Stages Of Congestive Heart Failure
The risk and progression of CHF in dogs is classified by stages similar to the way it is categorized for humans with CHF. The stages run from an initial risk for developing CHF but not showing any symptoms to severe symptoms .
- Stage A: Dogs with a higher risk for developing CHF but currently show no symptoms or structural changes to the heart. Dogs with a genetic risk include small breeds such as Miniature Poodles, Cocker Spaniels, Terrier breeds, and some larger dogs such as Great Danes or Dobermans.
- Stage B: Dogs with a heart murmur that a vet can hear but does not show any symptoms. A murmur indicates turbulent blood flow within the heart
- Stage B2: Dogs that show a structural change on an X-ray/radiograph or echocardiogram but are without symptoms.
- Stage C: In this stage, symptoms of heart disease are present. Dogs in this stage will have current or historic clinical signs of congestive heart failure, but still respond positively to medications and treatment.
- Stage D: This stage is referred to as end-stage disease. In this stage, a dog will typically have severe symptoms of disease that unfortunately no longer respond to medications or other treatments.
How Is Heart Failure In Dogs Diagnosed
The vet will check your dogs medical history and may conduct a physical exam. They will also run special diagnostic tests to definitively confirm that your dog is suffering from heart failure.
Here are the most common exams for heart failure in dogs:
1. Blood and Urine Testing
Heart diseases can affect the liver and kidneys of affected dogs. Both tests will help determine the type of medications appropriate to use on your dog. This also verifies if your dog has a taurine deficiency.
2. Chest X-Rays
This exam uses low radiation levels to acquire imaging of your dogs heart and lungs. Chest x-rays help the vet check the size and shape of his heart. It also aids in detecting fluid build-up in the lungs.
3. Echocardiogram
This exam makes use of ultrasound waves to observe the size and thickness of each heart chamber. The vet will also be able to note if there are abnormalities in the hearts contractions.
4. Electrocardiogram
It measures the electrical signals from your dogs heart. This test aids in confirming if there are any issues in his heart rate and rhythm such as heart murmurs.
5. Endomyocardial Biopsy
This is an invasive procedure done to gauge your dogs L-carnitine levels. It will figure out if he has L-carnitine deficiency.
6. Heartworm Antigen Test
Heartworms are one of the most common causes of heart failure in dogs. This type of test will examine your dogs blood to find out if your pooch has or has had heartworms.
7. Holter Monitor
Signs And Symptoms Of Congestive Heart Failure In Dogs
Depending on the underlying heart condition and whether the right or left side of the heart is damaged, the signs and symptoms of CHF may differ. In some circumstances, the symptoms are the same on both sides.
These warning symptoms must be taken carefully and discussed with your veterinarian as soon as possible:
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What Causes Congestive Heart Failure
The most common cause of congestive heart failure in dogs is congenital heart defects, meaning that it’s a genetic condition that can’t be prevented. Many small breeds have a genetic propensity toward CHF, says Love to Know, including toy poodles, Pomeranians, dachshunds, and cavalier King Charles spaniels. Small dogs in general tend to be more prone to developing CHF because the heart valves tend to degenerate more than in larger breeds. However, some large breeds, particularly giant breeds such as St. Bernards, Newfoundlands, and Great Danes are prone to developing CHF due to dilated heart muscles. It’s important to understand that congenital CHF typically manifests late in a dog’s life and that these dogs can live many years seemingly healthy and happy before symptoms begin to appear.
CHF can also develop in a heart that’s been weakened by other heart conditions, so it’s important to do what you can to prevent heart disease from occurring in your pet, including preventing obesity and providing heartworm prevention.
Life Expectancy Of Heart Failure In Dogs
Unfortunately, there is no cure for congestive heart failure in dogs.
Medical management can be effective in offering a dog more time, and making their life more comfortable as their disease progresses.
Though there is no known cure for CHF, daily medication and lifestyle changes can add significant time to their life.
If your dog has been diagnosed in the early stages of their heart failure, they may have anywhere from 1 to 3 years.
Early detection along with proper medical care can significantly improve a dogs prognosis.
However, if your dog is diagnosed with CHF when they have begun to display serious symptoms, their time may be limited.
These pups typically have a life expectancy of 1-6 months, and will need to be monitored closely for any sign of suffering.
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The Signs Of A Dog Dying Of Heart Failure
If your dog is in the final stages of their heart failure, you may be curious about the typical signs of a dog suffering in their CHF.
To help you make the best decision for your furry friend, lets list some of the signs of a dog dying from their heart failure.
- Frequent coughing
- Coughing up foam, or bloody foam
- Labored breathing
- Weakness, or inability to exercise
- Fainting episodes
- Blue, purple, or muddy gums
- Constant panting
If your dog is experiencing any of the above symptoms, it may be time to discuss quality of life with your veterinarian.
What Are The Different Stages Of Congestive Heart Failure In Dogs
The stages of congestive heart failure in dogs are classified into 4 groups. It is worth noting that certain clinical signs are more common at each stage.
Stage 1
This is the beginning of a dogs heart degeneration. Clinical symptoms of the condition are yet to show themselves.
Stage 2
Early symptoms of congestive heart failure start to take place. Affected dogs in this stage often have breathing difficulties, low energy, and slow respiratory rate.
