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Indian Journal of Animal Research

  • Chief EditorM. R. Saseendranath

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Research Article

Indian Journal of Animal Research, volume 52 issue 4 (april 2018) : 583-590

Evaluation of add on effect of carvedilol on standard protocol of digoxin, frusemide and benazepril in the management of dilated cardiomyopathy in dogs

Akhilesh Kumar, Sahadeb Dey, Abhishek Chandra Saxena, Sumit Mahajan
1Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly-243 122, Uttar Pradesh, India.
Cite article:- Kumar Akhilesh, Dey Sahadeb, Saxena Chandra Abhishek, Mahajan Sumit (2018). Evaluation of add on effect of carvedilol on standard protocol of digoxin, frusemide and benazepril in the management of dilated cardiomyopathy in dogs. Indian Journal of Animal Research. 52(4): 583-590. doi: 10.18805/ijar.B-3377.

ABSTRACT

This is a prospective, controlled, randomized clinical trial in canine patients with overt Dilated Cardiomyopathy (DCM). We hypothesized that the addition of the third generation beta-blocker carvedilol to the standard treatment of diuretic (furosemide), inotropic support (digoxin) and ACE-inhibitor (benazepril) would have beneficial effects over cardiac function and quality of life (QoL) that would be measurable 90 days post-treatment. 16 dogs diagnosed with overt DCM were recruited. They underwent clinical examination, electrocardiography, echocardiography and neurohormonal profiling (NT-proBNP and NO). Dogs were divided in two groups, receiving standard therapy or standard therapy plus carvedilol and subjected to re-evaluation on 90 days post-treatment. Our results indicated that the addition of carvedilol to the standard therapy improved echocardiographic indices of systolic function (FS and EF), reduced NT-proBNP and NO serum levels and quality of life within the group but did not showed the significant improvement over standard therapy. This suggested that the addition of carvedilol to the standard therapy in canine patients with overt DCM might have beneficial effects in cardiac function and quality of life in the treatment was continued for longer period.

