Heart diseases in dogs

Heart diseases in dogs

It is estimated that a little over 10% of all pets have some form of heart disease. There are many different reasons for the presence of heart disease – from genetics to poor diet, ageing, illness/infection and obesity – but what is common among all types of heart disease is that the condition does not simply go away on its own. It is usually progressive and, depending on how severe the symptoms are and when the dog is diagnosed with the disease, it can eventually lead to heart failure.

Types of heart disease

Heart disease can refer to any abnormality of the heart’s structure, electrical activity and function. The most common types of heart disease in dogs include those that affect the functioning of the heart valves (valvular degeneration), weaken the heart muscle (dilated cardiomyopathy), thicken the heart muscle (hypertrophic cardiomyopathy), and those in which the electrical activity of the heart is affected (arrhythmia).

Heart disease can be congenital – meaning dogs are born with a defect that results in the disease – or it can be acquired – meaning that it develops over time as a result of the side effects of infection, old age, (especially) if the dog is overweight or is not fed a complete and balanced diet.

The following are just some of the more common types of heart disease that affect dogs:

Valvular degeneration

Valvular degeneration occurs when the valves of the heart no longer function as they’re supposed to. The function of the valves is to open and close, allowing blood to flow through or stopping the flow, depending on where they are located. When they thicken, weaken and degenerate, the valves cannot open or close properly, which causes a leakage of blood and the enlargement of the heart.

Mitral valve disease or degenerative mitral valve disease is the valvular degeneration most often seen in dogs. It affects the two left heart chambers and can eventually lead to congestive heart failure. It can be diagnosed even before any symptoms show up, and will only present as a slight heart murmur. Once diagnosed, it can be managed through specific medications and the appropriate diet. It cannot be cured, which is why managing the condition is so important.

Mitral valve disease is a congenital disease for which the Cavalier King Charles spaniel is most commonly known. Almost all dogs of this breed will develop mitral valve disease and eventually succumb to heart failure.

Dilated cardiomyopathy (DCM)

If we break down the name, dilated (enlarged) cardio (heart) myo (muscle) pathy (disease) refers to a range of conditions that negatively affect the heart’s muscle, causing it to weaken and enlarge. The enlargement happens because the heart muscle (the walls of the heart) thins and weakens; the heart then cannot pump efficiently and it fails to pump all of the blood out of the heart, causing it to enlarge.

Dilated cardiomyopathy (DCM) is the most common heart disease diagnosed in large breed dogs, and second most common overall. It is progressive and often leads to congestive heart failure. If DCM is diagnosed early on, it can be managed with medication, allowing the affected dogs to live longer with fewer symptoms, but there is no cure. It is usually large and giant breed dogs who develop DCM – breeds like boxers, Great Danes, Doberman pinschers, St Bernards, Irish wolfhounds, some German shepherd dogs and some spaniels, especially those older than four years.

DCM is more common in certain breeds than others, but it is not always congenital and can be acquired due to other factors like diet and old age.

Pericardial disease

Also called pericardial effusion, this type of heart disease affects the thin sac around the heart called the pericardium. In healthy dogs, this sac contains a little fluid to assist the heart’s beating mechanism, while in pericardial effusion, the sac fills with fluid to the extent that it restricts the heart’s ability to fill with blood, which constrains its vital function.

Pericardial disease is usually a symptom or effect of hemangiosarcoma – cancer of the blood vessels near the heart – or inflammation of the heart, which causes scarring on the pericardium. When the cause of the scarring cannot be determined, the condition is called idiopathic pericardial effusion. Some dogs are even born with a pericardial sac that does not function properly, which risks normal heart function and causes heart disease.

This particular type of heart disease usually goes undetected until it causes a medical emergency. It requires the veterinarian to insert a long needle through the dog’s side and into the pericardium to drain the excess fluid that is restricting the heart’s function. The prognosis of pericardial effusion varies depending on the cause of the fluid build-up, and dogs can live for three months to three years with repeated treatments. There is no cure and the vet will encourage owners to consider the dog’s quality of life (with the possibility of sudden death) before consenting to ongoing treatments.

