DOI
https://doi.org/10.18849/ve.v5i4.300Abstract
PICO question
In dogs with congestive heart failure, does the use of torasemide as a first line diuretic result in a superior survival time when compared to furosemide?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Five studies were critically appraised, they were all prospective randomised controlled trials
Strength of evidence
Moderate
Outcomes reported
There is currently a lack of studies looking at comparing furosemide directly with torasemide in patients with congestive heart failure. There are many similarly drawn conclusions from the studies: torasemide is not inferior to furosemide in the treatment of CHF, torasemide is comparable to furosemide at one tenth the dose (or less) and that torasemide may be more effective at diuresis than furosemide with a prolonged duration of action
Conclusion
There is currently no clear and obvious benefit for the use of torasemide, over furosemide, as a first line diuretic for dogs with congestive heart failure
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Chetboul, V., Pouchelon, J.L., Menard, J., Blanc, J., Desquilbet, L., Petit, A., Rougier, S., Lucats, L., and Woehrle, F. (2017). Short-Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study. Journal of Veterinary Internal Medicine, 31(6): 1629–1642. DOI: https://doi.org/10.1111/jvim.14841
Cosín, J. & Díez, J. TORIC investigators (2002) Torasemide in chronic heart failure: results of the TORIC study. European Journal of Heart Failure, 4(4): 507–13.
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Peddle, G.D., Singletary, G.E., Reynolds, C.A., Trafny, D.J., MacHen, M.C., and Oyama, M.A. (2012). Effect of torsemide and furosemide on clinical, laboratory, radiographic and quality of life variables in dogs with heart failure secondary to mitral valve disease. Journal of Veterinary Cardiology, 14(1): 253–259. DOI: https://doi.org/10.1016/j.jvc.2012.01.003
Potter, B.M., Ames, M.K., Hess, A., and Poglitsch, M. (2019). Comparison between the effects of torsemide and furosemide on the renin-angiotensin-aldosterone system of normal dogs. Journal of Veterinary Cardiology, 26: 51–62. DOI: https://doi.org/10.1016/j.jvc.2019.11.003
Uechi, M., Matsuoka, M., Kuwajima, E., Kaneko, T., Yamashita, K., Fukushima, U., and Ishikawa, Y. (2003). The effects of the loop diuretics furosemide and torasemide on diuresis on dogs and cats. Journal of Veterinary Medical Science, 65(10): 1057–1061. DOI: https://doi.org/10.1292/jvms.65.1057
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