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Symptoms and Treatment of Congestive Heart Failure in Dogs

Adrienne is a certified dog trainer and former veterinarian assistant who partners with some of the best veterinarians worldwide.

Congestive heart failure can often go undetected by owners until symptoms worsen. Learn to recognize the signs so that you can catch it early.

Congestive heart failure can often go undetected by owners until symptoms worsen. Learn to recognize the signs so that you can catch it early.

Congestive heart failure in dogs may be considered a silent disease. Because of the heart's ability to compensate even though it's weakened, the disease may go unnoticed for many months and, in some cases, even years. Then, out of the blue, the dog or cat may begin exhibiting worrisome symptoms that will be brought to the attention of the veterinarian.

A normal heart functions very well and is able to provide adequate quantities of blood to all the tissues and organs of the body. In congestive heart failure, the heart is no longer able to pump blood effectively, negatively affecting circulation to the body and causing organ impairment. The liver, kidneys, lungs, and other vital organs will ultimately be affected as well.

What Causes Congestive Heart Failure?

The causes of congestive heart failure include the following:

  • The pet may have been born with a heart defect, in which case the condition may be considered congenital.
  • The presence of heartworms in the dog's heart may cause sufficient damage to cause heart failure.
  • Toy- and small-breed dogs, in general, are prone to chronic valvular disease, which may ultimately cause congestive heart failure.
  • Large- and giant-breed dogs, on the other hand, have a tendency to develop cardiomyopathy, which also may cause heart failure.
Heart disease can be managed with medication.

Heart disease can be managed with medication.

Symptoms of Congestive Heart Failure in Dogs

Symptoms may be moderate and in some cases barely noticeable at the early stages. Some signs of this condition include:

  • Unusual fatigue after exertion
  • Coughing up to several hours after exertion or at night
  • Restlessness (particularly at night)
  • Loss of appetite and weight loss
  • Rapid breathing

The affected pet may appear to be more tired than usual upon exertion and pant more during walks, require a break, or come home more tired than usual, breathing fast and panting. A cough may appear as well during exertion. However, as the disease advances, the pet may cough during the night a few hours after the pet lays down to sleep due to fluid pooling in the lungs. The dog may appear restless prior to going to sleep, pacing around and acting uncomfortable.

These symptoms may be subtle, and since congestive heart failure appears often in senior pets, they are easily confused with normal cases of aging. Once the disease advances, more specific symptoms may arise and the pet may refuse to eat, lose weight, and breathe rapidly. Also, because the heart does not function properly, fluids will accumulate in the legs (leg edema).

  • When the left ventricle of the heart is no longer functioning, the dog will cough up pink, bubbly fluid, a condition known as pulmonary edema.
  • Fluids will also tend to leak in the abdomen, causing a condition called ascites, and in the chest, causing a condition known as pleural effusion.
  • Affected pets will experience swelling in the abdomen, chest, and legs. A pet at the end stages of heart failure will have labored breathing and sit in a characteristic position with the head extended and elbows spread apart.
  • Because blood circulation is severely impaired, the gums will be bluish-gray.
  • The pet may collapse.

How a Diagnosis for Your Dog Is Reached

  • The veterinarian will examine the pet, listen to the heart and lungs, and order some specific tests.
  • A heartworm test may be run via blood sample to rule out heartworm disease. Chest X-rays or an echocardiogram may be ordered.
  • The pet's blood pressure may be monitored.

Treatment Options

  • Affected pets will be prescribed diuretics to remove excess fluids and reduce the workload of the heart.
  • If pleural effusion is present, a procedure called thoracocentesis may be required. Such a procedure consists of inserting a needle into the chest cavity and draining out some fluid.
  • Nitroglycerin may be prescribed to act as vasodilators.
  • If there is arrhythmia, medications such as digitalis may be prescribed.
  • A special diet low in salt is required. Most commercial pet foods have high levels of sodium. Therefore, prescription diets may be required such as Hill's H/d Purina CV or Royal Canin EC.
  • Potassium supplements are often prescribed because some diuretics tend to lower potassium levels.

Prognosis for Congestive Heart Failure

When treated early, supportive care may prolong the pet's life, even by years. Dogs will be able to lead a more comfortable life. However, routine check-ups will be required to monitor effectively the condition.

This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

Questions & Answers

Question: How can I get my dog to eat?