REFERENCES

  1. Adams, K. F. Jr. (2004).Pathophysiologic role of the renin-angiotensin- aldosterone and sympathetic nervous systems in heart failure. Am .J .Health-Syst. Pharm., 61(Suppl): S4–S13.
  2. Arsenault, W. G., Boothe, D. M., Gordon, S. G., Miller, M.W., Chalkley, J. R. and Petrikovics, I. (2005).Pharmacokinetics of carvedilol after intravenous and oral administration in conscious healthy dogs.Am. J.Vet.Res., 66: 2172-2176. 
  3. Boswood, A., Dukes-McEwan, J., Loureiro, J., James, R. A., Martin, M., Stafford-Johnson, M., Smith, P., Little, C. and Attree, S. (2008).The diagnosis accuracy of different natriuretic peptides in the investigation of canine cardiac disease. J. Sm. Anim.Pract., 49:26-32.
  4. Crivellente. F., Tontodanati, M., Fasdelli, N., Casartelli, A., Dorigatti, R., Faustinelli, I. and Cristofori, P. (2011). NT-proBNP as a biomarker for assessment of a potential cardiovascular drug induced liability in beagle dogs. Cell. Biol.Toxicol., 27: 425-438.
  5. Dandona, P., Ghanim, H. and Brooks, D. P. (2007).Antioxidant activity of carvedilol in cardiovascular disease. J. Hypertens., 25: 731–741.    Das, J.S., Ravikanth, V.V. and Sujatha, M. (2010). Nitric Oxide as a major risk factor for oxidative stress in coronary artery disease: a preliminary Investigation. Sci. and Cult., 76:174-175.
  6. Dukes-McEwan, J., Borgarelli, M., Tidholm, A., Vollmar, A. C. and Haggstrom, J. (2003). Proposed guidelines for the diagnosis of canine idiopathic dilated cardiomyopathy. J. Vet. Cardiol., 5: 7-19.
  7. Eichhorn, E. J. and Bristow, M. R. (1997). Practical guidelines for initiation of beta-adrenergic blockade in patients with chronic heart failure. Am. J. Cardiol., 79: 794-798.
  8. Gordon, S.G., Arsenault, W. G., Longnecker, M., Boothe, D. M., Miller M. W. and Chalkley, J. (2006). Pharmacodynamics of carvedilol in conscious, healthy dogs. J. Vet.Intern. Med., 20:297–304.
  9. Gugjoo, M. B., Saxena, A. C., Hoque, M. and Zama, M. M. S. (2014). M-mode echocardiographic study in dogs. Afr. J. Agric. Res., 9:387-396.
  10. Hall, S. A., Cigarroa, C. G., Marcoux, L., Risser, R. C., Grayburn, P.A. and Eichhorn, E. J (1995).Time course of improvement in left ventricular function, mass and geometry in patients with congestive heart failure treated with beta-adrenergic blockade. J. Am. Coll. Cardiol., 25: 1154–1161.
  11. Karlapudi, S. K., Srikala, D. and Rao, D.S.T. (2012). Hypothyroidism - A cause for dilated cardiomyopathy in dogs; four year study (2008-2011). Vet.World ., 5: 742-747. 
  12. Kumar, K. S., Nagaraj, P., Kumar, V.V.V.A. and Rao, D. S. T. (2010). Hypertrophic cardiomyopathy in 12 dogs (2004-2008): first report in India. Veterinarski Archiv., 80: 491-498.
  13. Lechat, P., Packer, M., Chalon, S., Cucherat, M., Arab, T. and Biossel, J.P. (1998) .Clinical effects of â-adrenergic blockade in chronic heart failure: a meta-analysis of double-blind, placebo-controlled, randomized trials. Circ.,98:1184–1191.
  14. Marcondes-Santos, M., Tarasoutchi, F., Antonio, P., Mansur, A. P. And Strunz, C. M. C. (2007). Effects of carvedilol treatment in dogs with chronic mitral valvular disease. J. Vet. Intern Med., 21:996–1001.
  15. Martin, M.W., Stafford, M.J., Strehlau, G. and King, J.N. (2010). Canine dilated cardiomyopathy: a retrospective study of prognostic findings in 367 clinical cases. J. Sm. Anim.Pract., 51:428-436.
  16. Meurs, K.M., Miller, M.W. and Wright, N.A. (2001). Clinical features of dilated cardiomyopathy in Great Danes and results of pedigree analysis: 17 cases (1990-2000). J. Am. Vet. Med. Assoc.,5: 729-732. 
  17. Neglia, D., De Maria, R., Masi, S., Gallopin, M., Pisani, P., Pardini, S., Gavazzi, A., L’Abbate, A. and Parodi, O. (2007).Effects of long term treatment with carvedilol on myocardial blood flow in idiopathic dilated cardiomyopathy. Heart., 93:808–813.
  18. Nichols, A. J., Gellai, M. and Ruffolo, R.R.J. (1991).Studies on the mechanism of arterial vasodilation produced by the novel antihypertensive agent, carvedilol. Fundamental & Clinical Pharmacology., 5:25-38.
  19. Noszczyk-Nowak, A. (2011). NT-pro-BNP and troponin I as predictors of mortality in dogs with heart failure.Pol. J. Vet. Sci., 14: 551-556.
  20. O’Grady, M.R., Minors, S.L., O’Sullivan, M.L. and Horne, R. (2008). Effect of pimobendan on case fatality rate in doberman Pinschers with congestive heart failure caused by dilated cardiomyopathy. J. Vet. Intern. Med., 22:897–904.
  21. Opasich, C., De Feo, S. and Cioffi,G. (2005). Does atrial fibrillation in elderly patients with chronic heart failure limit the efficacy of carvedilol? Suggestions from an observational study. Ital. Heart J., 6:323-327.
