Outlook For Heart Failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities you’re able to do and is often eventually fatal.
But it’s very difficult to tell how the condition will progress on an individual basis.
It’s very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
Diagnosing Chf In Dogs
The veterinarian will need your dogs complete medical history along with a complete physical exam to diagnose CHF. An accurate diagnosis will require a series of tests:
Blood and urine tests: Dogs with heart disease often have problems with their liver and kidneys.
Chest x-rays: These reveal the size and shape of the heart, as well as any changes in the lungs .
Electrocardiogram : This test detects abnormalities in the electrical activity of the heart .
Ultrasound : This tests examines the size, shape, and movement of the heart. It can also determine whether the heart is pumping efficiently. This diagnostic test should be performed only by a board-certified veterinary cardiologist .
Heartworm antigen test: This test detects abnormal proteins produced by heartworms.
CHF in dogs is broken down into four stages. Stages one and two present few symptoms, and owners may be unaware something is wrong until the condition has progressed to a later stage.
Medications For Heart Failure
Certain medications can help treat heart failure and its underlying cause:
- Aldosterone blockers block the effects of the hormone aldosterone, encouraging the body to release sodium and water. They also help prevent scarring in the heart.
- Angiotensin receptor-neprilysin inhibitor : Treatment with sacubitril-valsartan reduces excess fluid in the body and relaxes blood vessels. This makes it easier for your heart to pump blood. Alternatives to ARNIs include angiotensin-converting enzyme inhibitors andangiotensin receptor blockers .
- Beta blockers make the heart beat more slowly and with less force. They also help keep heart rhythm regular.
- Sodium-glucose transport protein 2 inhibitors are diabetes drugs that have recently been found to be very beneficial in heart failure. They help remove glucose via the kidneys into the urine.
Other medications can relieve the heart failure symptoms:
- Diuretics reduce the amount of fluid in the body.
- Vasodilators dilate the blood vessels and reduce the hearts workload.
- Digoxin helps the heart beat stronger with a more regular rhythm.
- Anti-arrhythmics control arrhythmia and maintain normal heart rhythm.
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Alpha And Beta Diversity
There were 28,374,445 reads generated by the Illumina sequencing of the 50 samples submitted. The assessment of alpha diversity is summarised in Table . There was no significant difference in the alpha diversity between the control versus CHF groups when assessed using operational taxonomic unit, Shannon diversity index or Faiths phylogenetic diversity . Beta diversity, analysed based on BrayCurtis distances, also showed no significant differences between the control versus CHF groups . However, a visual assessment of the principle coordinate analysis plot and Levenes test suggested a trend towards having a greater variation in the results of beta diversity in dogs with CHF =3.020, p=0.089). Additional analyses of the subgroups of CHF and CHF dogs living with or without other CHF or healthy dogs also showed no difference in alpha and beta diversity between the groups .
Table 2 The alpha diversity results from the 16S rRNA sequencing.Figure 1
Comparison of alpha and beta diversity between the control and congestive heart failure groups. The line in the alpha rarefaction curves marks the mean and the error bars mark the standard deviation. The principle coordinate analysis plot shows the results of BrayCurtis dissimilarity analysis . There was no statistical significance between the two groups in both analyses.
Heart Failure Treatment Is A Team Effort
Heart failure management is a team effort, and you are the key player on the team. Your heart doctor will prescribe your medications and manage other medical problems. Other team members — including nurses, dietitians, pharmacists, exercise specialists, and social workers — will help you achieve success. But it is up to YOU to take your medications, make dietary changes, live a healthy lifestyle, keep your follow-up appointments, and be an active member of the team.
If you notice anything unusual, don’t wait until your next appointment to discuss it with your doctor. Call them right away if you have:
- Unexplained weight gain
- Swelling in your ankles, feet, legs, or belly that gets worse
- Shortness of breath that gets worse or happens more often, especially if you wake up feeling that way
- Bloating with a loss of appetite or nausea
- Extreme fatigue or more trouble finishing your daily activities
- A lung infection or a cough that gets worse
- Fast heart rate
- New irregular heartbeat
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Stages Or Classes Of Heart Failure
Your patient may have been told what stage or class their heart failure is at this explains how severe it is.
NYHA classification divides heart failure into four classes:
- Class 1: no limitation of physical activity. Ordinary physical activity does not cause undue fatigue, breathlessness, or palpitations.
- Class 2: slight limitation of physical activity. Comfortable at rest but ordinary physical activity results in undue breathlessness, fatigue, or palpitations.
- Class 3: marked limitation of physical activity. Comfortable at rest but less than ordinary physical activity results in undue breathlessness, fatigue, or palpitations.
- Class 4: unable to carry out any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken discomfort is increased.
Patients with advanced heart failure will usually fit into class 3 and 4, despite the best specialist treatment. Read more about the definition of heart failure from NICE .
