Geriatric Cardiology in Dogs-Part 2 : Challenge with HF Therapy in Geriatric Dogs : Adverse Drug Reactions and Comorbidities

In geriatric dogs, aging-specific changes in cardiovascular physiology, drug metabolism, drug pharmacokinetics and drug tolerance contribute to adverse drug reactions (ADRs). Comorbidities can also cause polypharmacy and thus drug-drug interactions. Adverse drug reactions for ACE inhibitors, β–blockers, furosemide, aldosterone antagonists and digoxin are common. Geriatric cardiology epitomizes the principle that cardiovascular disease is only 1 component of a larger, multidimensional disease state with concomitant geriatric syndromes. Comorbidities (cardiorenal syndrome, hypertension, diabetes mellitus, atherosclerotic disease, metabolic syndrome, obesity, chronic obstructive pulmonary disease and frailty and cognitive dysfunction) are common, aggravate HF, complicate therapy and increase the total heart failure burden.