In dogs with congestive heart failure, is torasemide superior to furosemide as a first line diuretic treatment?

• Main Author: Leo Packham
• Format: Article
• Language: English
• Published: RCVS Knowledge 2020-11-01
• Series: Veterinary Evidence
• Subjects: congestive heart failure; cardiovascular disease; diuretics; torasemide; furosemide
• Online Access: https://veterinaryevidence.org/index.php/ve/article/view/300

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.