Heart arrhythmias

The heart’s beating function is controlled by an electrical current or pulse that stimulates the heart muscle and causes it to contract in a coordinated way. When there is an interruption in the electrical current or a disruption to the coordination, this causes arrhythmia. The different types of arrhythmias are defined by an increase or decrease of the heart rate (tachycardia or bradycardia, respectively), blockages, or a lack of coordination between the different parts of the heart (premature ventricular contractions and atrial fibrillation).

If a dog is diagnosed with an arrhythmia, there are various ways of treating or correcting it including medication or a pacemaker.

Congenital heart disease

Some heart diseases result from an abnormality in the dog’s heart development and are present at birth. Congenital heart problems account for around 4% of veterinary cardiology cases, so they are rare, but they can be devastating for the pet parents of the affected puppy. Congenital heart diseases are detected when the vet hears a heart murmur during the puppy’s checkup, but they require more extensive testing methods (such as ultrasound and electrocardiogram (ECG)) to make an accurate diagnosis.

When serious congenital heart diseases are detected in purebred puppies, it is critical that the breeders are notified so that they do not continue breeding with the parents of the sick puppies, and to provide data on the relevant  bloodlines.

Congenital heart diseases include:

  • Patent ductus arteriosus (PDA)

An open artery that should close after birth, but doesn’t. Can be corrected with surgery.

  • Pulmonic stenosis

An abnormally narrow heart valve that makes the right side of the heart work harder. Can be corrected with a catheter and balloon to open up the valve.

  • Subaortic stenosis

An abnormally narrow channel connecting the left ventricle to the aorta, which makes the left side of the heart work harder. Surgical treatment is difficult and often unsuccessful, while medication is used to slow the development of disease and heart failure.

  • Ventricular septal defect

This describes an abnormal connection between the heart’s two ventricles, which can result in an enlarged heart and more blood being pumped to the lungs. Depending on the size of the problem, the dog can live with VSD, or it can be treated with medication and a carefully managed diet. Surgical intervention depends on the severity of the progression of the disease.

Symptoms of heart disease

A dog with heart problems will experience symptoms such as:

  • shortness of breath
  • rapid breathing
  • coughing (especially after exercise)
  • round belly (abdominal swelling) from fluid build-up
  • fatigue
  • fainting
  • rapid weight loss

Some heart disease does not present any symptoms, but may first be suspected if the vet detects a heart murmur during a routine check-up. By the time symptoms show, the dog could already be nearing heart failure, which is why it’s important to get the dog checked by a vet if any of the above symptoms are present.

How are heart diseases diagnosed?

From the stethoscope to the electrocardiogram (ECG); the chest X-ray to a simple observation; from the echocardiogram (echo) to a blood pressure monitor – there are many diagnostic tools for identifying heart diseases, depending on which type of heart disease the vet suspects.

Can heart disease be treated?

Each type of heart disease is monitored and treated for the type and severity, as well as the impact it is having on the dog’s quality of life.

Dog heart diseases range in type and severity – with some not showing symptoms until well into the dog’s life, while others show symptoms in puppyhood and need serious treatment. The vast range of heart diseases means it’s vital that dog owners take their beloved dogs for their annual check-up to allow for regular screening; and that they pay attention to potential symptoms of heart disease and act quickly if they observe any troubling symptoms in their pets.

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Heart diseases in cats

Heart diseases in cats

The American Veterinary Medical Association suggests that one in 10 cats across the globe is either born with or develops some form of heart disease in their lifetime. There are a number of different types of heart disease in felines, but all of them present with some kind of abnormal structure or function of the heart’s chambers, valves or surrounding muscle.

Types of heart disease

Cats can develop different types of heart conditions. Each one depends on the cat’s genetics, possible trauma to the heart muscle, or some other kind of influence that causes the cat’s heart health to deteriorate. Cats can have congenital or acquired heart disease.