How Does Heart Disease Affect The Digestive System
Your heart pumps blood to every organ in the body including the digestive system. Heart disease, plaque or other conditions that interfere with the hearts ability to do its job can have a ripple effect on the rest of your body.
Your digestive system usually gets between 20-25% of the oxygenated blood pumped by the heart, with this amount doubling after you eat and your body needs to work to digest the meal. Unfortunately, if your heart isnt able to send enough blood to your stomach, it can cause severe issues from sharp abdominal pain to diarrhea, nausea or vomiting after a meal.
This can also create a feedback loop, since its not uncommon for people experiencing these issues to avoid eating, causing rapid and unhealthy weight loss and making it hard for them to maintain the activity they need to strengthen their overall health!
The reverse is also true the digestive system can also affect the heart. When someone has an inflammatory bowel disease, the intestinal barrier is affected, no longer protecting the rest of your body from dangerous bacteria. This bacteria, once entering the blood stream, can contribute to heart conditions and even chronic heart failure.
Thats why its important that you speak with your doctor about any recurring digestive or stomach issues as soon as possible.
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Medicines For Heart Failure
Most people with heart failure are treated with medication. Often you’ll need to take 2 or 3 different medicines.
Some of the main medicines for heart failure include:
- SGLT2 inhibitors
You may need to try a few different medicines before you find a combination that controls your symptoms but doesn’t cause unpleasant side effects.
Do Dogs Have Heart Attacks
Although it is very rare, the unexpected and sudden death of dogs from heart disease is possible. Some of the main risk factors that increase a dogs chances of having a heart attack include obesity, diabetes, high blood pressure, and serious bacterial infections.
If you believe your dog is having a heart attack take them to the nearest emergency care facility as soon as possible. There is a version of CPR that can be performed on dogs, however, it requires special training to do it properly. If done incorrectly, CPR can result in further injuries to your dog and delay getting proper medical attention from a veterinarian.
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Signs And Symptoms Of Congestive Heart Failure In Dogs
The signs and symptoms associated with CHF may vary, depending on the underlying heart disease and whether the right or left side of the heart is affected. In some cases, symptoms will be the same regardless of side.
These signs should be taken seriously and addressed with your veterinarian at first notice:
Change in gum and/or tongue color to a bluish gray
Increased heart rate
Crackling sound when listening to the lungs
Both right-sided and left-sided CHF ultimately lead to oxygen depletion in the tissues, and eventual heart failure.
History And Physical Exam
A clinician listens to your heart and lungs and measures your blood pressure and weight. They will also ask about your:
- Familys medical history, especially previous cardiac problems
- Medications, including prescriptions, over-the-counter drugs and supplements
- Personal medical history
Blood tests can measure several things related to heart failure:
- Sodium and potassium levels
- Creatinine, which helps measure how well your kidneys are working
- B-type natriuretic peptide , a hormone released from the ventricles in response to increased wall tension that occurs with heart failure
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Acute Or Chronic Heart Failure
Heart failure can be acute or chronic.
Acute heart failure happens when either:
- symptoms come on suddenly
- it’s the first time the patient has had heart failure
- symptoms suddenly become worse during chronic heart failure.
Chronic heart failure is when someone’s heart failure develops gradually over time and is a long-term condition.
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Cardiac Cachexia Or Anorexia
Cardiac cachexia happens when a patient loses fat and muscle tissue. Patients with cachexia may lose their appetite and significant amounts of weight.
Speak to a dietitian about managing cachexia and anorexia. They may suggest eating small, frequent meals or taking high calorie, high protein food and supplement drinks. Patients may need to avoid some fruit juices and food supplements, which can affect their medication.
Heart Medication For Dogs
- Diuretics like furosemide are medications used to remove excess fluid buildup from the lungs or abdomen.
- Inodilators are medications that both increase myocardial contractility and open up constricted blood vessels, reducing the workload on your dogs weakened heart. The only one available currently is Pimobendan .
- ACE inhibitors, or inhibitors of angiotensin-converting enzyme, are a group of medications that open up constricted blood vessels.
Bruiser is on Pimobendan, Furosemide, and a drug called Sprionolactone, which is another diuretic.
Support Them To Make Decisions About Treatments
As well as having an advance care plan, patients should be given the chance to discuss the following issues:
- Whether to deactivate an implantable cardioverter defibrillator , if they have one. This can prevent the ICD activating at the end of life, which can be distressing.
- What the patient would want to happen if they had a cardiac arrest. They may decide they do not want to have cardiopulmonary resuscitation .
- When to stop medication that no longer reduces symptoms or improves their quality of life. This can be a difficult conversation and it’s best carried out sooner rather than later. Make sure the patient and the people important to them understand what changes are being made to their medication and why.
