Felis ISSN 2398-2950

Therapeutics: diuretics

Synonym(s): Potassium sparing; loop diuretic; aldosterone antagonist

Contributor(s): Jonathon Elliot, Linda Horspool, Lauren Trepanier, Liz Bode

Introduction

  • Different types of diuretics act in different parts of the nephron and can, therefore, have various effects on electrolyte and acid-base balance as well as water loss.  
  • Diuretics are often used to treat congestive heart failure.  
  • They can be used in combination in congestive heart failure to provide sequential nephron blockade. 
  • Tolerance, especially to furosemide, can develop at higher doses.  
  • Renal and electrolyte parameters should be monitored with long term diuretic use. 

Furosemide

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Torasemide

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Mannitol

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Carbonic anhydrase inhibitors

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Spironolactone

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Thiazide diuretics

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • James R, Guillot E, Garelli-Paar C et al (2018) The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. J Vet Cardiol 20 (1), 1-12 PubMed.
  • Hofmeister E H, Brainard B M, Egger C M et al (2009) Prognostic indicators for dogs and cats with cardiopulmonary arrest treated by cardiopulmonary cerebral resuscitation at a university teaching hospital. JAVMA 235 (1), 50-57 PubMed.
  • Hezel A, Bartges J W, Kirk C A et al (2007) Influence of hydrochlorothiazide on urinary calcium oxalate relative supersaturation in healthy young adult female domestic shorthaired cats. Vet Ther (4), 247-254 PubMed.
  • Plummer C E, MacKay E O, Gelatt K N (2006) Comparison of the effects of topical administration of a fixed combination of dorzolamide-timolol to monotherapy with timolol or dorzolamide on IOP, pupil size, and heart rate in glaucomatous dogs. Vet Ophthalmol (4), 245-249 PubMed.
  • Ash R A, Harvey A M, Tasker S (2005) Primary hyperaldosteronism in the cat: a series of 13 cases. J Feline Med Surg (3), 173-182 PubMed.
  • Palmieri E A, Biondi B & Fazio S (2002) Aldosterone receptor blockade in the management of heart failure. Heart Fail Rev (2), 205-219 PubMed.
  • Gelatt K N & MacKay E O (2001) Changes in intraocular pressure associated with topical dorzolamide and oral methazolamide in glaucomatous dogs. Vet Ophthalmol (1), 61-67 PubMed.
  • Pitt B, Zannad F, Remme W J et al (1999) The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.​ N Eng J Med 341 (10), 709-717 PubMed.

Other sources of information

  • Kochevar D (2009) Diuretics. In: Riviere J E, Papich M G Veterinary Pharmacology and Therapeutics. 9th edition Chichester, Wiley-Blackwell, pp 647-670.
  • Bonagura J D, Lehmkuhl L B & de Morais H A (2002) Fluid and diuretic therapy in heart failure. In: DiBartola  SP,  Fluid Therapy in Small Animal Practice. 2nd edition, Philadelphia: WB Saunders, pp 387-409.
  • Jackson E K (1996) Diuretics. In: Hardman JG, Limbard LE,  Goodman & Gilmans The Pharmacologic Basis of Therapeutics 9th edition, New York: McGraw Hill, pp 685-713.


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