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Posted: 16th June 2025

RVC confirms benefits of pimobendan for heart disease
Congestive heart failure affects 1 in 28 dogs in England, including King Charles spaniels.
Pimobendan produced positive outcomes for dogs with heart disease.

A study from the Royal Veterinary College, conducted by the VetCompass team, has proved the positive outcomes from treating dogs with heart disease with pimobendan.

A prescription for pimobendan, provided within six months of a grade IV/VI heart murmur, delayed onset congestive heart failure (CHF) and improved survival.

This latest investigation followed RVC’s previous randomised controlled trial (RCT) in 2016. The study, titled the Evaluation of Pimobendan in Cardiomegaly, showed that there were benefits to dogs with preclinical degenerative mitral valve disease (DMVD).

The condition affects 1 in 28 dogs in England. It most commonly affects breeds such as Cavalier King Charles spaniels, King Charles spaniels and whippets.

Since RCTs are challenging to conduct, RVC’s VetCompass team sought to use a new approach to confirm the efficacy of pimobendan.

Instead, the team analysed the anonymised clinical records of dogs which were under first opinion veterinary care in the UK in 2016. Using this data, the researchers conducted an emulated trial, using the records of 928 dogs weighing 15kg or less and aged more than six years of age.

Of these dogs, 178 dogs had been prescribed pimobendan within six months of a diagnosis of a first grade IV murmur diagnosis.

For its analysis, the VetCompass team used complex statistical methods to balance the data of dogs which were prescribed pimobendan against similar dogs which were not.

Statistics revealed the risk of CHF in dogs at five years old to be 38.1 per cent when treated with pimobendan. Dogs which were not prescribed pimobendan had a 56.3 per cent risk of CHF.

Dogs which were prescribed pimobendan also lost 311 fewer days of health within five years.

The study also revealed the impact that pimobendan had on CHF survival rates. Survival at five years was 19.8 per cent when dogs were prescribed pimobendan, but only 9.6 per cent in dogs not prescribed the drug.

RVC hopes that the success of its emulated RCT could inform the future of evidence generation in veterinary research.

Adrian Boswood, professor of veterinary cardiology at the RVC, said: “There is a striking similarity between the results of the EPIC trial and the VetCompass emulated clinical trial. These findings allow us to draw two conclusions; firstly, emulated studies appear feasible using existing data derived from animals seen in primary care practice.

“Secondly, patients with presumed DVMD, with a very audible heart murmur, may benefit from treatment with pimobendan, even if they have not undergone echocardiography.

“This may benefit dogs where it is not possible to follow current treatment guidelines for financial reasons or where access to advanced diagnostic imaging is not available.”

The full study can be found in the journal PLOS One.

Image © Shutterstock



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