Expert: Herbs, NuVet Plus Supplements, Dog/Cat Food Recipes; ( Marie) - 5/22/2011

Question
Hi again Marie - I'm getting very confused about the treatment my vet is giving my little girl.  I reluctantly agreed to the pimobendan, as, on investigation, it appeared to have a very good track record.  I only started her on half a pill, and had to go out for a couple of hours.  when I got back, she was lethargic and I could hear a slight whimper.  She didn't want to move all night and appeared unhappy and somewhat distressed, though nothing scary, but in the morning (12 hours after dosing) she was great. I refused to give her anymore and told the vet.  She's now on lasix 12.5 b.i.d. and enalapril 5 mg b.i.d.  within an hour of taking the two meds, she becomes tired and is obviously bummed out, very quiet, and just lays there, doesn't even want to wag her tail.  BUT, within 8 hours after taking it, she's wired and her old self again, stronger than ever, pulling me down the street, though this tires her out a little, but she's still lively and not lethargic.  then I give her her dose of meds, and she's bummed again.  Also, she's not peeing as much as she was before and really isn't peeing anymore than she did before she was started on lasix. when first on lasix, she was soaking the little blankets I put in her crate AND peeing a lot outside, but for the past day or so, she's not. I feel like my vet is aggravated that I ask questions and question the meds and side effects (and his judgment - he told me I could give the entire pimobendan once a day - good thing I didn't), which is why I'm asking your opinion.  it sounds like she has a tiny bit of dry mouth early in the morning too.  she doesn't have a pot belly from fluid, her breathing is still more rapid,though she's not panting or in distress, and has lost about a pound.  her cough persists a few times a day, usually when she's resting - never with exercise. also, the inside of her ears appears pale after taking the medication, but when she's up and lively, sometimes they're pink(er). her gums are pink, but I can't really tell with her tongue.  I don't know if this is what the meds are supposed to do, if she's having adverse side effects, or what, and I'm almost afraid to ask the vet because I'm not sure I completely trust his judgment anymore. I know lasix and enalapril are the standard for dogs with the kind of condition she has, but I don't like the way they make her act and don't know if this is normal.  Thanks so much for all your help with this.  It's wonderful just to be able to tell someone who understands.  Thanks.  Evelyn

Answer
Hello again,  I would talk to your Vet about the possible "Low blood pressure" problem with the two drugs.  
~~~~ Please remember that I am not a Vet.

Tell your Vet the concerns you have over the 2 drugs and the interactions.  
If you feel that your VET can't answer your questions then move on to a new Vet.
You have every right to change your Pet's doctor if you wish.
You should feel comfortable with your Vet.

Talk to your Vet one more time with your concerns.
Be your Pet's advocate--- You are the only Voice your dog has.
Blessings to you!


This was taken from the Site for Enalapril: Side effects:
Precautions and Side Effects


•While generally safe and effective when prescribed by a veterinarian, enalapril can cause side effects in some animals.

•Enalapril should not be used in animals with known hypersensitivity or allergy to the drug.

•Enalapril may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with enalapril. Such drugs include furosemide, spironolactone and non-steroidal anti-inflammatories.

•Enalapril may relax blood vessels to such a degree that some animals become weak due to low blood pressure.

•Less commonly, enalapril may affect the blood supply to the kidneys leading to kidney failure. This is most common in dogs and cats treated with higher doses of the drug. It is also more common in animals with kidney disease and when diuretic drugs (such as furosemide) are administered.

•Side effects include changes in urination, decreased appetite, vomiting, sudden lethargy or weakness. These symptoms should be reported to your veterinarian.

•Side effects are more likely when enalapril is given with other potent drugs, such as diuretics or drugs that act to relax blood vessels.