FAQS About Congestive Heart Failure in Dogs
If you've just been to the vet and found out your dog has congestive heart failure (CHF), you are probably dealing with lots of conflicting emotions. While a diagnosis of CHF is serious, if the condition is discovered and treated early, the prognosis can be promising.
Dr. Cathy Alinovi, owner of Healthy PAWsibilities, shares her experience and expertise about the care and management of dogs with congestive heart failure.
Question 1: Are CHF and canine valvular heart disease related?
Dr. Cathy: The terms are not interchangeable but almost. Faulty heart valves are the most common cause of congestive heart failure, but not the only cause. Therefore, if your dog has valvular heart disease, then it has congestive heart failure. However, a diagnosis of CHF does not mean your dog's heart valves are faulty. Another term for CHF is cardiomyopathy, which means disease of the heart muscle.
Q2: What is congestive heart failure?
Dr. Cathy: If the heart's job is to pump blood, then in heart failure, the blood does not pump to the body as well as when the heart is healthy. When the blood does not flow properly, it gets backed up somewhere. The backed up blood leads to fluid buildup in the tissues, and very commonly in the lungs. This is where the term congestive comes from.
Q3: How many types of congestive heart failure are there?
Dr. Cathy: The types of congestive heart failure (CHF) refer to what side of the heart is failing. While we usually think of the heart as one organ, it is essentially two pumps put together; the right side of the heart takes blood from the body and pumps it into the lungs for oxygen, and the left side of the heart takes blood from the lungs and pumps it out to the body.
In left sided heart failure, the most common kind of heart failure, the blood backs up and leads to congestion in the lungs. In right-sided heart failure, the blood backs up and usually affects the liver, causing congestion there.
In small dogs, mitral valve failure is the most common cause of CHF. The mitral valve is the valve between the small and large chambers on the left side of the heart. In large breed dogs CHF is usually caused by dilated cardiomyopathy; this means that the muscle has stretched and grown weak causing inefficiency of heart pumping.
Q4: Why does my dog have CHF?
Dr. Cathy: There is an incredibly long list of reasons for heart failure in dogs. Speaking in broad generalizations, the most common cause of right-sided heart failure is heartworm infection either current or previously.
The most common cause of left-sided heart failure is a little harder to pinpoint; genetics definitely has a role in left-sided heart failure as does obesity. CHF can lead to high blood pressure; high blood pressure can lead to CHF. Faulty heart rhythms can lead to CHF, and vice versa. Even kidney failure can affect function of the heart.
CHF Cough in Dogs
Q5: Will my dog have a heart attack?
Dr. Cathy: Heart attack tends to be a human issue more than it is for animals. It is related to obstruction of the blood vessels in the heart. In humans, this condition is called atherosclerosis, or arteriosclerosis, which means hardening of the arteries. However, there are some cases where this can happen in animals. For obese dogs that have fat in their blood vessels, heart attack is a possibility.
More common is a condition called syncope. Syncope means fainting due to lack of blood flow to the brain. The brain must have oxygen carrying blood in order to function; if the dog is doing too much too fast and its heart can't keep up, the brain says stop and makes the dog lay down by fainting. Once the dog has enough blood flow, he will regain consciousness. This is very scary for the pet owner to see.
Q6: What is the prognosis for dogs with congestive heart failure?
Dr. Cathy: Untreated, the prognosis is not good. If caught early, then the prognosis is good because there are excellent medications, diet, and nutraceuticals to help the CHF patient.
Q7: How common is CHF?
Dr. Cathy: It is one of the more common older dog diseases.
Q8: Are there dog breeds that are predisposed to CHF?
Dr. Cathy: Dobermans and boxers commonly get dilated cardiomyopathy. Small and toy breeds of dog are most commonly affected by mitral valve failure and thus CHF. However, this group of disorders affects many, many breeds.
Does Breed Size Matter?
What size dog breed is the best choice?
Q9: What can I do to protect my dog against CHF?
Dr. Cathy: Because so much about CHF is genetically determined, there's only so much you can do to protect.
However, consistent exercise, great nutrition, proper administered preventative against heartworm disease, and weight control will do a lot for your dog.
Q10: What symptoms should I be watching for?
Dr. Cathy: The first sign is a subtle, occasional cough, which sounds just like a little heh sound from time to time. By the time other symptoms become more obvious, your dog may be in the advanced stages of congestive heart failure. These signs are fainting, exercise intolerance, inability to lay down to sleep, a serious frequent cough, or restlessness at night.
