How to deal with my dog’s congestive heart failure

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As with other conditions, dogs with congestive heart failure (CHF) may not present any symptoms at the onset of the disease. As the problem progresses, the symptoms become more apparent to the owner.

The progression of the disease is almost always progressive, but sudden episodes may occur and the disease may take a turn to the worse quite suddenly.

A large number of patients with CHF are older dogs, therefore owners may underestimate symptoms because they think they are due to old age.

The symptoms that arise depend on the cause of CHF and the side of the cardiac muscle (right or left) that is most compromised.

These are the most common symptoms in patients with CHF:

  • Cough (mainly at rest, being of the first symptoms described by the tutors) – the increase of the heart causes pressure on other thoracic structures, as well as pulmonary edema being these the causes for the appearance of this symptom.
  • Respiratory disorders (difficulty in breathing, increased respiratory rate, respiratory effort)
  • Tiredness (animals avoid making efforts, such as playing or running, because it costs them every time they do). So dogs are reluctant to accompany tutors on daily walks.
  • Exercise intolerance.
  • Syncopes (for example when the owner comes home, the excitement of receiving it, may be followed by an episode of loss of consciousness)
  • Loss of appetite and body condition
  • Several edema – pulmonary, ascites (fluid accumulates in the abdominal cavity and the abdomen of the animal becomes dilated), edema of the limbs, etc.
  • Jugular vein distension
  • Changes in mucosal colours – may be grayish, due to poor oxygenation; and pale, due to poor capillary perfusion.
  • Irregular heartbeat
  • Kidney complications due to insufficient kidney perfusion.
  • Animals can be impatient and restless without being able to rest comfortably




Congestive heart failure is a disease that has no cure. The earlier the diagnosis is made, the better the prognosis.

The first step is to contact your veterinarian as soon as you notice any symptoms or changes in your dog.

These are the main steps in the diagnosis of a patient with CHF:

1. The veterinarian will pose several questions in order to draw up a complete medical history.

2. The physical examination of the dog is the starting point along with the clinical history to assess the situation and build a diagnostic plan. In the clinical examination, there are important considerations to take into account:

  • Pulse
  • Evaluation of mucous membranes
  • General physical condition (weight, body condition and general appearance)
  • Respiratory pattern
  • Fluid accumulation

3. Thoracic X-ray: it allows your vet to evaluate the size and shape of the heart, as well as the presence of pulmonary changes (edema) or presence of liquid in the thoracic cavity.

4. ECG (electrocardiogram): it allows your vet to evaluate heart rate and rhythm and to provide information on possible dilatation of any chambers of the heart, or myocardial ischemia (it is not by itself an absolute diagnostic method, but it is a very important tool.

5. Echocardiography: a non-invasive and very complete method, that allows the vet to assess:

  • cardiac function in real time
  • heart cavities
  • thickness of the heart wall
  • function and shape of the heart valves
  • presence of fluid in the pericardium or pleura
  • presence of masses in the underlying heart or tissues
  • Doppler study, for a complete evaluation of the cardiac function. This examination is highly specialised and, in order to be conclusive, must be performed by an experienced technician.

6. Complete blood screening and parasitic screening is needed to exclude other causes.

The progression of heart failure can be described and classified in 4 different stages. Each stage represents a clinical phase (from initial phase up to the most severe phase that does not respond to conventional treatment). After the diagnosis and according to the presented symptoms and their severity, it will be possible to assess which phase the patient is.

From this point, the appropriate therapy is then initiated.




Although it is a serious problem and without a cure, CHF can be controlled and its progression slowed down.

There are many causes for this problem, with dilated cardiomyopathy and valvular insufficiencies being the most common, with many different types of treatments available.

It is important to understand that treatment is for life and should be adjusted whenever necessary.

In most cases the therapy aims to control edema and effusions, improve cardiac output, reduce cardiac effort, support myocardial function and control for possible arrhythmias.

Thus, drugs are used to:

  • control pulmonary edema of cardiac origin as well as other effusions
  • inhibit Angiotensin Converting Enzyme (ACE inhibitors)
  • increase myocardial contractility while ensuring pulmonary and systemic vasodilation. These are used as chronic medications, but also in acute and urgent situations, promoting an improvement in quality of life and a decrease in congestive symptoms.
  • promote vasodilation by allowing blood flow and decreasing the effort of the heart.

In terms of life management owners should guarantee:

  • Adequate diet with low salt content and adequate supplementation
  • Avoid situations of extreme and violent exercise

Whenever there is a sudden worsening of symptoms, we are facing a medical emergency. Professional veterinary aid should be sought urgently.

In acute conditions, oxygen and intravenous medication are usually needed to stabilise the dog until they can take medication at home.




Owners must learn what heart failure means and how different medications act, in order to learn to manage the disease at home.Also, they must be on the lookout for any signs that might indicate an imbalance in managing the disease. Here’s what you need to watch:

  • Changes in appetite
  • Changes in physical activity
  • Changes in weight
  • Respiratory rate when resting – learning how to measure the respiratory rate may be very useful. Ideally, there should be 30 or fewer breath per minute when resting (1 breath every 2 seconds). The persistent increase in this frequency is an early sign of worsening of clinical status.

Regular medical follow-ups, as well as compliance to medications and recommendations allow the patient to have a higher quality of life for a longer period of time. Download PETABLE to manage chronic conditions and set reminders for medication.


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