The principles of therapy depend on the presentation or current condition of the pet. If symptoms are severe, hospital therapy is necessary. Precise treatments depend on the problems caused but may include: treatment of congestive heart failure, control of an arrhythmia or abnormal heart rhythms, management of kidney failure, treatment of low blood pressure or shock caused by severe heart failure, or treatment of complications of thrombosis (blood clots). Hospital treatment of severe congestive heart failure includes oxygen, the diuretic furosemide (Lasix®), and often nitroglycerin or nitroprusside. If blood pressure is low or heart function very bad, the drug dobutamine, which is a stimulant of heart contraction, is often recommended for 24 to 72 hours. Therapeutic thoracocentesis taps accumulated fluid from the chest cavity to improve breathing, and is the best treatment for a large pleural effusion (fluid around the lungs).
When present, chronic congestive heart failure (CHF) is managed with drug therapy, including a diuretic, pimobendan angiotensin converting enzyme inhibitor, such as enalapril or benazepril ,and digoxin. Beta-blocker drugs such as carvedilol , metoprolol or atenolol is also used to help minimize "cardiotoxic" effects.
The diet is changed to reduce sodium intake.
Nutriceuticals like taurine pills, L-carnitine , and/or Omega-3 fatty acids are recommended in some instances.
In cases of arrhythmogenic dilated cardiomyopathy, drugs that regulate the electrical heart rhythm are indicated. If atrial fibrillation is present, digoxin often combined with either a beta blocker or a calcium channel blocker drug is prescribed.
The dog with "occult" dilated cardiomyopathy is healthy, but has been diagnosed with early DCM by echocardiography. There is evidence that an angiotensin-converting enzyme inhibitor drug can protect the heart muscle from further damage and enlargement. The drugs enalapril (Enacard) and benazepril are the most often used for this purpose. A beta-blocker drug is also effective in preventing further heart muscle damage, but must be chosen and dosed very carefully. See your veterinarian about that.