Beyond the Guidelines: Dose Escalation of Pimobendan

Presentation Description / Summary: Pimobendan is a cornerstone of guideline directed therapy for ACVIM Stages B2, C and D myxomatous mitral valve disease (MMVD). Additionally, pimobendan is an essential medication in preclinical and clinical stages of dilated cardiomyopathy (DCM). The dose of pimobendan is typically selected based on the recommended labeled dose, varying minimally between countries where Vetmedin is licensed (0.4-0.6 mg/kg per day divided twice daily). Despite chronic administration of pimobendan at the typical initial starting dose, many clinicians elect to dose escalate pimobendan as part of an evolving treatment strategy in the face of advancing disease (Stage B2 to C or Stage C to D). This case-based presentation will discuss the approach of pimobendan dose escalation and discuss experiences from three centers who routinely employ this strategy in management of MMVD and DCM in dogs.