Congenital heart disease

When a kitten is born with a heart problem, it is called ‘congenital’ and may very well be the result of its parents’ genetics. The heart problem can be in the form of a defective heart valve or a weakness or hole in the ventricle wall that separates the right side from the left side of the heart. Both types of malformations can negatively affect the way blood is pumped by the heart muscle and into the body, which can have a negative impact on health and cause some of the symptoms we’ll look at below.

Congenital problems are built-in and cannot simply be ‘medicated’ away; they may need lifelong treatment and sometimes result early death. Fortunately congenital heart disease is much rarer than acquired heart disease.

Acquired heart disease

Acquired – or adult onset – heart disease occurs in older cats and can be caused by wear-and-tear, injury or infection. The most common type of acquired heart disease is hypertrophic cardiomyopathy. This name directly translates to the thickening (hypertrophy) of the heart (cardio) muscle (myo), which causes the disease (pathy).

Less common acquired types of heart disease include:

  • Restrictive cardiomyopathy – when scar tissue builds up around the heart’s lining and reduces its ability to fill up and pump out the blood;

and

  • Dilated cardiomyopathy – when the walls of the heart become thin and the heart enlarges, severely disabling its ability to pump

Hypertrophic cardiomyopathy

This is the most common type of acquired heart disease in cats, and even though it’s not congenital, it is thought there may be a hereditary link. This means that certain cats may be genetically predisposed to developing hypertrophic cardiomyopathy (HCM) – either with age, or because of other triggers. The cat breeds that are more likely to develop HCM include Maine coons, ragdolls and American shorthairs. Rest assured, this doesn’t mean that they will; just that they have a higher chance of HCM than other breeds.

What are the symptoms of heart disease in cats?

When cats feel sick, they are very good at hiding their symptoms until the illness is quite severe or they go into hiding – a behaviour from their ancestors’ days in the wild, to protect themselves from predators. However, because of the way the heart functions and the other internal organs that depend on it for their own function, cats with heart disease may show the following symptoms:

  • rapid breathing – fast and shallow

  • laboured breathing – noisy or otherwise heavy

  • shortness of breath

  • fatigue

  • difficulty exercising

  • lack of appetite

  • weight loss

  • fainting/collapsing

  • abdominal swelling

  • coughing

  • sudden paralysis in the hind legs, accompanied by pain (caused by blood clots)

  • kittens may have stunted growth

These symptoms can also show in varying degrees, based on how sick the cat may be. When taken to the vet, the vet may detect a heart murmur and an elevated heartbeat (not the result of stress or discomfort, but as a baseline). If these symptoms are too far progressed, the cat may already be in a state of congestive heart failure, which is when the heart’s function is too poorly and there is fluid build-up around the lungs. The blood clots in the arteries near the hind legs can cause a thromboembolism or ‘saddle thrombus’, which is very painful and paralysing, and only about 40% of cats with this condition will have a good prognosis.

How are heart diseases diagnosed?

If a cat is showing any of the above symptoms, they may not necessarily be a sign of hypertrophic cardiomyopathy, but they are distressing enough that the vet should take a look. If the vet suspects HCM, they will perform a cardiac examination. This involves an external physical exam, usually done with a stethoscope to listen for any sounds in the heart and lungs that may be out of the ordinary. A non-invasive ultrasound will also give the vet a good inside view of the cat’s heart and lungs – indicating any abnormalities in the blood vessels, heart chamber, valves and the heart muscle.

The vet will then take the cat’s blood pressure and also do a bloodwork analysis to get an idea of the cat’s general health (sometimes heart disease can be a symptom of hyperthyroidism, so if thyroid hormones in the blood are elevated, this is likely the case). X-rays reveal the heart’s size and position in the chest and show the condition of the lungs, while an electrocardiogram (ECG) can show whether the cat has a heart murmur or any abnormal beat, using the electrical activity of the heart.

Can heart disease be treated?

