Overview of Systemic Pharmacotherapeutics of the Cardiovascular System: Systemic Pharmacotherapeutics of the Cardiovascular System: Merck Veterinary Manual

Pharmacology

Systemic Pharmacotherapeutics of the Cardiovascular System

Overview of Systemic Pharmacotherapeutics of the Cardiovascular System

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Overview of Systemic Pharmacotherapeutics of the Cardiovascular System

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Also see Cardiovascular System Introduction: Principles of Therapy of Cardiovascular Disease and see Heart Disease and Heart Failure: Management and see Fluid Therapy and see Ectoparasiticides: Macrocyclic Lactones (Avermectins and Milbemycins).

see Systemic Pharmacotherapeutics of the Cardiovascular System: Commonly Used Cardiovascular Drugs and Dosagesfor a listing of commonly used cardiovascular drugs and dosages.

Table 1

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Commonly Used Cardiovascular Drugs and Dosages
Drug	Dose
Amrinone	Dog and cat: 1–3 mg/kg, IV, loading dose, then 30–100 μg/kg/min, IV, CRI^a
Amlodipine	Dog: 0.1 mg/kg, PO, sid
	Cat: 0.18 mg/kg, PO, sid (0.625–1.25 mg/cat, PO, sid)
Aspirin, antiplatelet	Dog: 5–10 mg/kg, PO every 24–48 hr
	Cat: 80 mg, PO every 48–72 hr
Atenolol	Dog: 0.25–1 mg/kg, PO, sid-bid, to a maximum dosage of 2–5 mg/kg, PO sid
	Cat: 2–3 mg/kg, PO, bid
Benazepril	Dog: 0.25–0.5 mg/kg, PO, sid
	Cat: 0.5–1 mg/kg, PO, sid
Boldenone undecylenate^b	Horse: 1.1 mg/kg, IM, every 3 wk
Carvedilol	Dog, large breed with dilated cardiomyopathy: starting dose of 3 mg, PO, sid, titrating upward to a maximum of 25–50 mg, PO, divided bid
	Dog, small breed with atrioventricular valvular insufficiency: Starting dose of 0.25 mg/kg, PO, bid, titrating upward to a maximum of 1–1.25 mg/kg, PO bid
Dalteparin	Dog and cat: 100–200 IU/kg, SC, sid-bid
Desmopressin	Dog: 0.4 μg/kg, SC; 1 μg/kg in 20 mL saline, IV over 10 min
Diltiazem	Dog: 0.5–1.5 mg/kg, PO tid
	Cat: 0.5–2.5 mg/kg, PO, tid
Cardizem^® CD	Cat: 10 mg/kg, PO, bid
Dilacor XR^®	Cat: 15–30 mg/kg, PO, sid
Digoxin^c	Dog: 0.0055–0.011 mg/kg, PO, bid; 0.22 mg/m², PO, bid
	Cat: 0.005–0.01 mg/kg, PO, every 24–48 hr
Dobutamine	Dog: 2–20 μg/kg/min, IV, CRI
	Cat: 0.5–10 μg/kg/min, IV, CRI
Dopamine	Dog: 2–15 μg/kg/min, IV, CRI
	Horse: 1–5 μg/kg/min, IV, CRI
Enalapril^d	Dog and cat: 0.5 mg/kg, PO, sid-bid^e
Enoxaparin	Dog and cat: 1–2 mg/kg, SC, bid
