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Enalapril is a prescription ACE inhibitor that veterinarians use for selected dogs with congestive heart failure, high blood pressure, or proteinuria associated with kidney disease. The dose and monitoring plan depend on the dog’s diagnosis, kidney function, hydration, blood pressure, potassium, and other medications.
Do not calculate a tablet dose from an online chart or give your dog human enalapril without veterinary instructions.
What is enalapril used for in dogs?
Congestive heart failure
Enalapril may be used as part of combination treatment for congestive heart failure associated with conditions such as myxomatous mitral valve disease or dilated cardiomyopathy. It is usually an adjunct to other medicines when needed, such as furosemide or torsemide, pimobendan, spironolactone, digoxin, or an antiarrhythmic.
Enalapril is not a treatment for every heart murmur. A murmur or an enlarged heart does not automatically mean that a dog needs an ACE inhibitor. There is no proof that ACE inhibitors delay the onset of congestive heart failure in dogs with subclinical heart disease, according to the Merck Veterinary Manual.
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High blood pressure
Enalapril may be prescribed for canine hypertension, sometimes alongside another blood-pressure medicine. Its effect on the arteries is modest, so it should not be relied on alone for severe hypertension—generally, systolic blood pressure above approximately 160–180 mm Hg, according to the Merck Veterinary Manual.
Proteinuria and kidney disease
Some dogs lose excessive protein through their urine because of kidney disease. Enalapril can reduce urinary protein loss in selected cases. The treatment target and dose depend on urine protein results, kidney values, blood pressure, hydration, and the underlying disease.
Enalapril dosage for dogs
There is no single safe dose for all dogs. Published veterinary references include the following approximate ranges:
| Reason for treatment | Published veterinary range |
|---|---|
| Congestive heart failure | Approximately 0.25–0.5 mg/kg by mouth every 12–24 hours, according to the Merck Veterinary Manual |
| Protein-losing kidney disease | Approximately 0.5–2 mg/kg every 24 hours; some dogs receive divided doses, according to the Merck Veterinary Manual |
| Former U.S. canine product labeling | 0.5–1 mg/kg per day by mouth; Enacard approval was withdrawn in 2024 because the product was no longer manufactured or marketed, not for a safety or effectiveness concern, according to the Federal Register |
These figures are reference ranges, not dosing instructions for your dog. A veterinarian may start at the low end, use a different interval, or reduce the dose because of kidney disease, dehydration, low blood pressure, low sodium, liver disease, or interactions with other medicines. Tablet strengths and liquid concentrations also differ.
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In the United States, a veterinarian may prescribe a human enalapril product extra-label for a dog. The former FDA-approved canine product, Enacard, was voluntarily withdrawn in 2024 for marketing reasons—not because the FDA found it unsafe or ineffective.
How to give enalapril
- Give the prescribed amount by mouth at the interval on the label.
- It can generally be given with or without food. If it causes stomach upset on an empty stomach, ask whether future doses can be given with food.
- Measure a liquid formulation with the supplied oral syringe or another accurately calibrated syringe.
- Keep fresh water available. Dehydration can increase the risk of low blood pressure and kidney injury.
- Do not stop long-term treatment abruptly unless the prescribing veterinarian tells you to.
If you miss a dose, give it when you remember unless it is nearly time for the next one. Skip the missed dose in that situation and resume the usual schedule. Never give two doses together or add an extra dose.
Common side effects
Possible side effects include:
- Reduced appetite
- Vomiting
- Diarrhea
- Tiredness or lethargy
These signs are not always caused by enalapril. Vomiting, poor appetite, lethargy, and breathing changes can also indicate worsening heart failure, kidney disease, dehydration, or an adverse effect from another medicine.
Serious side effects: when to call a veterinarian
Contact your veterinarian promptly if your dog develops persistent vomiting or diarrhea, marked weakness, collapse, fainting, severe dizziness, worsening appetite loss, or signs of kidney trouble. Difficulty breathing or a substantially increased resting breathing rate is an emergency, particularly in a dog being treated for heart disease.
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Potentially serious ACE-inhibitor complications include:
- Hypotension: blood pressure that becomes too low
- Azotemia or acute kidney injury: worsening kidney-related blood results
- Hyperkalemia: excessively high blood potassium
- Syncope: fainting
- Weakness or ataxia: abnormal coordination
Cough is often listed as an ACE-inhibitor side effect because it occurs in people. However, the Merck Veterinary Manual says cough is not a recognized problem in dogs or cats receiving ACE inhibitors. A coughing dog taking enalapril should be assessed for heart failure, airway disease, infection, or another cause rather than automatically blaming the drug.
Monitoring while a dog takes enalapril
Follow-up testing helps determine whether the medicine is helping without putting excessive strain on the kidneys. Depending on the reason for treatment, monitoring may include:
- Blood urea nitrogen (BUN) and creatinine
- Potassium and other electrolytes
- Blood pressure
- Urine protein measurements
- Body weight, appetite, exercise tolerance, and hydration
- Resting breathing rate and breathing effort in dogs with heart failure
The VCA Animal Hospitals enalapril guidance recommends rechecking kidney values, electrolytes, and urine protein about 1–2 weeks after starting treatment, then approximately every three months once the dog is stable. Dogs with kidney disease, dehydration, unstable heart failure, or a recent dose change may need testing sooner or more often.
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Drug interactions and dogs at higher risk
Tell the veterinarian about every prescription drug, over-the-counter medicine, supplement, and salt substitute your dog receives. Important concerns include:
| Medicine or condition | Why it matters |
|---|---|
| NSAIDs, such as some pain relievers | May increase the risk of acute kidney injury, especially if the dog is dehydrated or has impaired kidney function. |
| Potassium supplements or spironolactone | May increase the risk of dangerously high potassium. |
| Diuretics or other vasodilators | May cause blood pressure to fall too far, especially after starting treatment or increasing a diuretic. |
| Dehydration, acute kidney injury, low sodium, liver disease, anesthesia, or kidney disease | May increase adverse-effect risk and require a different dose or closer testing. |
| Pregnancy or nursing | Requires specific veterinary risk assessment. |
Enalapril can be used with medicines such as furosemide and pimobendan when a veterinarian prescribes and monitors the combination. Their use together is not automatically unsafe.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What to do after an accidental overdose
The main overdose concern is excessively low blood pressure. Signs may include weakness, vomiting, pale gums, or an unusually fast heartbeat. Kidney injury and high potassium can also occur. Ingestions above approximately 20 mg/kg are generally concerning, according to the Merck Veterinary Manual, but report any accidental ingestion because risk varies with the dog’s size, kidney status, formulation, and other medicines.
- Call your veterinarian, an emergency veterinary hospital, or an animal poison service immediately.
- Have the medication name, tablet strength or liquid concentration, estimated amount eaten, time of ingestion, and your dog’s weight ready.
- Do not induce vomiting or give activated charcoal unless a veterinary professional specifically instructs you to do so.
- Follow instructions about examination, blood-pressure checks, intravenous fluids, and kidney or electrolyte testing.
Signs can begin within a few hours, and low blood pressure may persist for 12–24 hours; extended-release products can last longer, according to the Merck Veterinary Manual.
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FAQ
Can I give my dog enalapril for a heart murmur?
Not without a veterinarian’s diagnosis and prescription. Enalapril is used for specific conditions and treatment goals; a murmur alone does not establish that it is needed.
Does enalapril cause coughing in dogs?
Cough is not considered a recognized typical ACE-inhibitor side effect in dogs. A new cough should be evaluated for heart failure, airway disease, infection, or another cause.
Can enalapril be given with furosemide or pimobendan?
These medicines may be prescribed together for heart disease, but the combination requires veterinary supervision. Kidney values, hydration, blood pressure, and electrolytes may need monitoring.
What should I do if my dog eats extra enalapril?
Call a veterinarian, emergency veterinary hospital, or animal poison service immediately. Do not induce vomiting or give activated charcoal unless specifically instructed. Weakness, vomiting, pale gums, collapse, or fainting require urgent care.
The Bottom Line
Enalapril can be valuable for selected dogs with heart failure, hypertension, or proteinuria, but its dose is individualized and it is not appropriate for every murmur or kidney problem. Give it exactly as prescribed, avoid unapproved NSAIDs and supplements, keep your dog hydrated, and attend follow-up checks for kidney function, potassium, blood pressure, and urine protein when indicated. Seek urgent veterinary help for collapse, severe weakness, breathing difficulty, or a suspected overdose.
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