While there is no cure for HCM, and the damage it does to the physical structures of the heart is not reversible, if it is diagnosed early enough the vet may help to manage the symptoms, slow the progression of the disease and to lower the risk of the cardiomyopathy developing into congestive heart failure. Depending on the severity of the symptoms and the progression of the disease, the vet may prescribe medications that will relax the heart muscle, decrease the heart rate and take some pressure off the cat’s heart. They may also prescribe anti-clotting medication to reduce the risk of the cat developing blood clots or a thromboembolism.

Since these medications do make critical changes to the way the cat’s heart functions, it is crucial that cat owners follow the vet’s recommendations on when and how to administer the dosages. Cat owners may need to learn how to monitor their purry friends’ vital signs (like pulse, breathing, etc.), but since each case is different and may be more or less severe, it is best to follow the vet’s advice on each individual case.

What is the prognosis of cats with heart disease?

If the heart disease is caught early enough, the correct monitoring is performed and/or the correct medications are given, the cat may have a good prognosis and go on to live a fairly normal life. Some cats with a slight heart murmur do not show any symptoms for years; some have symptoms that show up immediately and progress rapidly, so that by the time they are diagnosed, their prognosis is poor.

If the heart disease has progressed to congestive heart failure, these patients can live anywhere from another six to 18 months.

Can heart disease be prevented?

As with many disease prevention protocols, the best way to limit the progression of a disease is through early detection or screening. Cat owners should take their cats in for an annual check-up and not wait for any distressing symptoms before they let the vet see their feline friend.

Feeding the cat a good, high-protein diet can reduce the risk of heart disease; balancing healthy diet with enough exercise and keeping the cat’s stress levels down also goes a long way to ensuring optimal heart health.

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Dilated cardiomyopathy (DCM) in dogs and cats

Dilated cardiomyopathy (DCM) in dogs and cats

What is dilated cardiomyopathy?

Cardiomyopathy is a disease condition of the heart muscle that inhibits its ability to function properly. In the case of dilated cardiomyopathy (DCM), the heart muscle is stretched and the muscle is thin and flabby, affecting its pumping ability. Dilated cardiomyopathy can affect both pets and people.

The heart is designed as a pump where each contraction pushes blood from the lungs to the rest of the body and back again. This allows the oxygen we breathe in to be absorbed in the blood and distributed to where it is needed. When the pump itself is affected, the distribution and flow of blood is compromised. In DCM, the bottom chambers of the heart, which are the power house for the pumping action, are dilated and thin, and unable to properly expel the blood presented to them from the lungs and body. This leads to a backup behind the heart. Depending on which side of the heart is more severely affected, this usually ends up with fluid and blood buildup in the lungs. In DCM, it is usually all four chambers of the heart that are stretched and affected, not just one side. This stretching of the muscle also affects the electrical conduction of the heart and its ability to pump at a normal rhythm.

How does dilated cardiomyopathy occur?

DCM is an acquired disease, meaning that an animal or person is not born with the condition, but it develops over time. DCM can be classified as:

  • primary, where the cause is genetic or unknown, or
  • secondary, where damage to the heart occurs as the result of toxins or infections.

Primary DCM is the most common and is seen more often in certain breeds of dogs, namely large and giant breeds such as the Doberman pinscher, Newfoundland, Great Dane and Irish wolfhound, as well as boxers and cocker spaniels.

Secondary DCM can be caused by viral infections to the heart muscle (myocarditis) or due to deficiencies in certain amino acids such as taurine (cocker spaniels) and carnitine (boxers). These causes of DCM are, however, rare in modern day due to the development of protective vaccination and well-researched and high quality pet diets.

Is there any truth to the connection between grain-free diets and heart disease in pets?

Yes, according to the United States Food and Drug Administration (FDA) there does seem to be a correlation between the use of grain-free pet diets and the development of heart disease, specifically DCM in both dogs and cats. In 2017 veterinary cardiologists noticed a rapid increase in the number of DCM cases they were seeing. These cases were occurring in dog breeds that were not known to be genetically predisposed to DCM, such as mixed breeds, beagles, golden retrievers and even small breed dogs.

