Today's Veterinary Practice

JAN-FEB 2016

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com PracTicaL TecHniQUes FroM THe naVc insTiTUTe Peer reviewed 106 ace = angiotensin-converting enzyme; BUn = blood urea nitrogen; cHF = congestive heart failure; Mr = mineralocorticoid receptor; raas = renin– angiotensin–aldosterone system FIGURE CREDITS Figure 1 reprinted with permission from Lantis ac, atkins ce, deFrancesco Tc, Keene BW. The effect of furosemide and pimobendan on the circulating renin angiotensin aldosterone system (raas) in dogs. Am J Vet Res 2011; 72:1646-1651. Figure 2 reprinted with permission from Uechi M, Matsuoka M, Kuwajima e, et al. The effects of the loop diuretics furosemide and torasemide on diuresis in dogs and cats. J Vet Med Sci 2003; 65(10):1057-1061. Figures 3 and 7 reprinted with permission from Hori y, Takusagawa F, ikadai H, et al. effects of oral administration of furosemide and torsemide in healthy dogs. Am J Vet Res 2007; 68(10):1058-1063. Figures 4 to 6 adapted from Vargo dL, Kramer WG, Black PK, et al. Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide and furosemide in patients with congestive heart failure. Clin Pharm Therap 1995; 57(60):601-609. References 1. Bikdeli B, strait KM, dharmarajan K, et al. dominance of furosemide for loop diuretic therapy in heart failure. Time to revisit the alternatives. J Am Coll Cardiol 2013; 61(14):1549-1550. 2. Greenberg a. diuretic complications. Am J Med Sci 2000; 319(1):10-24. 3. Vander aJ, carlson J. Mechanism of the effects of furosemide on renin secretion in anesthetized dogs. Circulation Res 1969; 25:145- 152. 4. sayer MB, atkins ce, Fujii y, et al. acute effect of pimobendan and furosemide on the circulating renin-angiotensin-aldosterone system in healthy dogs. J Vet Intern Med 2006; 23(5):1003-1006. 5. castrop H, Lorenz Jn, Hansen PB, et al. contribution of the ba- solateral isoform of the na-K-2cl-cotransporter (nKcc1/Bsc2) to renin secretion. Am J Physiol Renal Physiol 2005; 289:1185- 1192. 6. schrier rW, abraham WT. Hormones and hemodynamics in heart failure. N Engl J Med 1999; 341(8):577-585. 7. Hori y, ohshima n, Kanai K, et al. differences in the duration of diuretic effects and impact on the renin-angiotensin-aldosterone system of furosemide in healthy dogs. J Vet Med Sci 2010; 72(10):13-18. 8. Mann dL. Management of heart failure patients with reduced ejection fraction. in Libby P, Bonow ro, Mann dL, Zipes dP (eds): Braunwald's Heart Disease, 8th ed. Philadelphia: saunders elsevier, 2008, pp 611-640. 9. cosin J, diez J, Toric investigators. Torasemide in chronic heart failure: results of the Toric study. Eur J Heart Fail 2002; 4(4):507-513. 10. Mentz rJ, Hasselblad ad, deVore ad, et al. comparative effectiveness of torsemide versus furosemide in acute heart failure patients: insights from ascend-HF (abstract). Proc AHA Sci Session, 2014. 11. Peddle Gd, singletary Ge, reynolds ca, et al. effect of torsemide on clinical, laboratory, radiographic and quality of life variables in dogs with heart failure secondary to mitral valve disease. J Vet Cardiol 2012; 14(1):253-259. 12. oyama Ma, Peddle Gd, reynolds ca, et al. Use of the loop diuretic torsemide in three dogs with advanced heart failure. J Vet Cardiol 2011; 13(4):287-292. 13. Uechi M, Matsuoka M, Kuwajima e, et al. The effects of the loop diuretics furosemide and torasemide on diuresis in dogs and cats. J Vet Med Sci 2003; 65(10):1057-1061. 14. sogame y, okano K, Hayashi K, et al. Urinary excretion profle of torasemide and its diuretic action in dogs. J Pharm Pharmacol 1996; 48(4):375-379. 15. Hori y, Takusagawa F, ikadai H, et al. effects of oral administration of furosemide and torsemide in healthy dogs. Am J Vet Res 2007; 68(10):1058-1063. 16. Uchida T, yamanaga Mn, ohtaki y, et al. anti-aldosteronergic effect of torasemide. Eur J Pharmacol 1991; 205(2):145-150. 17. Gravez BG, Tarjus a, Jimenez-canino r, et al. The diuretic torasemide does not prevent aldosterone-mediated mineralocorticoid receptor activation in cardiomyocytes. PLos ONE 2013; 8(9):e73737. 18. Tsuamoto T, sakai H, atsuyuki W, et al. Torsemide inhibits transcardiac extraction of aldosterone in patients with congestive heart failure. J Am Coll Cardiol 2004; 44(11):2252-2253. 19. Lopez B, Gonzalez a, Beaumont J, et al. identifcation of a potential cardiac antifbrotic mechanism of torsemide in patients with chronic heart failure. J Am Coll Cardiol 2007; 50(9):859-867. 20. Lopez B, Querejeta r, Gonzalez a, et al. impact of treatment on myocardial lysyl oxidase expression and collagen cross-linking in patients with heart failure. Hypertension 2009; 53(2):236-242. 21. caro-Vadillo a, ynaraja-ramirez e, Montaya-alonso Ja. effect of torsemide on serum and urine electrolyte levels in dogs with congestive heart failure. Vet Rec 2007; 160(24):847-848. TAblE 4. indications for Torsemide • Failure of high-dosage diuretic to keep patient free of signs (ie, pulmonary edema, ascites) • When furosemide dosage exceeds 6 to 8 mg/kg Q 24 H • If a need to increase furosemide dosing frequency (eg, from Q 12 H to Q 8 H) cannot be met due to owners' schedule m arisa K. a mes Marisa K. Ames, DVM, Diplomate ACVIM (Cardiology), is an assistant professor at Colorado State University College of Veterinary Medicine. Dr. Ames received her DVM from Ohio State University. She completed a cardiology residency and the Jane lewis Seaks postdoctoral fellowship at North Carolina State University. Her research interests include neurohormonal activation in heart failure, specifcally the pharmacologic blockade of the renin–angiotensin–aldosterone system (RAAS). c lar K e e . aTKins Clarke E. Atkins, DVM, Diplomate ACVIM (Internal Medicine & Cardiology), is the Jane l ewis Seaks Distinguished Professor Emeritus of Companion Animal Medicine at North Carolina State University. He is also a member of the Today's Veterinary Practice Editorial Peer Review board and American Heartworm Society's Executive board. Dr. Atkins' research involves canine and feline heartworm disease and pharmacologic therapies for cardiac disease. He received the 2004 Norden Award for excellence in teaching.

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