The EPIC (Evaluation of Pimobendan In dogs with Cardiomegaly caused by preclinical mitral valve disease) Trial results have been published and look to propose new recommendations for dogs with heart enlargement secondary to degenerative valve disease that have not yet developed congestive heart failure (Stage B2 dogs).1 To date, this represents the largest (360 dogs) prospective, randomized, placebo-controlled, blinded cardiovascular study in veterinary medicine.
Results demonstrated that pimobendan delayed the development of a primary cardiac endpoint (mostly congestive heart failure, but also euthanasia or death due to heart disease) by approximately 15 months. The risk of heart disease related complications was reduced in the pimobendan group by approximately 1/3 that of the placebo group. Furthermore, pimobendan was well tolerated and found to be safe when given chronically.
It is important to note that these conclusions are only relatable to dogs similar to those in the study population, which were proven to have degenerative heart valve disease and met specific echocardiographic and radiographic thresholds for heart enlargement. The singular presence of a heart murmur would be insufficient to warrant pimobendan, and complete cardiac evaluation with echocardiography would be recommended to determine if all criteria are met to indicate initiation of pimobendan.
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