In July 2018 the FDA in conjunction with nutritionists and veterinary cardiologists began to investigate the relationship between the cases of DCM and grain-free pet diets. A strong correlation between the two were found, however the exact cause is still not known. The diets most commonly implicated were those using sweet potato or potato and legumes such as lentils and/or peas instead of grains. The protein sources varied in these diets from conventional chicken and beef to exotic sources such as bison, kangaroo or lamb. Due to the change in ingredients, it may be that an amino acid deficiency plays a role as it did in the past, or possibly that these ingredients affect the absorption or metabolism of these amino acids. The investigation is still ongoing.

How will I know if my pet has DCM?

In early cases of DCM the heart may still be able to cope and thus show very few signs of disease. It is when the heart becomes less able to cope and do its job that symptoms start to arise. At first it may be mild changes such as poor tolerance for exercise. These pets tire quickly when playing or exercising, which is sometimes accompanied by a soft cough, which almost sounds like they are clearing their throat.

As the condition progresses, signs may become more pronounced, like breathing fast and with difficulty. Affected animals may have a persistent cough, made worse by activity or exercise. You may notice fainting episodes, weight loss, poor appetite and even an increase in the size of your pet’s abdomen from fluid accumulation – also called ascites. Severely affected animals are restless, unable to lie down and rest comfortably, and have very little interest in food. If the heart has reached the point of being unable to cope, leading to symptoms as mentioned above, this is called heart failure.

What should I do if I suspect my pet has DCM?

If you are concerned that your pet has heart disease, it would be best to schedule an appointment with the veterinarian. The vet will perform a thorough physical examination and listen to your pet’s heart and lungs. Some cases of DCM will present with a soft heart murmur, and if there is congestion in the lungs this can sometimes be heard too.

My dog is one of the predisposed breeds and has a family history of heart disease. What should I do?

It would be wise to consult the vet as soon as possible to have your dog screened for DCM. This would involve a scan of the heart, known as an echocardiogram, as well as an electrocardiograph (ECG), which measures heart rate and rhythm through the heart’s electrical impulses. Some vets use a Holter ECG which is strapped to your dog for 24 hours in order to get the best possible picture of their heart’s electrical activity through the day.

These tests will indicate if your dog is at risk of developing DCM, even if they show no signs of the disease. Pets at risk of developing DCM and showing early indicators are treated with heart medication. This will not prevent the disease from developing, but will slow down the rate of degeneration through medical management. This is a lifelong treatment regimen. The earlier the vet can catch the condition, the better able we are to prolong your pet’s lifespan.

What about cats?

The main cause of DCM in cats has been found to be taurine deficiency, which was identified in the 1980s. Since this discovery cat food companies have supplemented taurine in their diets, resulting in this disease being a rare occurrence in this day and age. Dogs are able to produce their own taurine from other amino acids supplied through protein in the diet and do not suffer from this malady as often, but with a few exceptions. Cocker spaniels and golden retrievers are more sensitive to taurine deficiency and may develop taurine responsive DCM. Cats on grain-free diets have been known to develop DCM.

Cats can still develop heart disease with symptoms similar to DCM, namely hypertrophic cardiomyopathy and restrictive cardiomyopathy. Like in dogs, heart disease in cats can be primary (genetic in cases of ragdolls, Maine coons and some American shorthair breeds) or secondary in origin due to high blood pressure and high thyroid hormone levels.

Cats with heart disease are usually seen with breathing difficulty, poor appetite and weight loss. Treating these pets is usually focused on managing the underlying cause before focusing on the heart. Diagnosing a cat with heart disease is done in the same manner as dogs, discussed below.

What will the vet do if my pet has DCM?

Aside from the physical exam mentioned above, the vet will ask for a detailed history of your pet’s health, including diet, breathing difficulty and response to exercise. If there is any suspicion of heart disease the vet will likely recommend an x-ray and an echocardiogram. X-rays allow the vet to see the overall shape of the heart as well as see any changes to the lungs, whether it be fluid in the lungs (pulmonary oedema), fluid around the lungs (pleural effusion) as well as changes to the blood vessels in the chest. Where there is fluid buildup in the abdomen, this can also be seen on an x-ray.