Answer: I imagine your dog is on a low-sodium diet, or perhaps a prescription diet. I do not know how severe your dog's heart failure is, but recent research has shown that some sodium might have some benefit in subclinical heart failure. Look up the human study "Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?" Of course, high-sodium foods like human snack foods, cheeses or cold cuts should be avoided, as these cause a sudden spike in sodium levels. Consult with your vet about your dog's difficulties with eating. He or she may suggest appetite stimulants or another type of food. Some dogs do better with canned food. If you are feeding him dry, see if the brand you use also makes a canned version that you can mix in with the dry. Although it may be ideal to eat a cardiac prescription diet, your vet may be able to suggest another high-quality diet. That or you can ask a vet specializing in nutrition for a recipe for a balanced diet that you can prepare at home.

Question: My basset was recently diagnosed with CHF. She also has a large mass on her spleen. Will it ever be safe to remove the mass and/or spleen?

Answer: Usually, a mass isn't removed, but the whole spleen is removed and then is sent to a pathologist to determine whether the cancer is benign or malignant. Regardless, without taking the spleen out, there is a risk of splenic bleeding which can cause death even if the mass is benign. Therefore, the mass on her spleen could likely be the most pressing problem at this time.

Generally, splenectomy can be done quite safely in dogs with early CHF. However, every situation is different, and the risks may be higher if the dog is very old or frail and the surgery may not be a good option if there are signs of cancer spread to other organs.

Consulting with an oncologist may be helpful for expert advice. The oncologist may suggest having a CT scan done to see whether there may be signs of cancer spread to make a more informed decision based on the findings.

If the oncologist feels surgery is warranted, it would be best to have it done by a board-certified surgeon and in a place where the dog is monitored for a couple of nights in case there are complications such as arrhythmias.

Nowadays, there are sophisticated new anesthetics that are fairly safe for dogs with CHF; however, there are always risks with surgeries and anesthesia and the recovery time. Palliative care is still an option when things are too advanced, and the chances are too great. So these are all things you want to talk about when consulting with your vet.


Adrienne Farricelli (author) on June 17, 2018:

The weakness is concerning, it can be heart issue or sometimes old dogs of this age get tumors that may bleed and cause anemia and weakness. A vet visit would be in order to see what's going on. Care Credit can help if you are in a difficult financial situation. There is no interest if you pay withing a certain timeframe.

Rebecca on June 15, 2018:

I have a black lab/ golden retriever mix, he is approx. 12 and has been in good health. Even a short walk at night and enjoys. The heat is different from where we lived, just hi 90’s but lower humidity. He has been panting but not heavily. Outta the blue last night had a weakness. Today listless but ate, drank, restroom normal. I have given him 1 baby aspirin and a pedilyte/ water mix. Due to living situations and no employment yet Im in a very bad way from a very lousy bitter divorce after 30 yrs. so hope a little shade tree Vet advice could be given. Thank you


Adrienne Farricelli (author) on February 24, 2017:

Dear Jill, I am sorry to hear your dog is suffering lately.I would talk with your vet about the symptoms you are seeing. The symptoms you are seeing can be due to vestibular disease, which often can be helped with motion sickness medications, but advanced heart disease can also cause this. You may also be seeing the onset of canine cognitive dysfunction which can sometimes be helped with medications from your vet. So you will need to see the vet so he/she can assess what is causing the drunk-like walking (ataxia) and pacing you are seeing and see if there is anything you can do to make him comfortable. Keeping you in my thoughts at this difficult time.

Jill Fuller on February 24, 2017:

Well,my Vet diagnosed my Lab mix 13 year old dog with congestive heart failure. I've been giving him his meds,"heart pill & water pills. This didn't work for 2 wks. Now he is walking around like he's drunk. He's also won't stop pacing all over the house. I haven't slept in about 3 days trying to follow him, I'm so worried for him. He's keeps running into everything. Is there anything I can do for him until we take him to the vet this afternoon. We've decided the best thing for him is to put him to sleep...

Adrienne Farricelli (author) on September 03, 2016:

Oh, Pamela, that must be devastating to go through. It's so terrible when there are holidays. Wondering if you can travel to en emergency vet in some bigger town that is opened 24/7 or see if some mobile vet is available or a vet working for a shelter. Please don't blame yourself, as you said, it's very difficult to predict things and we can only do the best we can. I will be keeping you in my thoughts and prayers.

