Diuretics are also known as “water pills” and are used to treat pulmonary edema (lung congestion) caused by heart failure. In Malaysia, the common diuretic is “furosemide.” In recent years, “torasemide” has also begun to attract the attention of veterinarians.
Furosemide has a duration of action of about 6 hours in the body and needs to be taken two to three times a day. Torasemide’s action is more prolonged, lasting about 18 hours, and is taken once or twice a day.
Diuretics are also referred to as “life-saving drugs” because once pets develop heart failure, they must take them regularly to maintain life.
Other drugs such as “pimobendan,” “benazepril,” “spironolactone,” etc., are adjunctive medications. For example, just as we add different ingredients to enrich the flavor of soup, through polypharmacy, pets may not need to take high doses of diuretics to reduce side effects.
Do diuretics worsen kidney function?
Excessive diuretics cause the body to excrete a large amount of urine, resulting in loss of water and electrolytes. Dehydration reduces kidney blood flow and circulation, leading to an increase in substances that are supposed to be transported to the kidneys for detoxification. Thus, the levels of uremic toxins in blood tests such as Blood Urea Nitrogen, Creatinine, and SDMA increase. It is worth noting that this often occurs when the dosage of diuretics is too high and the owner does not regularly bring the pet for follow-up visits to adjust the medication dosage.
In author’s study, there was no significant difference in kidney values between dogs with stage B (not taking diuretics) and stage C (taking diuretics) MMVD. This demonstrates the importance of regular check-ups, as they can detect kidney problems early and adjust medication dosage accordingly.
Pets with heart failure must take diuretics in the “just right” amount to maintain life. Once diuretics are stopped, pulmonary edema will recur. In other words, if a pet shows no abnormalities even after stopping diuretics, the reason is simple: it never had heart failure in the first place. Another explanation is, your veterinarians use diuretics to treat non-cardiac diseases. Lastly, when a pet shows exceptionally rare reversed remodelling of heart disease, diuretic can be discontinued.
