5. Coughing in the 15-year-old dog

If heart disease is diagnosed, the owner has to give the medicine diligently if she wants her beloved old dog to live long. Otherwise, the coughing recurs and the dog dies from heart failure.

Effective dosage is the key to success. This is done by observation of no coughing with minimal dosage and regular timing of medication. You cannot just forget one day or two.

An example of effective dosage is this 15-year-old dog.
Every 2 weeks, the lady would come for the medication which is:

Body weight 19 kg.
Vetmedin 5mg x 14 (1/2 twice a day)
Fortekor 20mg x7 (1/2 once a day)
Fursemide 40mg  x28 (1 twice a day).

The dog is active and she is so happy.

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Treatment
1. Vetmedin. Congestive heart failure originating from valvular insufficiency or dilated cardiomyopathy in dogs.
2. Fortekor. Heart failure due to mitral regurgitation (endocardiosis) and dilated cardiomyopathy and chronic kidney disease in dog.
 Frusemide 1-4mg/kg orally to clear fluid from the lungs as a diuretic


Calculated dosage
1.  Vetmedin    0.2 to 0.6 mg/kg/day (half dose in morning and the other half 12 hours later).
In this 19 kg dog, the dosage should be 3.8 mg to 11.4 mg/ divided in 50% 2 x /day 

2. Fortekor  0.25 - 0.5 mg/kg once daily with or without food.
In this 19 kg dog, the dosage should be 4.75mg - 9.5mg once a day.

3. Frusemide 1-4mg/kg orally to clear fluid from the body as a diuretic
In this 19 kg dog, the dosage should be 19 mg - 76 mg once a day.


Effective dosage in this 19kg dog after 2 months of trial and error:

Body weight 19 kg.
Vetmedin 5mg x 14 (1/2 twice a day)  ie. 5 mg divided into 50% of 2 doses 2x/day
Fortekor 20mg x7 (1/2 once a day) ie. 10 mg/once/day
Fursemide 40mg  x28 (1 twice a day). 40 mg 2x/day


CASE 2
There is another old coughing Chihuahua with congestive heart failure and abandoned by his owner who went to Thailand and now adopted by a young couple, doing well with the above-mentioned drugs for several months. Able to eat and no coughing. Once the drugs are not given, coughing recurs.  Some cases may need injections to stabilise. Coughing affects the caring owner as the nocturnal cough can be quite stressful for the dog and owner.