Beyond the Guidelines: Diuretic

Presentation Description / Summary: The use of diuretics is the cornerstone for management of congestive heart failure in veterinary medicine. Furosemide, a loop diuretic, is the ACVIM consensus first-line diuretic recommend for the treatment for acute life-threatening pulmonary edema and home-based chronic therapy. In advanced stages of heart failure, resistance to furosemide might occur, requiring increased diuretic dose or alternative diuretic choices. Torsemide is a loop diuretic with more potent and long-lasting diuretic activity compared with furosemide. Torsemide has a higher bioavailability that furosemide and has demonstrated in humans and animal models to possess additional beneficial effects beyond diuresis, including: vasodilation, improved cardiac function, reduced cardiac remodeling and direct antialdosterone effects. The TOrasemide in Congestive Heart Failure (TORIC) Study demonstrated that torsemide had a more beneficial effect than furosemide and other diuretics on the mortality and morbidity of human patients suffering from chronic heart failure. There is anecdotal data on the use of torsemide in veterinary patients and the popularity and clinical use of this drug in heart failure continues to increase. This case-based presentation will detail the uses of torsemide as both a rescue drug and first-line alternative to furosemide while encourage audience participation for comments and questions on how torsemide is used in veterinary medicine.

Learner Outcomes: 1. After completion, participants will be able to select appropriate use of torsemide in their patients. 2. After completion, participants will be able to anticipate outcomes, potential complications, and prognosis associated with the use of torsemide in advanced heart failure.