Effect of torsemide on serum and urine electrolyte levels in dogs with congestive heart failure
Effect of torsemide on serum and urine electrolyte levels in dogs with congestive heart failure
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DOI：
10.1136/vr.160.24.847
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发表时间：
2007-06-16
影响因子：
2.2
通讯作者：
Montoya-Alonso, J. A.
中科院分区：
文献类型：
--
作者：
Caro-Vadillo, A.;Ynaraja-Ramirez, E.;Montoya-Alonso, J. A.
TORSEMIDE is a loop diuretic of the pyridine-sulfonylurea class. It is one of the most powerful loop diuretics, and clinical trials in human beings have proven its efficacy due to the greater elimination of sodium and water in urine than that provided by furosemide, with a much lower loss of potassium (Dunn and others 1995). Although there are several trials providing evidence of ion excretion by torsemide in human medicine (Goebel 1993, Patterson and others 1994, Stringer and others 1994, Blose and others 1995, Dunn and others 1995, Fowler and Murray 1995, Vargo and others 1995) there have been no reports in the veterinary literature. This short communication describes a study to assess the effect of 28 days’ treatment with torsemide on serum and urine electrolytes in dogs with moderate to severe congestive heart failure (CHF) due to chronic valve disease. Eighteen dogs with CHF secondary to chronic volume overload caused by chronic valve disease, classified as phase 2 to 3 according to the Scandinavian modified New York Heart Association classification (Kvuart and others 2002), were studied by the Cardiology Service of the Faculty of Veterinary Medicine, Complutense University, Madrid; consent was obtained from all the owners. The diagnosis of chronic valvular disease was made based on the dog’s clinical history, complete physical examination, six-lead electro cardiographic study, radiological study and echocardiographic study. Peripheral blood pressure was measured using a non-invasive indirect oscillometric method (Dinamap), and blood and urine analyses, including specific gravity, were performed in order to rule out dogs with disease other than CHF. The dogs had not received any other treatment for heart failure within two months before entering the trial. Patients with signs of other systemic disease were excluded. The dogs were randomly assigned to a treatment group or a control group, and all dogs were also treated with 0· 2 mg/kg angiotensin converting enzyme (ACE) inhibitor, perindopril (Coversyl; Sevier) orally once a day, for the duration of the study. In the treatment group (10 dogs), 0· 2 mg/kg torsemide (Sutril; Ferrer grupo) was administered orally, in one daily morning dose. The control group comprised eight dogs that received perindopril alone. Only one of the investigators was aware of which animals were in which group. All the dogs were fed three times a day with a commercial low-sodium diet (k/d; Hill’s) according to the manufacturer’s instructions, taking into account the bodyweight of each dog; water was given ad libitum.Blood samples and urine samples for ion measurement were taken from all the dogs on day 0 and on day 28 at the end of the study period. The blood samples were taken from the jugular vein and the urine samples were obtained using a bladder catheter. The last blood and urine samples were collected between two and four hours after oral ingestion of the medicines. The levels of sodium, potassium and chloride ions were determined using an ion analyser (Krone Microlyte), the level of calcium was determined by a cresolftaleina-complexona method using a kit (Calcio-Boehringer Mannheim), the level of phosphorus was determined using the molibdato test for ultraviolet (Boehringer Mannheim) and the level of magnesium was determined by colorimetric assessment without deproteinisation using a kit (bioMérieux). The excretion fraction was calculated to determine the concentration of ions in the urine.