  22. Oyama, M. A., Sisson, D.D and Solter, F. (2007a).Prospective screening for occult cardiomyopathy in dogs by measurement of plasma atrial natriuretic peptide, B-type natriuretic peptide, and cardiac troponin-I concentrations. Am. J. Vet. Res.,68: 42–47.
  23. Oyama, M.A., Sisson, D.D., Prosek, R., Bulmer, B.J., Luethy, M.W. and Fuentes, V. L. (2007b). Carvedilol in Dogs with Dilated Cardiomyopathy.J. Vet. Intern. Med., 21:1272–1279.
  24. Packer, M., Bristow, M.R., Cohn, J.N., Colucci, W.S., Fowler, M.B., Gilbert, E.M. and Shusterman, N.H. (1996). The Effect of carvedilol on morbidity and mortality in Patients with chronic heart failure. N. Engl. J. Med., 334:1349-1355.
  25. Palazzuoli, A., Quatrini, I. and Vecchiato, L. (2005). Left ventricular diastolic function improvement by carvedilol therapy in advanced heart failure. J. CardiovascPharmacol., 45:563-568.
  26. Pandian, J. S. (2005): Clinical and ultrasonographic investigation of ascites in dogs. M.V.Sc. thesis. Kerala Agriculture University, Thrissur, India.
  27. Pereira, L., Larsson, M.H.M.A., Leomil Neto, M and Brito, F.S. (2004). Cardiomyopathy in the English Cocker Spaniel: clinical, electrocardiographic, radiographic and echocardiographic aspect. Ciencia Rural., 34:419-424.
  28. Pitt, B., Zannad, F., Reme, W.J., Cody, R., Castaigne, A., Perez, A., Palensky, J. and Wittes, J. (1999). For the randomized aldactone evaluation study investigators. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N. Engl. J. Med., 341: 709–717.
  29. Poole-Wilson, P.A., Swedberg, K., Cleland, J.G.F., Lenarda, A.D., Hanrath, P., Komajda, et al., (2003). Comparison of carvedilol or metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): randomized controlled trial. Lancet., 362: 7–13.
  30. Pouchelon, J. L., Martignoni, L., King, J .N., Berres, M. (1999). The effect of benazepril on survival times and clinical signs of dogs with congestive heart failure: Results of a multicenter, prospective, randomized, double-blinded, placebo-controlled, long-    term clinical trial. J. Vet.Cardiol., 1: 7-18.
  31. Rossig, L., Haendeler, J., Mallat, Z., Hugel, B., Freyssinet, J.M., Tedgui, A., Dimmeler, S. and Zeiher, A.M. (2000).Congestive heart failure induces endothelial cell apoptosis: protective role of carvedilol. J. Am. Coll. Cardiol., 36:2081–2089.
  32. Sastry, K.V.H., Moudgal, R. P., Mohan, J., Tyagi, J.S and Rao, G.S. (2002). Spectrophotometric Determination of Serum Nitrite and Nitrate by Copper–Cadmium Alloy. Anal.Biochem., 306:79–82.
  33. Sesh, P.S.L., Venkatesan, P., Jeyaraja, K., Chandrasekar., M and Pandiyan, V. (2015). Xanthine oxidase as a biochemical marker of dilated cardiomyopathy in dogs. Indian J. Anim. Res., 49: 187-190.
  34. Snedecor, W.G. and Cochran, G.W. (1994). Statistical Methods. 8thed. lowa State University Press, Ames.
  35. Soares, E.C., Pereira, G.G., Petrus, L.C., Leomil Neto, M., Yamaki, F. L. and Larsson, M.H.M.A. (2010). Survival and echocardiographic evaluation of dogs with idiopathic dilated cardiomyopathy treated with carvedilol. Braz. J. Vet. Anim. Sci., 62: 555-563.
  36. Summerfield, N.J., Boswood, A., O’Grady, M.R., Gordon, S.G., Dukes-McEwan, J., Oyama, M.A., et al., (2012). Efficacy of Pimobendan in the prevention of congestive heart failure or sudden death in Doberman Pinschers with preclinical dilated cardiomyopathy (The PROTECT Study). J. Vet. Intern. Med.,26:1337–1349.
  37. Takaya, J., Ikemoto, Y., Teraguchi, M., Nogi, S. and Kobayashi, Y. (2000): Plasma nitric oxide products correlate with cardiac index of congenital heart disease. Pediatr Cardiol., 21:378–381.
  38. Thomas, W.P., Gaber, C.E. and Jacobs, G.J. (1993).Recommendations for standards in transthoracic two-dimesional echocardiography in the dog and cat. J. Vet. Intern. Med., 7: 247:252.
  39. Tidholm, A. (2006). Survival in dogs with dilated cardiomyopathy and congestive heart failure treated with digoxin, furosemide and propranolol: A retrospective study of 62 dogs. J. Vet. Cardiol., 8:41-47. 
  40. Tidholm, A. and Jonsson, L. (2005): Histologic characterization of canine dilated cardiomyopathy. Vet.Pathol., 42:1–8.
  41. Tilley, L.P. (1985): Analysis of P-QRS-T deflections. In: Essentials of Canine and Feline Electrocardiogrphy. 2nd ed., Lea and Febiger, Philadelphia, USA, pp. 57-97.
  42. Wali, R.K., Iyenger, M., Beck, G.J., Chartyan, D.M., Chonchol, M., Lukas, M.A., Cooper, C., et al., (2011). Efficacy and safety of carvedilol in treatment of heart failure with chronic kidney disease. Circ: Heart Fail., 4: 18-26.
  43. Wiersma, A.C., Leegwater, P.A.J., Van Oost, B.A., Ollier, W.E. and Dukes-McEwan, J. (2007): Canine candidate gene for dilated cardiomyopathy: annotation of and polymorphic markers for 14 genes. BMC Vet. Res., 3: 28-35. 
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