Epoetin alfa	Dog and cat, initial: 100 U/kg, SC, 3×/wk
	Dog and cat, maintenance: 75–100 U/kg, SC, 2–3×/wk
Folic acid	Dog: 5 mg, PO, sid
	Cat: 2.5 mg, PO, sid
Heparin, high dose	Dog: 150–250 U/kg, SC, tid
	Cat: 250–375 U/kg, SC, bid
Heparin, low dose	Dog and cat: 75 U/kg, SC, tid
	Horse: 25–100 U/kg, SC, tid
Hydralazine	Dog: 0.5–3 mg/kg, PO, bid
	Cat: 0.5–0.8 mg/kg, PO, bid
Iron (dextrans)^f	Pig, neonate: 100 mg, IM^e
Iron (ferrous sulfate)	Dog: 100–300 mg, PO, sid
	Cat: 50–100 mg, PO, sid
Lidocaine^g	Dog: 1–2 mg/kg, IV; 40–80 μg/kg/min, IV, CRI
Mexiletine	Dog: 4–10 mg/kg, PO, tid
Nandrolone decanoate	Dog: 1–1.5 mg/kg, IM, weekly
	Cat: 1 mg/kg, IM, weekly
	Horse: 1 mg/kg, IM, every 4 wk
Nitroglycerin ointment (1 in. = 15 mg)	Dog: 4–15 mg, topically, tid
	Cat: 2–4 mg, topically, tid
Nitroprusside	Dog: 1–10 μg/kg/min, IV, CRI
Oxymetholone	Dog and cat: 1–5 mg/kg, PO, every 18–24 hr
Phenytoin	Dog: 30–50 mg/kg, PO, tid
Pimobendan^h	Dog: 0.5 mg/kg, PO, daily, divided bid
	Cat: 0.625 mg/kg, PO, sid-bid
Procainamide	Dog: 10–30 mg/kg, PO, qid; 10–40 μg/kg/min, IV, CRI
	Cat: 3–8 mg/kg, PO, tid-qid; 10–20 μg/kg/min, IV, CRI
	Horse: 25–35 mg/kg, PO, tid; 1 mg/kg/min, IV to a maximum of 20 mg/kg
Propranolol	Dog: 0.1–2 mg/kg, PO, tid
	Cat: 2.5–5 mg/cat, PO, tid
Quinidine sulfate	Dog and cat: 4–20 mg/kg, PO, tid-qid
	Horse: 22 mg/kg, PO every 2 hr
Quinidine gluconate	Horse: 1–1.5 mg/kg, IV every 5–10 min
Tocainide	Dog: 15–20 mg/kg, PO, tid
tPA	Cat: 0.25–1 mg/kg/hr, IV (total dose 1–10 mg/kg)
Vitamin B₁₂^f	Dog: 100–200 μg, PO or SC, sid
	Cat: 50–100 μg, PO or SC, sid
Warfarin sodium	Dog and cat: 0.1–0.2 mg/kg, PO, sid
	Horse: 0.067–0.167 mg/kg, PO, sid
^a CRI = continuous rate infusion
^b Approved by FDA for adjunctive therapy in treating debilitated horses.
^c Approved by FDA for initial and chronic treatment of heart failure and supraventricular tachycardia, atrial flutter, and atrial fibrillation in dogs.
^d Approved by FDA for treatment of mild, moderate, or severe heart failure in dogs due to mitral regurgitation and/or reduced ventricular contractility.
^e FDA/CVM approved dosage regimen
^f Several FDA-approved products are available.
^g Several FDA-approved products are available; however, none are specifically approved for control of cardiac arrhythmias.
^h Approved by FDA for management of the signs of mild, moderate, or severe CHF in dogs due to atrioventricular valvular insufficiency or dilated cardiomyopathy.

