RVC hails new pimobendan study as ‘game-changer’ for heart disease

A medication used to manage canine heart disease could help to make treatment more accessible to pet owners than it is now, a leading veterinary cardiologist has suggested.

A new study has both supported the findings from earlier analyses of pimobendan and suggested it could be used earlier to help delay the onset of congestive heart failure (CHF).

RVC researchers have described the latest findings as a “game-changer”, while a leading canine charity said it hoped they would enable “more informed” treatment decisions.

The latest study, published in the PLOS One journal, used clinical records of 928 dogs held within the VetCompass scheme to replicate the EPIC trial of pimobendan, whose results were published nearly a decade ago.

Grade IV murmur

Almost one in five (178; 19.2%) were prescribed pimobendan within six months of a grade IV heart murmur being diagnosed, while the remainder were not.

Following statistical adjustments for factors including age, breed, chronic co-morbidities and diagnostic tests, the study found the risk of CHF at five years was reduced to 34.6% among the pimobendan group from 56.3% in the group that had not been prescribed the drug.

Dogs that received the drug were also found to live longer, with a mean survival time of 1,051 days against 905 days for those that did not receive it, compared to 1,059 days and 902 days respectively in the EPIC trial.

‘Striking similarity’

Adrian Boswood, RVC professor of veterinary cardiology who led the EPIC trial and co-authored the new study, said there was “a striking similarity” between their results.

But he also suggested the findings could encourage vets to use pimobendan for dogs which are presumed to have degenerative mitral valve disease (DMVD) and have an audible murmur without undergoing echocardiography first.

He said: “This may benefit dogs where it is not possible to follow current treatment guidelines for financial reasons or where access to advanced diagnostic imaging is not available.”

A similarly optimistic tone was struck by Jane Murray, deputy head of research for Dogs Trust, who said she was “delighted” by the findings.

Informed decisions

She added: “The information provided by these results allow vets and owners to make more informed decisions about how and when to medicate dogs with heart disease, improving life expectancy and quality of life.”

But the researchers are also encouraged that the study highlights the potential of a research technique known as target trial emulation that is made possible through programmes like VetCompass.

Co-authors Camilla Pegram and Dan O’Neill said: “This study showcases how target trial emulation within VetCompass can generate robust, clinically meaningful evidence, particularly in situations where randomised controlled trials may not be feasible.

“By successfully reproducing the outcomes of the EPIC trial using real-world data, we demonstrate not only the reliability of this method but also its potential to inform clinical decision-making in veterinary practice. The dream of harnessing the cumulative clinical experiences of first opinion veterinary professionals to answer research questions that really matter to first opinion care has now become even more of a reality.

“This study is a game-changer for what future questions can be asked and answered using VetCompass.”