Pamela Cook on September 03, 2016:

My little dog has been on meds for a year and this week got worse set up time to put him to sleep but it wasn't till next week. Now he's taken turn for the worse and I can't get ahold of any vet in our small community. I called animal control because the sheriffs office said they could put him down but due to the holiday they won't be back till Tues. I should have not waited so long and now he's suffering. It's so hard to know when to put them down. It breaks my heart that I waited so long. But he was eating and drinking and I just thought he wouldn't take such a turn for the worse.

Adrienne Farricelli (author) on February 23, 2014:

Sending Chico best wishes, I hope a solution can be found so to buy him more time with you.

bill on February 21, 2014:

I just found out about my pup having chf I am absolutely destroyed inside and so is my father. I cannot stand to see him like this and am in tears uncontrollably. Its nice to hear from people that have had this feeling. As you all know I am doing as much info chasing as I can and can only hope that he knows we are trying our best I wish u all the best of life has to offer losing a pet is a pain no one should have to feel thank you for your comments and please give my dog chico your best.

Paulart from 2510 Warren Avenue Cheyenne,Wyoming 82001 on January 18, 2012:

Very nice information is given on hub regarding congestive heart failure in dogs.

Adrienne Farricelli (author) on November 14, 2011:

Silvia, I would let the vet know and see if he/she has any other options. Is she on any heart medications? I have a hub about a dog's quality of life that can perhaps help, best wishes.

Silvia on November 14, 2011:

I don't know what to do. My dog is coughing all day, non stop. She has an enlarged heart and a heart murmur and is 14-1/2 years old. Other than that she acts normal. The Vet gave her antibiotics, then a cortisone shot, but nothing helped. How do I know if she's suffering and when to put her to sleep??

Lisa on October 01, 2011:

I agree with the above comment. Love you pet enough to know when to let him go. Just yesterday I had to put my beloved dog to sleep,hardest thing I've ever had to do. He had CHF. His first attack was 2 months ago, almost put he down but opted to see if he would bounce back and he did. He was like his old self for those 2 months playing and running around, but he started coughing again brought him to the hospital that was treating him they did a chest x-ray and they said he was ok that the coughing was due to his heart getting bigger and pressing on his trachea but within an hour he started coughing up blood and I knew that it was his time. It happened so fast I always wonder if I would know when the time was here and like I have read before I did know . His took his last breath about 2:20 pm with me holding

Beatriz on July 10, 2011:

HI I too was devastated when I had to put my loving dog to sleep it was the hardest thing I have ever done. I know I did the right thing he was suffuring to much he was 10 years old he also had CHF. was breathing to fast I had him on meds but was not working anymore I loved my dog to much to see him suffer. I miss him dearly but know that he is not suffering any more. People don't wait till the last min love your dog and let him go.

Susan Stevenson on July 06, 2011:

My dog mama has no been new to our family as of a year ago, she was a stray and we could tell she had just had baby's. so we took her in not knowing that she had been a new mommy. so we named her mama, she had just started coughing about three months after we found her, it was occasional but not often. We took her to the vet and they told us she was too loose a couple of pounds and i thought it was kennel cough but no way i was wrong, they gave me antibiotics and they cough went away for awhile but then came back but worse then ever, she has excessive drool on her chest she is alittle over weight, and she has very heavy breathing, & is alittle more tired then usual but i can't really offord another vet visit, so what should i do? Is it Congestive Heart Failure! i'm consitering just putting her down. i don't know her life history. but i love her and it scares me! HELP!

Tessa on June 12, 2011:

Kelly, our cat just died of CHF yesterday. Except it was very sudden and unexpected. He was doing BETTER. His heartrate was good, his respiratory rate was good, he even was eating and playing. It was like he was never ill. And then it happened.

IF we would have had warning that he was really, really sick, we would have put him to sleep. It was fast, but he looked miserable. When he died, he was pale, he lossed his bowels, he was gasping, and then finally coughing up blood until he let go of life. If you know he's getting very ill and he has little quality of life left, put her to sleep to spare her of that kind of death.

kelley on April 28, 2011:

Our Min Pin is in final strages of CHF they say it is painless, but to have the bellied tummy and labored b reathing we are torn between letting her go naturally or putting her to sleep, we are beside ourselves......

Maria Cecilia from Philippines on October 19, 2010:

this is very informative made me look at my senior dog and try to observe the symptoms that you mentioned, though I know he is okey, I still want him to have a check up,, He is a bit overweight but the good thing is he walks regularly morning and evening

jt on August 06, 2010:

this was very helpful...thanks

patty on May 14, 2010:

This was very helpful and easy for a concerned lay person to comprehend. Thank you.