Cardiac Medications of Dogs and Cats
Drug | Species | Route and Dosage |
|---|---|---|
Diuretics | ||
Furosemide | Dog | Acute treatment: 2–4 mg/kg, IV or IM, q 1–6 h (initially q 1–2 h, then q 4–8 h) or 0.25–1 mg/kg/h, IV CRI Long-term management: 1–6 mg/kg, PO, q 8–12 h; maximal total dose of 12 mg/kg q 24 h. Typical starting dose: 2 mg/kg, PO, q 12 h |
Cat | Acute treatment: 0.5–2 mg/kg, IV or IM, q 1–8 h (initially q 2 h, then q 6–8 h) or 0.25–0.6 mg/kg/h, IV CRI Long-term management: 1–2 mg/kg, PO, q 12–24 h; maximal total dose of 6 mg/kg q 24 h | |
Torsemide | Dog | 0.1–0.4 mg/kg, PO, q 12–24 h |
Cat | 0.05–0.25 mg/kg, q 12-24 h or 1.25 mg/cat, PO, q 12–24 h | |
Spironolactone | Dog | 1–2 mg/kg, PO, q 12 h or 2–4 mg/kg, PO, q 24 h |
Hydrochlorothiazide | Dog | 1–4 mg/kg, PO, q 12–24 h |
Cat | 0.5–2 mg/kg, PO, q 12–24 h | |
Acetazolamide | Dog | 4–7 mg/kg, PO, q 12 h |
Positive Inotropes | ||
Pimobendan | Dog | 0.25–0.3 mg/kg, PO, q 8–12 h; 0.15 mg/kg, IV, single dose (extralabel) 0.5 mg/kg, PO, q 12 h for delay of CHF due to stage 2 MMVD |
Cat | 0.25 mg/kg, PO, q 12 h (extralabel) Usually 1.25 mg/cat, PO, q 12 h | |
Digoxin | Dog | 0.0025–0.005 mg/kg, PO, q 12 h (do not exceed 0.25 mg/dog, PO, q 12 h) |
Cat | For cats < 3 kg: 0.01 mg/kg, PO, q 48 h; for cats 3–6 kg: ¼ of 0.125 mg tablet, PO, q 24–48 h; for cats > 6 kg: ¼ of 0.125 mg tablet, PO, q 12–24 h | |
Dobutamine | Dog | 1–15 mcg/kg/min, IV CRI |
Cat | 0.5–5 mcg/kg/min, IV CRI | |
ACE Inhibitors | ||
Enalapril | Dog, cat | 0.25–0.5 mg/kg, PO, q 12–24 h |
Benazepril | Dog | 0.25–0.5 mg/kg, PO, q 12–24 h |
Cat | 0.25–0.5 mg/kg, PO, q 12 h or 0.5 mg/kg, PO, q 24 h | |
Benazepril/spironolactone | Dog | Chewable tablets: 2.5 mg benazepril/20 mg spironolactone (5/40, 10/80) by weight per label |
0.25 mg/kg benazepril and 2 mg/kg spironolactone, PO, q 24 h | ||
Ramipril | Dog | 0.125–0.25 mg/kg, PO, q 24 h |
Lisinopril | Dog | 0.5 mg/kg, PO, q 12–24 h |
Cat | 2.5 mg/cat, PO, q 24 h | |
ARBs | ||
Telmisartan | Dog | 1–2 mg/kg, PO, q 24 h |
Cat | 1.5 mg/kg, PO, q 12 h for 14 days, then 2 mg/kg, PO, q 24 h | |
Vasodilators | ||
Nitroglycerin 2% | Dog, cat | 6.3 mm (0.25 in) paste/5–10 kg, applied with gloves to unhaired inside of pinna, q 8 h for first 24 h |
Nitroprusside sodium | Dog | Initial dose 1 mcg/kg/min, IV CRI; then titrate to effect q 15–30 min up to maximal dose of 10–15 mcg/kg/min; continue for up to 24–48 h. Do not bolus. |
Cat | Initial dose 1 mcg/kg/min, IV CRI; then titrate up to 3 mcg/kg/min if needed | |
Hydralazine | Dog | Initial dose 0.5 mg/kg, PO, once; then titrate up to 1–3 mg/kg q 12 h |
Cat | Initial dose 0.2–0.5 mg/cat, SC; repeat after 15 min if needed | |
