recommends pimobendan specifically for:
- Cats with global LV systolic dysfunction (e.g., DCM-like phenotype) — recommended (low evidence level).
- Cats with low cardiac output signs (hypotension, hypothermia, bradycardia) during acute CHF — may be considered, provided DLVOTO (dynamic left ventricular outflow tract obstruction) is absent.
- Pimobendan is not routinely recommended for cats with hypertrophic cardiomyopathy (HCM) without systolic dysfunction due to theoretical risk of worsening outflow tract obstruction.
- Oldach et al. (2021) showed acute pimobendan increased LV outflow tract velocity, reinforcing caution in obstructive HCM.
Summary Comparison Table
| Species | Standard Dose | Frequency | Route | Notes |
|---|---|---|---|---|
| Dog | 0.25–0.3 mg/kg | q12h | PO | ~1 hr before food; total 0.4–0.6 mg/kg/day |
| Dog (licensed) | 0.25 mg/kg | q12h | PO | Vetmedin label dose |
| Cat | 0.625–1.25 mg/cat | q12h | PO | Flat dose; avoid in obstructive HCM |
References
- Boswood A et al. Effect of Pimobendan in Dogs with Preclinical MMVD: The EPIC Study. J Vet Intern Med 2016. [PMID: 27678080]
- Keene BW et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med 2019.
- Luis Fuentes V et al. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 2020. [PMID: 32243654]
- Oldach MS et al. Acute pharmacodynamic effects of pimobendan in client-owned cats with subclinical HCM. BMC Vet Res 2021. [PMID: 33622315]
- McManamey AK et al. Pharmacokinetics of pimobendan in dogs with MMVD. J Vet Intern Med 2023. [PMID: 37776546]
Note: The medical textbook library available in this system contains only human medicine textbooks (e.g., Goodman & Gilman's, Harrison's), where pimobendan is referenced only as a calcium sensitizer used in Japan — without veterinary dosing. The above doses are sourced directly from peer-reviewed veterinary literature and ACVIM consensus guidelines.
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