Torasemide is shown to be noninferior to furosemide as first line oral (PO) treatment for new onset congestive heart failure (CHF) caused by degenerative mitral valve disease (DMVD) in dogs. It also has the advantage of increased owner compliance (due to once daily dosing) and less than half the risk of cardiac death, euthanasia or worsening CHF compared to furosemide
Journal citation

Besche, B., Blondel, T., Guillot, E. et al (2020)
Efficacy of oral torasemide in dogs with degenerative mitral valve disease and new onset congestive heart failure: The CARPODIEM study
Journal of Veterinary Internal Medicine; 34 (5) 1746-1758
Full text available

Published September 2020

Type of study
  • Double-blinded, randomised, non-inferiority study
  • n = 319 dogs
Key points
  • Objective of the study was to evaluate the efficacy and safety of torasemide compared to furosemide in dogs at first occurrence of CHF caused by DMVD
  • Doses employed in the study were not fixed, but instead, were based on the production of equivalent degrees of diuresis
  • Torasemide was safe but was associated with a significantly higher percentage of dogs experiencing non-serious renal and urinary adverse effects (thought to be related to the higher potency of torasemide)
  • Quality of life improved to a similar extent in each group
  • Torasemide was significantly associated with less than half the risk of cardiac death or euthanasia or worsening CHF as compared to furosemide

Limitations

  • Follow-up time was relatively short
  • Study subjects were recruited and examined by several study veterinarians and diagnostic results were not centrally adjudicated. This may have led to the enrolment of dogs with non DMVD conditions causing signs of respiratory disease however randomisation should have distributed these cases equally
Conclusions
  • Torasemide is non-inferior to furosemide in treating clinical and radiographic signs at first occurrence of CHF caused by DMVD. It has the advantage of increased owner compliance (due to once daily dosing) and less than half the risk of cardiac death, euthanasia or worsening CHF compared to furosemide