An echocardiogram is an ultrasound scan of the heart. This is often performed by a diagnostic imaging specialist and the heart is visualised in motion. Each chamber as well as the valves can be seen and evaluated. The size of the heart chambers, wall thickness and the pumping effectivity of the heart are all measured with an echocardiogram. Often an ECG is also done at the same time, measuring the rate and rhythm of the heart.

Pets and people with DCM often have abnormal electrical conductivity of the heart due to the changes in structure and shape. This leads to an abnormal heart rhythm (arrhythmia). This asynchronous contraction of the heart makes for a very inefficient pump and may lead to fainting episodes as blood is not getting to where it needs to go, specifically to the brain. In severe cases arrhythmia can result in sudden death.

Can DCM be treated?

DCM is a devastating disease. Once a pet is symptomatic and in heart failure, the condition can only be managed, but not cured. The existing damage is irreversible; however,  treatment does significantly improve their quality of life and life expectancy.

If deficiency or diet-related DCM is suspected, some pets will respond to supplementation and dietary adjustment. The mainstay of DCM treatment, however, is medical management. DCM can be managed through the use of heart medications, which assist the heart in coping in its weakened state. Other medications such as diuretics (medication that promotes the increased production of urine) are often combined with these to reduce the buildup of fluid in the lungs and abdomen. Blood pressure medications can also be useful. If arrhythmia is a problem in your pet, then medication can be provided to assist with this as well. Each patient is unique and treatment is tailored individually.

Following up with the vet is important, especially in the beginning to monitor progress and to see if treatment adjustments need to be made. The vet will likely advise follow-up echocardiograms and x-rays at regular intervals.

My pet has been diagnosed with DCM. How long do they have?

Any pet diagnosed with DCM is given a poor prognosis, which is especially true once pets are in heart failure. Most pets diagnosed with the condition succumb to it. The severity of the disease and the breed of pet determines their life expectancy. In clinically affected Doberman pinschers, for example, life expectancy is less than a year. However, cocker spaniels tend to progress a little more slowly and can live more than a year with treatment.

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Understanding congestive heart failure in your pet

Understanding congestive heart failure in your pet

Congestive Heart Failure (CHF) is a very common condition affecting our pets, and is more often seen in dogs than cats. Although it is a serious condition, and a major concern for a pet owner, it can be easily diagnosed and once diagnosed, it can be managed effectively. The important thing is to make an early diagnosis and start treatment immediately. Congestive Heart Failure can occur in pets of any age, but is more common in older animals. For this reason it is important to have annual checks done on older generation pets. First, let’s have a look at how the heart works to be able to understand this condition better.

How does the heart work and how does it go wrong?

The heart works as a pump in the body, pushing blood through the arteries towards all organs and accepting blood coming through the veins towards the heart. It can thus be seen as a closed system of pipes running through the body. The heart itself is a muscular organ with four chambers. There are valves separating the chambers, preventing blood from moving in the wrong direction. It is usually here that the problem occurs. With age, although there are other reasons as well, the valves start to degenerate and deform, and cause the valves to fail in their function. Depending on which valve in the heart fails; it will result in either left heart failure also known as ‘forward failure’, or right heart failure or ‘backward failure’. As blood gets pumped from one chamber to the next, a small percentage of the blood gets pushed back to the previous chamber. Due to the fact that the circulatory system is a closed system, pressure will build up in that chamber. This puts more pressure on the heart muscle and the heart needs to work harder to get the blood pumped to where it needs to go to in the body. The damming back of blood is where the word Congestion comes from in Congestive Heart Failure. At first the heart can cope fine with this increased work load (compensatory phase) and no clinical signs will be noted. At some stage however the heart muscle will weaken to the point where it cannot cope with the increased work load anymore and a chain of events will be set off that result in clinical signs to be shown by the patient (decompensatory phase). This is usually the stage where owners will notice something is not quite right with the pet and take it to the vet.

How do I know my pet is suffering from congestive heart failure?

