Prospective clinical trial evaluating spironolactone in Doberman pinschers with congestive heart failure due to dilated cardiomyopathy |
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| Affiliation: | 1. Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire, CH64 7TE, UK;2. Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire, CH64 7TE, UK;1. Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA 24061-0442, USA;2. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA;3. Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, 43126 PR, Italy;4. Department of Clinical Science, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Science, Box 7054, Uppsala, Sweden;5. CVCA Cardiac Care for Pets, 1209 Cromwell Bridge Road, Towson, MD 21286, USA;6. CVCA Cardiac Care for Pets, 165 Fort Evans Road NE, Leesburg, VA 20176, USA;1. Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden;2. Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden;1. Clinica Veterinaria Malpensa, AniCura, Viale Marconi, 27, 21017, Samarate, VA, Italy;2. Ospedale Veterinario I Portoni Rossi, AniCura, Via Roma 57, 40069, Zola Predosa, BO, Italy;3. Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50, 40064, Ozzano Dell''Emilia, BO, Italy;4. Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, 14853, Ithaca, NY, USA |
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| Abstract: | Introduction/objectivesWhether the aldosterone antagonist spironolactone has beneficial survival effects in dogs with dilated cardiomyopathy (DCM) is not known. The primary objective of the study was to evaluate the effect of spironolactone, when added to conventional therapy, on survival time in Doberman pinschers with congestive heart failure (CHF) due to DCM.AnimalsSixty-seven client-owned Doberman pinschers with CHF due to DCM.Materials and methodsThe trial design was prospective, randomized, blinded, and placebo controlled. Dogs were randomized to receive 50–75 mg of spironolactone twice daily (n = 34) or a placebo (n = 33), in addition to standard CHF therapy. Follow-up visits were targeted every one–six weeks until endpoint. Quality-of-life questionnaire and physical examination were performed at every visit, while renal biochemistry, ECG, echocardiography, and thoracic radiography were reassessed as needed. The primary endpoint was time to cardiac death, defined as death or euthanasia from CHF or sudden death.ResultsMedian time to primary endpoint in the spironolactone group (183 days) was not statistically significantly different than that for the placebo group (124 days) (P = 0.254). The development of atrial fibrillation (AF) was significantly less frequent in the spironolactone group (n = 7) than the placebo group (n = 15, P = 0.037).ConclusionsWhile median time to cardiac death in the spironolactone group was not statistically significantly different than that in the placebo group, adding spironolactone to conventional therapy resulted in reduced occurrence of AF. |
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| Keywords: | Cardiology Aldosterone antagonist Mineralocorticoid receptor blocker Canine Survival |
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