Furosemide
Chronic Cardiac Disease
Maintainance Dosing Protocol
1-5 mg/Kg, PO, q12-24h,
Administration
Dosing Frequency: Administer furosemide either as a single dose q24h, or as two divided doses q12h.
Refractory Cases: Refractory cases should be regularly examined and the diagnosis reviewed. Any previous daily dose may be temporarily doubled depending on the severity of the oedema or ascites or in refractory cases.
Diagnosis: Recommendations in the literature describe anecdotal use and major species extrapolations [MSE], as the criteria for diagnosis of CHF (Chronic (Congestive) Heart Failure) remain elusive in rabbits (Müller and Mancinelli, 2022; Ozawa et al., 2021; Pariaut 2009; Reusch, 2005).
Additional Medications
PDA protocols (Pimobendan - Diuretics- ACEi) are widely used to manage CHF associated with chronic valvular heart disease in rabbits.
Pimobendan
Diuretics
Angiotensin-converting enzyme inhibiton (ACEi)
Sole Use
Diuretic monotherapy in the management of acute cardiac failure in most mammalian species should be avoided, as patients receiving diuretics alone may deteriorate more rapidly than those receiving other treatment modalities.
Multimodal Use
We recommend following a major species extrapolation of ACVIM and similar consensus guidelines for disease staging and Furosemide use in rabbit heart failure. This means considering the concurrent use of Pimobendan or Benazepril.
Efficacy Profile
No efficacy data has been located in our literature searches.
We are unable to buod an efficacy data at this time as data is lacking
Treatment Goals
To maintain patient comfort and prolong the length and quality of life of rabbit patients presenting with AHF.
Assessing any improved quality of life of rabbit patients with AHF receiving Furosemide currently relies upon a subjective, case-by-case judgement.
Organ Level: Treatment aims to reduce oedema and ascites and improve cardiac function.
Patient Level: The treatment objective is to increase patients' quality and quantity of survival time and to slow, halt or reverse the disease progression.
Client level: The goal of treatment is to offer a value-for-money increase in beneficial quality-adjusted life years (QALYs) to clients with rabbits experiencing MMVD.
Treatment End Point
The duration of treatment is -
Therapeutic Monitoring
Renal function, hydration status and serum electrolytes status should be monitored (Serum electrolytes, BUN, creatinine, SDMA +/- glucose if diabetic):
When treatment is commenced
24-48h post commencement
24-48h post-dose adjustment
If adverse events occur.
Additionally, patients will benefit from regular physical assessments covering. Heart rate and quality, respiratory rate and effort (resting and sleeping), blood pressure, signs associated with oedema, thirst, urine output and weight.
Alternative Products
Other Diuretics
Alternative Protocols
VCI recommends extrapolation of the principles within the ACVIM protocols for cardiac failure.
UK Formulations
Injection: 50 mg/ml Solution for Injection
Tablets: 10 mg, 20 mg, 40 mg tablets
Oral Liquids: 20 mg/5 ml Oral Solution and 10mg/ml Oral Solution