Pimobendan (Vetmedin) & Furosemide (Lasix)
Together for Dogs with Heart Disease
The most common combination for dogs in congestive heart failure. Pimobendan strengthens the heart while furosemide removes excess fluid from the lungs.
Why are these prescribed together?
When a dog enters congestive heart failure (Stage C), both medications are typically started simultaneously. Pimobendan improves the heart's pumping ability and reduces workload, while furosemide is a diuretic that removes fluid buildup. The QUEST study showed this combination had fewer adverse outcomes than ACE inhibitor + furosemide.
How they interact
These medications complement each other well. As pimobendan improves heart function, furosemide doses can sometimes be gradually reduced. There are no direct pharmacological conflicts between the two drugs.
Dosing and timing tips
Pimobendan is given twice daily on an empty stomach (1 hour before or 2 hours after food). Furosemide timing is more flexible but should be given consistently. Many owners give pimobendan first thing in the morning and last thing at night, with furosemide given with meals.
Monitoring needed
Monitor resting respiratory rate daily. Watch for excessive thirst/urination (furosemide effect). Regular bloodwork to check kidney values and electrolytes (furosemide can deplete potassium and magnesium). Recheck echocardiogram every 3-6 months.
Important warnings
Ensure fresh water is always available - furosemide increases water loss
Never skip pimobendan doses even if your dog seems better
If respiratory rate rises above 40 despite both medications, contact your vet immediately
Used for these conditions
Learn about each medication
Other combinations with these drugs
Cardiac protocols stack up over time. These pages cover the other combinations your dog may end up on.
Pimobendan + Furosemide & Benazepril
The 'triple therapy' - the standard of care for dogs in congestive heart failure. Most cardiac dogs in Stage C will be on all three of these medications.
Furosemide (Lasix) & Benazepril
A foundational combination in heart failure management. Furosemide removes fluid while benazepril reduces the hormonal response that causes fluid retention.
Furosemide (Lasix) & Enalapril
Same rationale as furosemide + benazepril. Enalapril blocks the hormonal response that causes fluid retention while furosemide directly removes excess fluid.
Furosemide (Lasix) & Spironolactone
A complementary diuretic combination. Furosemide is a powerful loop diuretic that depletes potassium, while spironolactone is a mild potassium-sparing diuretic that helps balance this effect.
Important:Never start, stop, or adjust your dog's medication without consulting your veterinarian. The dosages and protocols described here are general references - your vet will determine the right approach for your dog based on their individual condition, weight, and overall health.