How Is Chf Diagnosed In Dogs
Bruiser needed an echocardiogram , which revealed degeneration of the mitral heart valve and subsequent heart enlargement. This is common in older dogs.
A full physical examination will be needed to determine the cause and whether there is an abnormal heart size, fluid accumulation, pleural effusion, and heart defects.
Steps toward a diagnosis of congestive heart failure in dogs:
- Listening to the heart with a stethoscope
- An electrocardiogram . Sometimes an ultrasound is done as well.
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Treatment For Congestive Heart Failure In Dogs
Treatment depends on the underlying heart disease, along with the severity. There is usually no cure for CHF, but there are effective treatments to ensure a good quality of life. If the cause of CHF is a congenital abnormality like a PDA, surgical correction may help to reverse heart failure if performed in a timely fashion. The goal when treating CHF is to reduce fluid buildup and maximize the amount of blood being pumped to the lungs and the rest of the body.
Here are some of the medications, supplements, and diets that may be recommended:
ACE inhibitors : Help reduce blood volume and pressure, relieve stress on the heart, and slow the deterioration of the heart muscles.
Diuretics: Help stimulate the kidneys to remove excess fluid buildup in the lungs and abdomen.
Vasodilators and positive inotropic drugs: Vasodilators help relax blood vessels and decrease pressure on the heart, allowing it to pump blood more easily. Positive inotropes increase the force with which the heart muscle beats, allowing the heart to pump more blood to the lungs and the rest of the body.
Nutrition: Limiting the amount of sodium in your dogs diet can decrease fluid buildup in the body. Supplements like vitamin B, taurine, and carnitine, along with antioxidants like coenzyme Q10 and vitamin E, can also help. Finally, a diet that allows your dog to maintain a healthy weight is very important for heart health.
Emotional Symptoms Towards The End Of Life
People with heart failure may experience different emotions and feelings. They may feel:
- up and down, with good days and bad days
- like they lack control over their life
- like it’s hard to cope with the reactions of others.
People may not think heart failure is as serious as other illnesses, such as cancer. Patients with heart failure can look well even when they feel very ill.
If a patient has anxiety or depression, their healthcare team will assess how it affects them and whether they need treatment, such as cognitive behavioural therapy or medication.
You can support the patient by providing emotional care and helping them with activities to make them feel better, such as reading, going outside and listening to music or audio books. Find out more about providing emotional care.
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Medical Treatment Options For Diarrhea
It may not be a pleasant subject to discuss , but diarrhea is a common problem that is sure to affect everyone at one time or another. Numerous health conditions can cause diarrhea. Most of the time, diarrhea is caused by a dietary indiscretion or a viral illness and is short-lived, but for some diarrhea can be a symptom of a more serious condition. If your diarrhea last longer than a few days, you should make an appointment to come in and see me.
Surgery For Heart Failure
Your doctor may recommend surgery to implant a medical device that helps the heart function more effectively:
- Pacemaker, which maintains a steady heart beat in people with a slow or irregular heartbeat
- Implantable cardioverter defibrillator , which monitors the heart for fast rhythm and delivers an electrical shock to reset normal rhythm
- Left ventricular assist device , which takes over the pumping action of the heart
People with advanced heart failure may be candidates for heart transplantation. A heart transplant replaces the diseased heart with a donated heart from a person who has died.
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Summary Of Congestive Heart Failure In Dogs
Congestive Heart Failure in dogs is fairly common, affecting 75% of senior dogs. While there is no cure, medication and lifestyle changes can help manage the condition. As its not always easy to detect in its early stages, prevention is important proper diet, exercise, and weight maintenance are key for canine cardiovascular health. Be aware of the signs and symptoms so you can seek help as soon as you suspect CHF could be an issue, and stay up to date on your annual vet visits.
Talk To Them About Their Symptoms
People with heart failure may feel worried about their symptoms, treatment or risk of dying suddenly. Reassure them by talking openly and honestly about their concerns. Speak to their cardiac or palliative care team if you need support. If the patient has a plan for managing symptoms or emergencies, they may feel less anxious.
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Preventing Congestive Heart Failure In Dogs
To prevent CHF, owners need to be aware of the signs and symptoms associated with heart problems and address them right away. Proper nutrition is important, but supplements can also play a role heart disease prevention.
Some preliminary studies have shown a link between grain-free diets and heart disease . If your dog is eating a grain-free diet, speak with your veterinarian about whether your dog should change to a diet containing grain.
What Is The Outlook For People With Heart Failure
With the right care, heart failure may not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.
Everyone with a long-term illness, such as heart failure, should discuss their desires for extended medical care with their doctor and family. An “advance directive” or “living will” is one way to let everyone know your wishes. A living will expresses your desires about the use of medical treatments to prolong your life. This document is prepared while you are fully competent in case you are unable to make these decisions at a later time.
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