Heart disease in dogs
Leaky heart valves in small older dogs and weak heart muscle in large breeds are the common forms of canine heart disease. Treatment delays and then manages heart failure with pimobendan, a diuretic and an ACE inhibitor, with other drugs for rhythm problems. Pimobendan is veterinary-only; the rest are human generics a pharmacy fills.
What it is
Myxomatous mitral valve disease, a slowly leaking valve, affects many small-breed dogs as they age and is heard as a murmur years before any sign. Dilated cardiomyopathy, a weakening and enlargement of the heart muscle, affects large breeds and has been linked in some dogs to certain diets. Both progress towards heart failure: coughing, breathlessness, exercise intolerance, fainting and a swollen belly.
Diagnosis is by examination, chest X-rays, an echocardiogram and sometimes blood tests, and the disease is staged. Treatment starts before failure in dogs with an enlarged heart, because starting pimobendan at that point has been shown to delay the onset of failure, and then escalates. Owners learn to count the sleeping breathing rate at home, which is the earliest sign of fluid in the lungs.
How it is treated
Pimobendan (Vetmedin) strengthens the heart’s contraction and widens blood vessels and is the cornerstone from the enlarged-heart stage onward; it is a veterinary product with no human equivalent. Furosemide, or torsemide when furosemide is not enough, removes fluid from the lungs in heart failure and is adjusted against the breathing rate. An ACE inhibitor, enalapril or benazepril, reduces the heart’s workload. Spironolactone is added in some dogs. All but pimobendan are cheap human generics.
Atrial fibrillation and other rhythm problems are treated with diltiazem, digoxin, sotalol or amiodarone, chosen by the cardiologist. Dogs with dilated cardiomyopathy on certain diets are switched to a different food and may be given taurine or L-carnitine. Cats with heart disease are treated with some of the same drugs plus clopidogrel to prevent clots.
What an owner pays cash for
A dog in heart failure is typically on pimobendan, furosemide and an ACE inhibitor every day, sometimes with spironolactone and a rhythm drug, plus periodic X-rays, echocardiograms and blood tests. Pimobendan is the expensive item and is bought from the vet or a pharmacy that stocks veterinary products; generic pimobendan has begun to appear and a prescription allowing substitution matters. Furosemide, enalapril, benazepril, spironolactone and diltiazem cost pharmacies pennies, so a flat-price pharmacy on ninety-day fills makes them almost incidental, though doses change often in heart failure.
The medicines, one guide each
- Pimobendan (Vetmedin)Vet-only
Pimobendan is the cornerstone drug for dogs with heart disease from a leaking mitral valve or dilated cardiomyopathy, started when the heart enlarges and continued through heart failure. It is a veterinary-only product with no human equivalent, and generic versions have started to appear.
- FurosemidePharmacy can fill
Furosemide is the diuretic that keeps fluid out of the lungs in dogs and cats with heart failure, and it is used for other fluid build-up. Veterinary versions are approved, and the human generic is the same drug; it is one of the cheapest tablets a pharmacy stocks.
- Benazepril and enalaprilPharmacy can fill
Benazepril and enalapril are ACE inhibitors used in dogs with heart failure and in dogs and cats with kidney disease and protein loss in the urine. Veterinary versions exist, but the human generics are the same drugs and are what most pharmacies dispense on a vet’s prescription.
Questions for your vet
- What stage is the disease, and should pimobendan start now?
- What sleeping breathing rate should I count, and what rate means I should call?
- Can the human-generic medicines be written for a pharmacy to fill on ninety-day prescriptions?
- Is a generic pimobendan available, and can the prescription allow it?
- Is my dog’s diet a factor, and should it change?
How Script Unlock gets you a cash price for your pet’s prescription
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Sources
- Merck Veterinary Manual
- FDA Approved Animal Drug Products (Green Book)
- FDA Center for Veterinary Medicine
- American Veterinary Medical Association
Written by the Script Unlock editorial team from the sources above. Not yet reviewed by a veterinarian. Last checked 2026-10-03. Your vet\u2019s diagnosis and plan come first; nothing here replaces them.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.