title: Effect of torsemide and furosemide on clinical, laboratory, radiographic and quality of life variables in dogs with heart failure secondary to mitral valve disease.
abstract: OBJECTIVE
  Diuretic therapy reduces preload and relieves congestion secondary to cardiac dysfunction. Torsemide (torasemide) is a loop diuretic with longer duration of action, decreased susceptibility to diuretic resistance, and adjunctive aldosterone antagonist properties compared with furosemide. We hypothesized that torsemide would be well tolerated and no less effective than furosemide at diuresis, control of clinical signs, and maintenance of quality of life (QOL) in dogs with congestive heart failure (CHF).
  
  
  METHODS
  Seven client-owned dogs with stable CHF receiving twice daily oral furosemide and adjunctive medications. Utilizing a double-blinded, randomized, crossover design, dogs were administered either oral furosemide at their current dose or an equivalent oral dose of torsemide (1/10 of the daily furosemide dose divided into twice daily dosing) on day 0. Crossover occurred at day 7 and the study ended on day 14. Clinical, laboratory, radiographic, and QOL variables were evaluated on days 0, 7 and 14.
  
  
  RESULTS
  No dogs developed recurrent CHF during the study. Mean furosemide dose on day 0 was 5.13 mg/kg/day (range 2.8-9.6). Following torsemide treatment, creatinine (P = 0.020), urea nitrogen (P = 0.013), phosphorus (P = 0.032), albumin (P = 0.019), carbon dioxide (P = 0.015) and anion gap (P = 0.005) were significantly increased, and urine specific gravity (P = 0.004) and chloride (P = 0.021) were significantly decreased compared with furosemide dosing. No differences in QOL were found.
  
  
  CONCLUSIONS
  Results indicate that torsemide is equivalent to furosemide at controlling clinical signs of CHF in dogs and is likely to achieve greater diuresis vs. furosemide. Larger clinical trials evaluating torsemide as a first or second-line loop diuretic for congestive heart failure in dogs are warranted.
authors.affiliation: Department of Clinical Studies-Philadelphia, Matthew J. Ryan Veterinary Hospital of University of Pennsylvania, Philadelphia, PA, USA. gpeddle.vmd@gmail.com
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Peddle
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Singletary
authors.forename: Caryn A
authors.initials: CA
authors.lastname: Reynolds
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Trafny
authors.forename: Maggie C
authors.initials: MC
authors.lastname: Machen
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
mesh_terms: D000818:Animals; D018592:Cross-Over Studies; D004232:Diuretics / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D005665:Furosemide / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000662:veterinary*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077786:Torsemide
chemical_list: D004232:Diuretics; D013449:Sulfonamides; D005665:Furosemide; D000077786:Torsemide