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

  • Leo Packham

Published:

2020-11-04

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DOI

https://doi.org/10.18849/ve.v5i4.300

Abstract

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

Treatment

The number and type of study designs reviewed

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

Strength of evidence

Moderate

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

Conclusion

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

References

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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: https://doi.org/10.2460/javma.2005.226.1864

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: https://doi.org/10.2460/ajvr.68.10.1058

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: https://doi.org/10.1016/j.jvc.2011.10.001

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: https://doi.org/10.1016/j.jvc.2012.01.003

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: https://doi.org/10.1016/j.jvc.2019.11.003

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: https://doi.org/10.1292/jvms.65.1057

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  /