03 Jul Entresto for Dogs: A Promising New Option for Heart Disease
Heart disease is one of the most common health conditions we manage in aging dogs. Among the most frequent causes is myxomatous mitral valve disease (MMVD), which gradually weakens one of the heart valves and can lead to congestive heart failure. Traditional treatments like pimobendan, diuretics, and ACE inhibitors have long formed the foundation of care for dogs with heart disease. But as veterinary medicine advances, new options are emerging that may improve both quality and length of life. One of these is Entresto.
What Is Entresto?
Entresto is the brand name for a combination of two medications—sacubitril and valsartan—that work together to reduce the strain on the heart. Sacubitril enhances the body’s natural ability to relax blood vessels and reduce fluid buildup, while valsartan helps block the effects of hormones that contribute to high blood pressure and heart damage. This drug has been a game-changer in human cardiology, especially for patients with heart failure, and its use is now being explored in veterinary medicine.
Why Use Entresto in Dogs?
Dogs with MMVD experience progressive heart changes over time. As the valve becomes more leaky, the heart must work harder to keep up with normal circulation. Entresto works in a unique way to help reduce this burden. While it’s not yet FDA-approved for veterinary use, early research and clinical experience suggest that Entresto may help slow the progression of disease, reduce heart size, and improve quality of life, especially when standard therapies are no longer enough.
How Is It Used?
At our clinic, Entresto is reserved for specific patients who may benefit from additional support beyond conventional therapy. We typically start at a dose of 5 mg/kg by mouth twice daily, and increase gradually to a full dose of 10 mg/kg twice daily if tolerated. Dogs on Entresto are monitored closely for blood pressure, kidney function, and electrolytes, just like with other heart medications. So far, we’ve had success using Entresto in a handful of carefully selected patients, and the improvements have been encouraging.
What Does the Research Say?
While still considered investigational in dogs, Entresto is being studied more actively in veterinary cardiology. These are the key publications available so far:
- A 2021 pilot study in dogs with stage C MMVD showed significant improvement in heart size and function when Entresto was added to conventional treatment.
Study Link – Frontiers in Veterinary Science - A double-blind placebo-controlled trial in dogs with stage B2 MMVD found that Entresto was safe and effectively reduced hormone levels involved in heart disease progression.
Study Link – Journal of Veterinary Internal Medicine (2018) - A 2024 study in healthy dogs suggested that Entresto may also improve kidney blood flow, which could offer additional benefits in patients with kidney compromise.
Study Link – International Journal of Molecular Sciences (2024)
Is Entresto Safe for Dogs?
In the limited veterinary studies published so far, Entresto has been well tolerated in dogs, with no serious side effects noted. Still, like any medication, it should be used under close supervision by a veterinarian familiar with your dog’s heart condition. Dogs receiving Entresto require periodic rechecks to monitor kidney values, blood pressure, and response to therapy.
Final Thoughts
Entresto is not the right medication for every dog with heart disease, but in certain cases, it may offer a new layer of support for the heart when traditional medications are no longer keeping up. We are cautiously optimistic about its role in canine cardiology, and as more research becomes available, we expect to learn even more about which patients benefit most.
If your dog has been diagnosed with mitral valve disease or congestive heart failure and you’re interested in exploring whether Entresto may be appropriate, please don’t hesitate to reach out. We’re happy to discuss this emerging option and determine what’s best for your dog’s individual needs.
Images used under creative commons license – commercial use (07/03/2025) Image by Radovan Zierik from Pixabay