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208 Breeds, 422 Health Conditions  |  Find a Vet

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Congestive Heart Failure

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Condition Overview

Congestive heart failure is the inability of the heart to provide adequate circulation to meet the body's needs. It is the end result of a weakened heart muscle.

Symptoms

The early signs of congestive heart failure are tiring easily, a decrease in activity level, and intermittent coughing. The coughing occurs during periods of exertion or excitation. It also tends to occur at night, usually about 2 hours after the dog goes to bed. Dogs may be restless - pacing instead of quickly going to sleep.

These early signs are non-specific and may even be considered normal for the dog's age. As heart failure progresses, the dog develops other signs such as lack of appetite, rapid breathing, abdominal swelling, and a marked loss of weight.

Since the heart no longer pumps effectively, blood backs up in the lungs, liver, legs, ans other organs. Increased pressure in the veins causes fluid to leak into the lungs and peritoneal cavity. Fluid in the lungs is the cause of the coughing. A rapid accumulation of fluid in the small airways can cause the dog to cough up a bubbly red fluid - a condition called pulmonary edema. Pulmonary edema indicates failure of the left ventricle.

With failure of the right ventricle, fluid leaks into the abdomen, giving the belly a characteristic swelling or potbellied appearance (called ascites). This may be accompanied by swelling of the legs (dependent edema). An accumulation of fluid in the chest cavity (pleural effusion) also occurs with right-sided heart failure.

In the late stages of congestive heart failure, the dog sits with his elbows spread and his head extended. Breathing is labored. The pulse is rapid, thready, and often irregular. The mucous membranes of the gums and tongue are bluish-gray and cool. A thrill may be felt over the chest. Fainting can occur with stress or exertion.

Causes

In toy and small breed dogs, chronic valvular disease with mitral regurgitation is the most common cause of congestive heart failure. In large-breed dogs, it is dilated cardiomyopathy.

Diagnosis

An accurate diagnosis is established though chest X-rays, ECG, echocardiography, and possibly the heartworm antigen test.

Treatment

It is important to correct any underlying cause whenever possible. Heartworms, bacterial endocarditis, and some forms of congenital heart disease are potentially curable if they are treated before the heart is damaged.

Treatment of congestive heart failure involves feeding the dog a low salt diet, restricting exercise, and giving appropriate medications to increase heart function and prevent cardiac arrhythmias.

Most commercial store brand foods contain excessive amounts of salt. Your vet may try to prescribe you a prescription diet to control salt intake. For higher quality nutriton, it is recommended that you seek premuim brand foods such as Innova, Eagle Pack, or Canidae which contain little to no salt. In dogs with mild symptoms, salt restriction may be the only treatment required.

Exercise is beneficial, but only for dogs who are not symptomatic. If symptoms such as easy tiring, coughing, or rapid breathing appear with exercise, do not allow your dog to engage in activities that elicit these symptoms.

Various drugs are available that increase the force and contraction of the heart muscle r decrease the workload. They include the digitalis glycosides, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and anti-arrhythmics. These are the same drugs used in people. ACE inhinitors such as enalapril meleate (Enacard) and benazepril(Fortekor) may prolong the life of dogs with valvular heart disease. Fluid accumulation in the lungs and elsewhere is managed by diuretics such as furosemide (Lasix). Potassium supplements may be necessary when giving certain diuretics. A diuretic that spares the potassium the body needs is spironolactone (Aldactone).

Dogs with congestive heart failure may benefit from vitamin-B supplements and taurine or carnitine. Coenzyme Q is another supplement that may help dogs with cardiac problems.

When treating cardiac arrhythmias, it is important to search for and correct any underlying electrolyte or metabolic problems that might trigger an attack. A number of cardiac drugs, including digitalis, lidocaine, diltiazem, procainamide, atropine, and propanalol (Inderal), are used to control arrhythmias in dogs. Dogs whose primary problem is an arrhythmia may be able to have a pacemaker implanted to help control the heart rate.

Prevention

With proper treatment, a dog with congestive heart failure can live a longer and more comfortable life. However, heart disease requires close monitoring. You will need to return to your veterinarian regularly for checkups.

Support

Please contact your veterinarian with questions regarding this condition.

Show Sources & Contributors +

Sources

Dog Owners Home Veterinary Handbook

Publisher: Wiley Publishing, 2007

Website: http://www.wiley.com/WileyCDA/

Authors: Debra M. Eldredge, Liisa D. Carlson, Delbert G. Carlson, James M. Giffen MD

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