Q11: How do vets diagnose CHF?
Dr. Cathy: We use a combination of tools to get to the underlying problem. These tools will include listening to the heart with a stethoscope, chest x-ray, blood pressure, ultrasound of the heart, and/or an ECG. An ECG stands for an electrocardiogram, which is a measure of the electrical function of the heart. Potential blood work will look at overall kidney function, electrolytes, and a heartworm test.
Q12: What treatments are available?
Dr. Cathy: There are many medical treatments available, and several are very similar to what humans with heart disease take. A great diet that is low in salt and processed foods is the beginning of any CHF treatment. There are pills to lower blood pressure and others to get fluid out of the lungs or liver. There are pills to decrease scar tissue formation in the heart. In addition, of course, reasonable amounts of exercise can be beneficial. The heart is a muscle and it does need exercise; however, it just needs to not overdo it when it is in really serious condition.
Q13: What side effects can these treatments cause?
Dr. Cathy: The most common problem is with the diuretics, which are the pills that help get the excess fluid out. These pills, frequently called Lasix (furosemide) or a water pill, can cause the side effect of losing too much salt from the blood. The dissolved salt in the blood is what helps our nerves and muscles function. This is why the CHF patient needs routine monitoring at the vet's office to make sure things don't get out of hand and we figure it out too late.
Alternative Options for Treating CHF
Compound Dan Shen
Real food diet
Zhen Wu Tang
Q14: Are there alternative treatment methods?
Dr. Cathy: Diet and sufficient water intake are two of the best treatments for CHF. Any dry dog food is full of carbohydrates, which the body can turn to sugar and fat, and this will put the heart at a disadvantage. Real food where the dog owner controls the salt intake is the best first step for the canine CHF patient. Additionally, there are some great nutraceuticals that can help.
CoQ10 is a well-known supplement used in both humans and dogs to decrease blood pressure 10 to 15 points. While vitamin D is not essential to dogs like it is to humans, judicious supplementation of vitamin D can help some canine patients. One caveat when looking at vitamin D is because it is fat-soluble it is possible to give too much so pet owners must be careful.
There are also some great herbal blends to help treat CHF. I prescribe Zhen Wu Tang as an herbal diuretic, and it does not have the potassium (salt) depleting side effects of furosemide. Borneol, alone or in a combination called Compound Dan Shen, can help greatly with irregular heartbeat.
It may be hard to believe, but both acupuncture and chiropractic make the body and thus the brain work better; a better functioning brain leads to better heart function. Massage, while less effective, can also help. I have one patient whose blood pressure goes up when she has pain so when I treat the pain I fix the blood pressure. There are many alternative options to help your baby feel better and they work well coupled with regular western medicine.
Q15: What role do diet and exercise play in treating CHF?
Dr. Cathy: These both do wonders in humans; they will do wonders in the canine CHF patient as well.
The heart is a muscle so exercise will help it be strong. However, the exercise should be moderate, not done at a break neck speed. It should be like a gentle, steady trot and it should be daily.
A diet consisting of low salt (therefore not kibble) ingredients, real meat, and plenty of fluids will decrease blood pressure in the CHF patient.
Q16: How can I tell the difference between kennel cough and a cough caused by CHF?
Dr. Cathy: The kennel cough sound has a hack, almost like a honk, afterwards. The CHF cough sounds more like a dry, single cough. (See video below for a great example of the difference in the sound of these two coughs.) Both kinds of coughing are worse after exercise. The CHF cough is also very common at night.
Kennel Cough versus Heart Cough
Q17: What do I need to know about caring for my CHF dog?
Dr. Cathy: The big thing is quality of life. Without treatment, your dog suffers. With treatment, your dog can have great quality for quite a while and gets some of that puppy-like behavior back.
This veterinary medical information is based on information provided during a telephone interview with a professional, qualified, retired veterinarian. However, it is provided for educational purposes only. It is not intended to replace the advice of your own veterinarian. Always seek your veterinarian’s advice about your pet’s health.
While this information is periodically researched and updated (under the guidance of veterinary input) in the attempt to be timely and factual, no guarantee is given the information is correct, complete, and/or up-to-date.
Recommendations as to therapeutics, diagnostics and best standards of practice in the veterinary industry and/or opinions between professionals may differ or change as technologies and information changes. You should not use this article as your sole source of information on any matter of veterinary health or attempt to self-diagnose or treat your pets as the information herein may not be appropriate for your pet. The safest option for you and your pet is to rely on the advice of your veterinarian to diagnose and recommend the best treatment options.
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