Commonly Used Cardiovascular Drugs and Dosages

Drug

Dose

Amrinone	Dog and cat: 1–3 mg/kg, IV, loading dose, then 30–100 μg/kg/min, IV, CRI^a
Amlodipine	Dog: 0.1 mg/kg, PO, sid
	Cat: 0.18 mg/kg, PO, sid (0.625–1.25 mg/cat, PO, sid)
Aspirin, antiplatelet	Dog: 5–10 mg/kg, PO every 24–48 hr
	Cat: 80 mg, PO every 48–72 hr
Atenolol	Dog: 0.25–1 mg/kg, PO, sid-bid, to a maximum dosage of 2–5 mg/kg, PO sid
	Cat: 2–3 mg/kg, PO, bid
Benazepril	Dog: 0.25–0.5 mg/kg, PO, sid
	Cat: 0.5–1 mg/kg, PO, sid
Boldenone undecylenate^b	Horse: 1.1 mg/kg, IM, every 3 wk
Carvedilol	Dog, large breed with dilated cardiomyopathy: starting dose of 3 mg, PO, sid, titrating upward to a maximum of 25–50 mg, PO, divided bid
	Dog, small breed with atrioventricular valvular insufficiency: Starting dose of 0.25 mg/kg, PO, bid, titrating upward to a maximum of 1–1.25 mg/kg, PO bid
Dalteparin	Dog and cat: 100–200 IU/kg, SC, sid-bid
Desmopressin	Dog: 0.4 μg/kg, SC; 1 μg/kg in 20 mL saline, IV over 10 min
Diltiazem	Dog: 0.5–1.5 mg/kg, PO tid
	Cat: 0.5–2.5 mg/kg, PO, tid
Cardizem^® CD	Cat: 10 mg/kg, PO, bid
Dilacor XR^®	Cat: 15–30 mg/kg, PO, sid
Digoxin^c	Dog: 0.0055–0.011 mg/kg, PO, bid; 0.22 mg/m², PO, bid
	Cat: 0.005–0.01 mg/kg, PO, every 24–48 hr
Dobutamine	Dog: 2–20 μg/kg/min, IV, CRI
	Cat: 0.5–10 μg/kg/min, IV, CRI
Dopamine	Dog: 2–15 μg/kg/min, IV, CRI
	Horse: 1–5 μg/kg/min, IV, CRI
Enalapril^d	Dog and cat: 0.5 mg/kg, PO, sid-bid^e
Enoxaparin	Dog and cat: 1–2 mg/kg, SC, bid
Epoetin alfa	Dog and cat, initial: 100 U/kg, SC, 3×/wk
	Dog and cat, maintenance: 75–100 U/kg, SC, 2–3×/wk
Folic acid	Dog: 5 mg, PO, sid
	Cat: 2.5 mg, PO, sid
Heparin, high dose	Dog: 150–250 U/kg, SC, tid
	Cat: 250–375 U/kg, SC, bid
Heparin, low dose	Dog and cat: 75 U/kg, SC, tid
	Horse: 25–100 U/kg, SC, tid
Hydralazine	Dog: 0.5–3 mg/kg, PO, bid
	Cat: 0.5–0.8 mg/kg, PO, bid
Iron (dextrans)^f	Pig, neonate: 100 mg, IM^e
Iron (ferrous sulfate)	Dog: 100–300 mg, PO, sid
	Cat: 50–100 mg, PO, sid
Lidocaine^g	Dog: 1–2 mg/kg, IV; 40–80 μg/kg/min, IV, CRI
Mexiletine	Dog: 4–10 mg/kg, PO, tid
Nandrolone decanoate	Dog: 1–1.5 mg/kg, IM, weekly
	Cat: 1 mg/kg, IM, weekly
	Horse: 1 mg/kg, IM, every 4 wk
Nitroglycerin ointment (1 in. = 15 mg)	Dog: 4–15 mg, topically, tid
	Cat: 2–4 mg, topically, tid
Nitroprusside	Dog: 1–10 μg/kg/min, IV, CRI
Oxymetholone	Dog and cat: 1–5 mg/kg, PO, every 18–24 hr
Phenytoin	Dog: 30–50 mg/kg, PO, tid
Pimobendan^h	Dog: 0.5 mg/kg, PO, daily, divided bid
	Cat: 0.625 mg/kg, PO, sid-bid
Procainamide	Dog: 10–30 mg/kg, PO, qid; 10–40 μg/kg/min, IV, CRI
	Cat: 3–8 mg/kg, PO, tid-qid; 10–20 μg/kg/min, IV, CRI
	Horse: 25–35 mg/kg, PO, tid; 1 mg/kg/min, IV to a maximum of 20 mg/kg
Propranolol	Dog: 0.1–2 mg/kg, PO, tid
	Cat: 2.5–5 mg/cat, PO, tid
Quinidine sulfate	Dog and cat: 4–20 mg/kg, PO, tid-qid
	Horse: 22 mg/kg, PO every 2 hr
Quinidine gluconate	Horse: 1–1.5 mg/kg, IV every 5–10 min
Tocainide	Dog: 15–20 mg/kg, PO, tid
tPA	Cat: 0.25–1 mg/kg/hr, IV (total dose 1–10 mg/kg)
Vitamin B₁₂^f	Dog: 100–200 μg, PO or SC, sid
	Cat: 50–100 μg, PO or SC, sid
Warfarin sodium	Dog and cat: 0.1–0.2 mg/kg, PO, sid
	Horse: 0.067–0.167 mg/kg, PO, sid
^a CRI = continuous rate infusion
^b Approved by FDA for adjunctive therapy in treating debilitated horses.
^c Approved by FDA for initial and chronic treatment of heart failure and supraventricular tachycardia, atrial flutter, and atrial fibrillation in dogs.
^d Approved by FDA for treatment of mild, moderate, or severe heart failure in dogs due to mitral regurgitation and/or reduced ventricular contractility.
^e FDA/CVM approved dosage regimen
^f Several FDA-approved products are available.
^g Several FDA-approved products are available; however, none are specifically approved for control of cardiac arrhythmias.
^h Approved by FDA for management of the signs of mild, moderate, or severe CHF in dogs due to atrioventricular valvular insufficiency or dilated cardiomyopathy.

Last full review/revision March 2012 by Mark J. Novotny, DVM, MS, PhD, DACVCP

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