Top 8 Veterinary Prescription Heart and Blood Pressure Medications for Dogs in Canada - 2025 Veterinary Guide to ACE Inhibitors, Beta-Blockers, Diuretics, Vasodilators & Antiarrhythmics with Dosing, Monitoring and Combination Therapy

Vetmedin (pimobendan) is a market leader in canine cardiac care as a positive inotrope and vasodilator frequently used alongside ACE inhibitors to improve clinical outcomes in congestive heart failure. Although not an ACE inhibitor itself, its clear survival and quality-of-life benefits make it a standard complementary therapy to the ACE products listed here, and its established efficacy can reduce downstream treatment costs by stabilizing patients more quickly. Practically, clinicians favor pairing Vetmedin with ACE inhibitors for a combined pharmacologic strategy rather than as a standalone blood-pressure agent.

Semintra is the market-leading telmisartan oral solution specifically formulated for veterinary use, offering precise, small-volume dosing and validated stability which makes it technically superior for canine cardiovascular applications. Compared with compounded telmisartan or generic ARBs, Semintra delivers consistent potency and regulatory-backed safety data for dogs, reducing monitoring uncertainty and often justifying a higher price by lowering the risk of under- or overdosing. Its single-product formulation can also simplify inventory and prescribing for clinics that prioritize licensed veterinary options over off-label compounded alternatives.

Atenolol 25mg holds a best-in-class position for small-breed dogs because its lower tablet strength enables precise, titratable dosing for chronic management of hypertension and some cardiomyopathies. As a beta-1 selective agent it tends to have less bronchial and central nervous system penetration than non-selective propranolol products, and it is often more cost-effective per milligram for long-term therapy compared with higher-strength tablets that require splitting. Compared with sotalol, it lacks Class III antiarrhythmic effects but offers a simpler safety profile that can reduce monitoring costs in suitable patients.

Lasix is the long-standing market leader for acute and chronic diuretic management in dogs because of its rapid, potent loop diuretic effect and widespread veterinary familiarity; it is especially effective for acute pulmonary edema and congestive heart failure. Compared with other agents on this list it offers the lowest acquisition cost per dose and a predictable IV/oral dosing profile, though it lacks the potassium-sparing and RAAS-modifying properties of spironolactone and the longer duration of torsemide.

Sildenafil 20mg is positioned as the lead pulmonary vasodilator option for dogs because it selectively targets pulmonary arterial pressure and is widely used for pulmonary hypertension cases where systemic vasodilators are less effective. Compared with systemic agents like hydralazine or nitrates, sildenafil’s pulmonary specificity reduces the risk of systemic hypotension and is generally available as a cost-effective generic option, making it the preferred choice when pulmonary vasodilation is the clinical priority.

Diltiazem is a calcium‑channel blocker widely recognized as best‑in‑class for supraventricular tachyarrhythmias and AV nodal rate control in dogs, offering predictable hemodynamic effects and compatibility with other rhythm agents. Compared with amiodarone and sotalol, it is often preferred for atrial‑origin tachyarrhythmias because of a favorable side‑effect profile and cost‑effective generic availability, making it an efficient choice for outpatient management of SVT.

Vetmedin (pimobendan) chewables are widely regarded as the clinical gold standard positive inotrope for canine congestive heart failure, holding a leading position because of extensive clinical trial support and consistent veterinary adoption. Compared with the other products on this list, Vetmedin's technical advantage is its established evidence base and veterinarian familiarity, while its trade-brand pricing can be higher than generics or compounded alternatives.