In dogs with congestive heart failure, is torasemide superior to furosemide as a first line diuretic treatment?

  • Leo Packham



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PICO question

In dogs with congestive heart failure, does the use of torasemide as a first line diuretic result in a superior survival time when compared to furosemide?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

Five studies were critically appraised, they were all prospective randomised controlled trials

Strength of evidence


Outcomes reported

There is currently a lack of studies looking at comparing furosemide directly with torasemide in patients with congestive heart failure. There are many similarly drawn conclusions from the studies: torasemide is not inferior to furosemide in the treatment of CHF, torasemide is comparable to furosemide at one tenth the dose (or less) and that torasemide may be more effective at diuresis than furosemide with a prolonged duration of action


There is currently no clear and obvious benefit for the use of torasemide, over furosemide, as a first line diuretic for dogs with congestive heart failure


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Chetboul, V., Pouchelon, J.L., Menard, J., Blanc, J., Desquilbet, L., Petit, A., Rougier, S., Lucats, L., and Woehrle, F. (2017). Short-Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study. Journal of Veterinary Internal Medicine, 31(6): 1629–1642. DOI:

Cosín, J. & Díez, J. TORIC investigators (2002) Torasemide in chronic heart failure: results of the TORIC study. European Journal of Heart Failure, 4(4): 507–13.

Freeman, L. M., Rush, J. E., Farabaugh, A. E. & Must, A. (2005). Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease. Journal of the American Veterinary Medical Association, 226(11), 1864–1868. DOI:

Hori, Y., Takusagawa, F., Ikadai, H., Uechi, M., Hoshi, F., and Higuchi, S. (2007). Effects of oral administration of furosemide and torsemide in healthy dogs. American Journal of Veterinary Research, 68(10): 1058–1063. DOI:

Oyama, M.A., Peddle, G.D., Reynolds, C.A., and Singletary, G.E. (2011). Use of the loop diuretic torsemide in three dogs with advanced heart failure. Journal of Veterinary Cardiology, 13(4): 287–292. DOI:

Peddle, G.D., Singletary, G.E., Reynolds, C.A., Trafny, D.J., MacHen, M.C., and Oyama, M.A. (2012). Effect of torsemide and furosemide on clinical, laboratory, radiographic and quality of life variables in dogs with heart failure secondary to mitral valve disease. Journal of Veterinary Cardiology, 14(1): 253–259. DOI:

Potter, B.M., Ames, M.K., Hess, A., and Poglitsch, M. (2019). Comparison between the effects of torsemide and furosemide on the renin-angiotensin-aldosterone system of normal dogs. Journal of Veterinary Cardiology, 26: 51–62. DOI:

Uechi, M., Matsuoka, M., Kuwajima, E., Kaneko, T., Yamashita, K., Fukushima, U., and Ishikawa, Y. (2003). The effects of the loop diuretics furosemide and torasemide on diuresis on dogs and cats. Journal of Veterinary Medical Science, 65(10): 1057–1061. DOI:

Vol. 5 No. 4 (2020): The fourth issue of 2020

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /