7 ACE Inhibitors for Dogs Recommended by Veterinarians — Types and Selection Criteria

HeartTop PicksMeongsiljang Veterinary Advisory Board

We’ve compared and analyzed three recommended ACE inhibitor products to help you choose the right one for managing your dog’s heart disease. Always use these medications under veterinary guidance to ensure safety.

What Is ACE Inhibitor Heart Care for Dogs?

A medical illustration showing the structure of a dog's heart and the flow of blood through it.

ACE inhibitors are a cornerstone of heart care for dogs, used to manage conditions such as heart failure and hypertension. These medications work by blocking the production of angiotensin II, which helps dilate blood vessels and reduce plasma volume, making it easier for the heart to pump blood. They are commonly prescribed by veterinarians for chronic heart failure, dilated cardiomyopathy, and chronic valvular insufficiency. However, potential side effects include hypotension, gastrointestinal upset, elevated kidney values (azotemia), and hyperkalemia, so regular check-ups and monitoring are essential during treatment. ACE inhibitors: A class of medications effective in dilating blood vessels and reducing cardiac workload through their mechanism of action.

Criteria for Choosing an ACE Inhibitor for Dogs

When selecting an ACE inhibitor for your dog, it’s important to carefully consider factors such as the drug’s stability, risk of side effects, and ease of administration. Your veterinarian will determine the appropriate dosage based on your dog’s weight and overall health. The medication’s absorption rate and duration of action are also key considerations, and you should monitor your dog’s response depending on the formulation—whether capsule, powder, or liquid. Additionally, always check for potential interactions with other medications. In particular, combining ACE inhibitors with potassium-sparing diuretics or ARBs can increase the risk of hyperkalemia and place additional strain on the kidneys. - Ease of Administration: Powder or liquid forms are often more convenient for small dogs or those that have difficulty swallowing pills. - Side Effect Management: Watch for possible side effects such as low blood pressure, gastrointestinal issues (vomiting, loss of appetite), elevated kidney values, and hyperkalemia.

A veterinarian showing ACE inhibitors in capsule, liquid, and powder forms.

BEST 1: Benazepril Capsule

Benazepril capsules are an effective ACE inhibitor for heart function decline and high blood pressure, with veterinarians prescribing 0.5mg/kg every 12 to 24 hours based on weight. The capsule form makes administration easy, and it can be taken regardless of meals. Its effects are sustained, and it shows relatively few side effects, making it stable for long-term use. It is often used as a key medication in cases of heart failure. - Highly Stable Medication: With proven effectiveness and safety in clinical settings over a long period, it is highly reliable. - Convenient Administration: Capsules are easy to store and administer, making them convenient for pet owners to manage.

Product image of Benazepril 10mg capsules

BEST 2: Enalapril Powder

Enalapril powder is a convenient form that allows for easy dosage adjustment, making it ideal for small dogs or cases where administering medication is challenging. The recommended dose is 0.5 mg/kg, given once or twice daily at 12- to 24-hour intervals. It can be easily mixed with water or food for convenient administration. It also provides stable therapeutic effects even in cases of heart valve abnormalities. This form is particularly advantageous when precise dosage adjustments are needed. - Easy dosage adjustment: Accurate dosing is possible even with small amounts. - Independent of meals: Can be administered regardless of whether the dog has eaten.

Image of the enalapril powder product and measuring spoon

BEST 3: Telmisartan Liquid

Telmisartan belongs to the angiotensin receptor blocker (ARB) class, not the ACE inhibitor class. It works by directly blocking the action of angiotensin II, which causes blood vessels to constrict, thereby dilating blood vessels and lowering blood pressure. While its goal of suppressing the RAAS is similar to that of ACE inhibitors, its mechanism of action is different. The usual dosage is 1 mg/kg once daily. It comes in a liquid form, making it very easy to administer, and it can be given regardless of meals. It is particularly useful for managing kidney disease accompanied by proteinuria or hypertension. - Advantages of liquid form: Dosage adjustment is easy, and it is suitable for small dogs or cases where administration is difficult. - Characteristics of ARB class: Telmisartan has been reported to have a greater effect on reducing proteinuria compared to ACE inhibitors, making it beneficial for kidney protection.

Comparison Table of BEST 1–3 ACE Inhibitors for Dogs

Item	Form	Daily Dosage	Key Advantages
Benazepril capsule	Capsule	0.5mg/kg	12–24 hour intervals, convenient to administer
Enalapril powder	Powder	0.5mg/kg	Easy dosage adjustment, can be mixed with food
Telmisartan liquid	Liquid	1mg/kg	Drop form, easy to administer, stable for long-term use

The veterinarian determines the dosage according to body weight and condition. A check-up must be received before administration.

Precautions and Contraindications

ACE inhibitors for dogs should be used with caution in cases of dehydration or hypotension. If kidney values (azotemia) rise, reduce the diuretic dose first, then decrease or discontinue the ACE inhibitor if necessary. If dizziness due to low blood pressure, gastrointestinal symptoms such as vomiting or loss of appetite, or coughing occur during treatment, consult your veterinarian immediately. However, coughing may be a sign of progressing heart disease rather than a common side effect of the medication itself. Additionally, interactions such as hyperkalemia can occur when combined with other medications like potassium-sparing diuretics, so please inform us of all medications your dog is currently taking. Regular blood and kidney function tests are necessary to monitor for side effects.

Usage Tips and Management Points

- Regular administration: Consistent dosing at regular intervals is essential to maintain the medication’s effectiveness. - Dosing log: Keeping a record of each dose makes consultations with your veterinarian much easier. - Feeding considerations: The medication can be given with or without food, but administering it with a meal helps reduce stomach irritation. - Monitoring for side effects: If you notice symptoms such as coughing, vomiting, or decreased appetite, please visit the clinic immediately. - Check-up schedule: Schedule blood tests and cardiac ultrasounds every three months.

Puppy medication log and veterinary check-up schedule

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

When should ACE inhibitors be started?

The timing of when to start medication varies depending on the condition. For symptomatic heart failure, ACE inhibitors are a standard part of treatment. However, in the preclinical stage of valvular disease where no symptoms are present, there is currently no clear evidence that ACE inhibitors delay the onset of heart failure. Therefore, your veterinarian will determine the appropriate time to begin treatment based on the results of diagnostic tests.

My pet is coughing while taking the medication. Is this normal?

In dogs, coughing is more likely a sign that heart disease is progressing rather than a common side effect of ACE inhibitors themselves. Known side effects of ACE inhibitors include low blood pressure, gastrointestinal upset, elevated kidney values, and high potassium levels. If the cough persists, consult your veterinarian to determine the underlying cause.

Can it be taken with meals?

It can be taken with or without food, but it's best to give it after meals to minimize stomach irritation.

Will heart problems return if I stop the medication?

Stopping the medication can increase the burden on the heart. Do not discontinue the medication without your veterinarian's instructions.

My pet won’t take its medication. What should I do?

You can mix the medication with food or open the capsule and mix the powder in. Your veterinarian can provide guidance on how to administer it.

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References

[1] Handbook of Veterinary Pharmacology (2023). Chapter 3: Drugs Used in Heart Failure Therapy.

[2] Textbook of Cardiovascular Medicine in Dogs and Cats (2021). Section on ACE Inhibitors in Canine Heart Disease.

[3] Plumb's Veterinary Drug Handbook, 10th Edition (2022). ACE Inhibitors: Clinical Use and Dosing in Dogs.