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Nor are we aware of any peer-reviewed veterinary journal articles proposing treating MVD dogs only in Stage B1 with pimobendan

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If symptoms persist despite these measures, healthcare providers may consider slower dose titration schedules, temporary dose reductions, or prescribing anti-nausea medications for short-term relief

Serious side effects requiring immediate medical attention include: Allergic reaction: rash, hives, swelling of face, tongue, or lips, trouble breathing Liver damage: signs include dark urine, fatigue, upset stomach, stomach pain, yellowing of skin or eyes Excessive acetaminophen can lead to lifethreatening liver failure