Traditional and nontraditional effective and noneffective therapies for cardiac disease in dogs and cats.

In this article, I presented my (admittedly biased) perspective of the current state of knowledge addressing the role of traditional and non-traditional therapeutics. The focus has been on the nontraditional therapeutics. Among these, the only ones I currently consider to have any documented value are taurine and, less commonly, L-carnitine. The role of taurine (and likely carnitine) remains limited to cases of documented deficiency. In the case of cats with taurine deficiency-induced myocardial failure, it is now clear that most cases are the result of formulation errors by owners and manufacturers. In dogs, it is less clear if the causes of taurine deficiencies represent manifestations of pathologic conditions or dietary formulations errors. Increasingly, it seems the latter may prove to be the case in most, if not all, circumstances. Finally, I would like to reiterate the conclusions of the last time I addressed this topic (with coauthors Kittleson and Sanderson) in this publication. Remember that there is limited evidence to support the therapeutic recommendations you read or hear in most circumstances. The urge to do "something" for patients can be overwhelmingly attractive. Nevertheless, whether it is administration of drugs or prescribing nutraceuticals or prescription diets, strongly consider the source of the information urging you to prescribe, the strength of the evidence presented, the financial costs to the owner, and the potential risks and benefits to the patient.