Paper:

RESUMEN CORTO - SHORT SUMMARY

Pimobendan is an inodilator drug, commonly prescribed in veterinary cardiology. Intoxication due to pimobendan overdose is rarely reported, clinical signs vary among reports and there is just one full description of a clinical case.

An 11years-old female spayed crossbreed dog, previously diagnosed in another centre with mixomatous mitral valve disease Stage B2, presented at our hospital between 1-3 hours after having ingested 11 tablets of 5mg of pimobendan resulting in a toxic ingestion of 7,3mg/kg. Clinical signs included tachycardia and hypotension. Echocardiography revealed a pseudohipertrophic phenotype, dynamic right ventricular outflow tract obstruction and impaired relaxation. Electrocardiogram showed increased T wave amplitude (50% of R wave, reference < 25% of R wave). Troponin I (cTnI) was markedly elevated (4.67ng/ml; reference < 0.05ng/ml), indicating important acute myocardial damage. Decontamination was performed by inducing emesis and active charcoal afterwards; fluid therapy was administered in order to correct the hemodynamic status. The dog was hospitalized during 24 hours for monitoring and all the altered findings normalized with the exception of cTnI which remained high, although it decreased to half (2.05ng/ml); therefore, she was discharged with no medication.

On a recheck 7 days later, she was completely fine. A full cardiology evaluation was performed, cTnI normalized (0.08ng/ml) and she was classified as Stage B1.

According to the scarce literature and the present case, pimobendan intoxication seems to have a good prognosis with adequate management.

BIBLIOGRAFÍA

1- Boyle K, Leech E: A review of the pharmacology and clinical uses of pimobendan. J Vet Emerg Crit Care 2012; 22(4): 398-408.

2- Booswood A, Haggstrom J, Gordon S et al.: Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: The EPIC Study—A randomized clinical trial. J Vet Intern Med 2016; 30(6): 1765-1779.

3- Reinker LN, Lee JA, Hovda LR, Rishniw: Clinical signs of cardiovascular effects secondary to suspected pimobendan toxicosis in five dogs. J Am Anim Hosp Assoc 2012; 48:250-255.

4- Tokuruki T, Miyagawa Y, Takemura N: Overdose ingestion of pimobendan in a dog. Adv Anim Cardiol 2015; 48(1): 21-25.

5- Langhorn R, Willesen JL: Cardiac troponin in dogs and cats. J Vet Intern Med 2016; 30: 36-50.

Pimobendan intoxication in a a dog