The clinical signs seen will depend on which side of the heart is affected more. With left heart failure you will notice exercise intolerance, meaning the animal will get tired more easily than usual during increased activity. Your pet will also be breathing more heavily and might seem uneasy. Coughing also occurs with left heart failure, due to the buildup of fluid in the lungs.  Coughing will often be more prevalent at night and the animal will find it difficult to settle down.  If the coughing gets severe, they will often retch up a white foamy substance. The animal may pace backwards and forwards at night and seem uneasy. In severe cases, the animal can faint or lose consciousness for a few seconds. This may look like a seizure as the animal might paddle with their front and back legs.

With right heart failure, fluid builds up behind the heart. This fluid can fill the abdomen causing the abdomen to distend. The liver often enlarges as well, adding to the distended abdomen. Due to the closed nature of the circulatory system you will often find clinical signs related to both left and right heart failure, as a pressure overload on the one side quickly affects the other side.

When you bring your pet to the vet, the vet will have a good listen to the heart. An affected heart will have a murmur audible with a stethoscope. This sound is due to the increased turbulence of the blood flow past the malfunctioning valves. The sound of a murmur can be very faint in early cases or quite severe and very audible in severe cases. In severe cases there may also be a thrill on the side of the chest which one can feel with your hand. On examination the tongue will often have a slight purple tinge to it, indicating the lack of oxygen supply to the body. The heart rate will be increased as well due to the increased work load put on the heart. If these signs are found by the vet, he or she may suggest further diagnostic tests for example X-rays, ultrasound or an electro-cardiogram (ECG). In some cases the vet may also suggest blood tests because other organs may also be affected by the heart’s failure.

Is congestive heart failure a death sentence for my pet?

As mentioned previously, the earlier it is diagnosed and treatment started, the better the outcome. Due to the nature of this condition, heart failure cannot be cured, only managed. The medication that is given is there to make the animal more comfortable. Studies have proven that certain medication can even lengthen the life span of the animal. The different medications prescribed all have different goals. Some medications (ACE inhibitors) are given to decrease the work load on the heart and in effect decrease damage to already malfunctioning valves. Other drugs which help to remove excess fluid buildup, also called diuretics, will be given and this helps with coughing by decreasing the fluid buildup in the lungs. Long term use of certain diuretics can cause the potassium in the body to decrease and potassium supplements may be necessary. Some drugs which help the heart to contract stronger and better (Positive inotropes) work directly on the heart, and increases the strength of each heart beat. It also decreases the work load of the heart by decreasing resistance in the blood vessels themselves. Other drugs less commonly used are bronchodilators, calcium channel blockers and amino acids like Taurine and L- Carnitine.

Other helpful advice

It is important to feed the right diet. Often commercial pet food contains high amounts of sodium. This will increase blood pressure and thus increase the work load on the heart. There are special veterinary prescription diets available that are low in sodium and have a good, high quality protein. Dogs suffering from severe cardiac failure often lose muscle mass called cardiac cachexia. A good quality dog food is therefore very important to build up and maintain the heart. In most cases of congestive heart failure exercise should be restricted. Never exert the pet to the point where the animal is battling to breath. If going out for short walks rather walk during the cooler parts of the day.

Pets that have been diagnosed with congestive heart failure need to visit the vet more often. Depending on the degree of heart failure and the progression of the disease, the initial treatment may require weekly visits to the vet. For most mild cases of congestive heart failure a checkup every 6 months is crucial. During these visits the vet will evaluate how the patient is coping and if any changes in medication needs to be made. The kidneys and liver of a cardiac patient need to be monitored closely, as the decrease in heart function has a negative impact on their function. Liver and kidney functionality is normally tested by means of urine and blood samples.

Although there are many dogs diagnosed with congestive heart failure living a happy comfortable life, one need to keep in mind that congestive heart failure is a progressive disease that will deteriorate over time. As the valves degenerate with age, the severity of the clinical signs will increase as well.  

Regular visits to the vet will ensure early detection of congestive heart failure, and may just give you a few more precious years with your pet.

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