Amlodipine | Dog | 0.1–0.2 mg/kg, PO, q 12 h or 0.2–0.4 mg/kg, PO, q 24 h |
Cat | Acute treatment: 0.125–0.25 mg/kg, PO; then titrate to a maximum dose of 0.6 mg/kg (2.5 mg/cat), PO, q 24 h Long-term management: 0.125 mg/kg, PO, q 24 h; increase slowly (weekly) up to 0.5 mg/kg | |
Sildenafil | Dog, cat | 1–3 mg/kg, PO, q 8 h |
Tadalafil | Dog | 1–2 mg/kg, PO, q 12 h (extralabel) |
Antiarrhythmics | ||
Magnesium chloride | Dog | 0.15–0.3 mEq/kg, slow IV, over 5–15 min |
Sodium channel blockers (Class I) | ||
Lidocaine | Dog | Loading dose 2 mg/kg, IV, over 30 sec–2 min (maximal cumulative dose of 8 mg/kg over 30 min); then 25–80 mcg/kg/min, IV CRI |
Cat | Loading dose 0.1–0.4 mg/kg, IV, over 1 min (maximum 3 doses over 5–20 min); then 10–20 mcg/kg/min, IV CRI, if effective. Lower dose recommended due to cats' sensitivity to potential CNS effects. | |
Procainamide | Dog | Loading dose 2 mg/kg, IV, over 5 min; then titrate up to maximum dose of 20 mg/kg over 10–15 min, then 25–40 mcg/kg/min, IV CRI, or 10–20 mg/kg, IM or SC, q 4–6 h Maintenance dose: Immediate-acting formulation: 4–6 mg/kg, PO, q 2–4 h Sustained-release formulation: 10–20 mg/kg, PO, q 8 h |
Mexiletine | Dog | 4–8 mg/kg, PO, q 8 h |
Beta-blockers (Class II) | Start low and titrate up | |
Atenolol | Dog | 0.2–1.5 mg/kg, PO, q 12 h |
Cat | 1–2.5 mg/kg (6.25–12.5 mg/cat/dose), PO, q 12 h | |
Esmolol | Dog, cat | 0.1–0.5 mg/kg, slow IV bolus over 2–5 min; then 10–200 mcg/kg/min, CRI, if needed |
Propranolol | Dog | 0.2–1.5 mg/kg, PO, q 8 h |
Cat | 0.4–1.2 mg/kg (2.5–5 mg/cat/dose), PO, q 8 h | |
Metoprolol | Dog | 0.4–1.0 mg/kg, PO, q 12 h; start at 0.2 mg/kg, PO, q 12 h with slow uptitration |
Carvedilol | Dog | 0.2–0.4 mg/kg, PO, q 12 h; then titrate q 2 wk up to 1.5 mg/kg q 12 h |
Cat | 1.6–3.125 mg/cat, PO, q 12 h | |
Potassium channel blockers (Class III) | ||
Sotalol | Dog, cat | 1–3.5 mg/kg, PO, q 12 h |
Amiodarone | Dog | Loading dose 8–10 mg/kg, PO, q 12 h for 7–10 days; maintenance dose 5–10 mg/kg, PO, q 24 h 2–5 mg/kg, IV infusion over 30–60 min; then 0.8 mg/kg/h, IV CRI for 6 h, then 0.5 mg/kg/h, IV CRI |
Calcium channel blockers (Class IV) | ||
Diltiazem (immediate acting) | Dog, cat | 0.05–0.1 mg/kg, IV bolus over 5 min; additional boluses as needed q 15 min up to 0.05 mg/kg cumulative dose |
Dog | 0.5–3 mg/kg, PO, q 8 h | |
Cat | 1.5–3 mg/kg (7.5–15 mg/cat/dose), PO, q 8–12 h | |
Diltiazem extended-release | Dog | 2–4 mg/kg, PO, q 12 h |
Cat | 7.5 mg/cat, PO, q 8 h Extended release: 30–60 mg/cat, PO, q 12–24 h | |
Vagolytics | ||
Atropine | Dog, cat | 0.02–0.04 mg/kg, IV, IM, or SC, to effect |
