Aloha! You're speaking to Dr. Michael Salkin That's just what I would do. Always reach for the diuretic first when the respiratory rate exceeds 40 breaths/minute. Thrice daily administration (or higher) is acceptable if needed. Once stabilized, taper down to the lowest effective dose once again. Please note that PLT contains prednisolone (1 mg) as well. I can understand if prednisolone is necessary for treating "Westie lung" but, I agree, it should be avoided when congestive heart failure exists. Please respond with further questions or concerns if you wish.