Glycopyrrolate | Dog, cat | 0.005–0.01 mg/kg, IV, IM, or SC, to effect |
Anticholinergics | ||
Hyoscyamine | Dog | 0.003–0.006 mg/kg, PO, q 8–12 h |
Propantheline | Dog | 0.5–1.5 mg/kg (7.5–30 mg/dog/dose), PO, q 8 hr |
Antitussives | ||
Hydrocodone | Dog | 0.2–1 mg/kg, PO, q 6–12 h (or as needed) |
Butorphanol | Dog | 0.55–1.1 mg/kg, PO, q 6–12 h |
Maropitant | Dog | 2 mg/kg, PO, q 48 h |
Diphenoxylate/atropine | Dog | 0.2–0.5 mg/kg, PO, q 6–12 h |
Antithrombotics | ||
Aspirin | Dog | 2–10 mg/kg, PO, q 24 h |
Cat | Not recommended as sole antithrombotic, as clopidogrel is superior in preventing feline arterial thromboembolism; 1–2 mg/kg, PO, q 24 h or ¼ of 81-mg tablet/cat, PO, q 3 days | |
Clopidogrel | Dog | 1–4 mg/kg, PO, q 24 h |
Cat | Loading dose 37.5–75 mg/cat, PO, once; maintenance dose 18.75 mg/cat, PO, q 24 h | |
Enoxaparin | Dog | 0.8 mg/kg, SC, q 6 h |
Cat | 0.75–1 mg/kg, SC, q 6–12 h | |
Dalteparin | Dog | 100–175 IU/kg, SC, q 8 h |
Cat | 75–150 IU/kg, SC, q 6 h or 100–200 IU/kg, SC, q 12 h | |
Rivaroxaban | Dog | 1–2 mg/kg, PO, q 12–24 h |
Cat | 0.5–1 mg/kg (1.25–2.5 mg/cat), PO, q 12–24 h | |
Apixaban | Dog | 0.25–0.5 mg/kg, PO, q 8–12 h (q 8 h for 3–7 days in dogs with active thrombosis; maintenance dose: q 12 h); decrease if renal disease |
Cat | For cats < 5 kg: 0.625 mg/cat, PO, q 12 h For cats ≥ 5 kg: 1.25 mg/cat, PO, q 12 h | |
Amino Acids | ||
L-carnitine | Dog | 1,000–3,000 mg/dog, PO, q 12 h Note: must be L-carnitine and not R-carnitine |
Taurine | Dog | Small dog: 250–500 mg, PO, q 12 h; medium-sized dog: 500 mg, PO, q 12 h; large-breed dog: 500–1,000 mg, PO, q 12 h (no weights are included to clarify) |
Cat | 250–500 mg/cat, PO, q 12 h | |
Heartworm Treatments | ||
Doxycycline | Dog | 10 mg/kg, PO, q 12 h for 28 d |
Melarsomine | Dog | 2.5 mg/kg, deep IM injection into epaxial lumbar muscle belly (between L3 and L5); total of 3 injections (days 60, 90, and 91) |
Prednisone | Dog | 1st wk: 0.5 mg/kg, q 12 h 2nd wk: 0.5 mg/kg, q 24 h 3rd & 4th wk: 0.5 mg/kg every other day following each melarsomine injection, or sooner in patients with clinical signs |
Macrocyclic lactones: ivermectin, moxidectin, milbemycin, selamectin | Dog | PO, topical, and parenteral formulations; dosed year-round based on body weight per manufacturer's instructions and American Heartworm Society guidelines |
DRUGS NO LONGER ROUTINELY USED | ||
Amiloride, amrinone, milrinone (except postoperatively in canine cardiac surgery), quinidine (except to convert equine atrial fibrillation), triamterene, warfarin | ||
Abbreviations: ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; CHF, congestive heart failure; MMVD, myxomatous mitral valve disease. | ||