Stage 3
What are the final stages of congestive heart failure? Stage 3 is one of the final stages of congested heart failure in dogs. Around this time, dogs with CHF become tired more quickly. Chronic coughing and severe difficulty in breathing may arise too.
Stage 4
What are the last stages of congestive heart failure in dogs? Stage 4 is the last stage of CHF in dogs. Pooches that are in this stage will experience breathing difficulties even when at rest.
Other symptoms to be aware of are a bloated abdomen, swollen limbs, and blue-coloured gums.
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End Stages Of Heart Failure In Dogs
The end stages of heart failure in dogs are the hardest for dog owners to endure. When the heart fails to pump as effectively as it should, a cascading chain of events takes place. While the body can try to compensate, and medications can help reduce strain on the heart, this will be effective only up to a certain extent. As the heart is forced to work more, a point will inevitably come where the heart is no longer able to pump correctly. Veterinary care at this point is still important. Your vet can suggest you a therapeutic plan and you should follow up to report the level of success of such intervention.
Clogged arteries leading to heart disease is mostly seen in humans.
When the Heart Fails
In dogs, congestive heart failure is mostly caused by two heart conditions, namely valve degeneration and dilated cardiomyopathy .
Congestive heart failure in dogs is a chronic condition that worsens over time. Although symptoms can be managed, there is no cure, and in time, affected dogs will unfortunately reach the final stages.
When dealing with heart failure, therefore vets aren’t really fixing anything, but just trying to relieve symptoms and delay the inevitable for as long as possible. Dogs with end stage heart failure are unfortunately on “borrowed time.”
Clinical Features At The Time Of Inclusion
All cats at inclusion presented clinical signs related to CHF.
Dyspnea secondary to pleural effusion , pulmonary edema , or both was observed in all cats as confirmed by radiography and echocardiography, with paradoxical breathing in 5 cats . Other clinical signs included abdominal distension secondary to ascites , and anorexia .
Out of the 21 included cats, 10 presented with a first CHF episode requiring a first oral prescription of loop diuretic and 11 had experienced at least one previous episode of CHF requiring treatment adjustment owing to CHF deterioration despite furosemide prescription once a day , twice a day or three times a day , and furosemide was replaced with torasemide in these 11 cats . The median number of furosemide intakes was 2.0, with a median dosage of 3.3mg/kg q24h. Other cardiac treatments administered prior to torasemide prescription included benazepril , clopidogrel , aspirin , pimobendan , spironolactone , diltiazem , amlodipine , and taurine supplementation .
Fig. 1
Out of the 54 included control cats, 44 presented with a first CHF episode requiring a first oral prescription of loop diuretic while 10 had experienced at least one previous episode of CHF requiring treatment adjustment owing to CHF deterioration despite furosemide prescription. This was significatively different from the torasemide group in which only 10/21 cats presented with a first CHF episode requiring an initial loop diuretic prescription .
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Congestive Heart Failure In Dogs
Simon Swift
MA, VetMB, CertSAC, DECVIM-CA , MRCVS
After qualifying from Cambridge University, Dr. Swift spent 2 years in mixed practice before moving to a specialist small animal practice in the Northwest of England. He developed an interest in cardiology, taking the RCVS cardiology certificate in 1990. He became a partner in a large emergency and referral hospital building up the cardiology referral service until he left in 2005 to follow an alternative residency program at Liverpool University. Since becoming a European Diplomate in cardiology, he worked in a private referral hospital before moving to Florida to join the College of Veterinary Medicine as Clinical Associate Professor. He is service chief for cardiology and has recently been appointed medical director. He has been involved in breeding programs and the treatment of degenerative valvular disease especially in the cavalier King Charles spaniel having been adviser to the UK CKCS club for 20 years and more recently has helped develop advanced interventional techniques at the University of Florida.
STAGE
A: A dog at risk of heart disease
B1: Signs of heart disease . The dog is asymptomatic.
B2: Signs of heart disease . The dog is asymptomatic.
C: Congestive heart failure is present or has been present and the dog is receiving treatment.
D: Congestive heart failure is present and refractory to standard therapies. The patient requires hospitalization.
Does Vetmedin Have Any Side Effects
Normally dogs tolerate Vetmedin very well. It is rare for side effects to be observed but some dogs may experience vomiting, diarrhoea, lethargy, an increase in mitral valve regurgitation, reduced appetite or a slight increase in heart rate. Other signs are very rare, but if you are concerned about your dog for any reason, please refer to the adverse reactions section on the package leaflet or contact your vet for advice.
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Treatment Options For Heart Failure
Once your vet has diagnosed your dog with congestive heart failure with a physical exam and diagnostic imaging, there will be a few treatment options that can offer your dog more time.
These management options will only be a band aid for your dogs heart disease, but can offer them much needed comfort as the condition progresses.
Some of the most common treatment options for dogs with CHF include:
Treatment Of Congestive Heart Failure
Congestive heart failure is a condition that occurs when a pets heart can no longer pump enough blood, causing fluid to back up into the lungs or the belly. The specific treatment for congestive heart failure depends on the underlying type of heart disease and its severity.
The primary goals of treating congestive heart failure are to reduce the buildup of fluid and to increase the blood being pumped by the heart to the lungs and the rest of the body. These outcomes can help to improve the quality and length of your pet’s life. A variety of medications, diets, and nutritional supplements are available to help reach these goals. To learn more about supplements and diets that may be appropriate for a pet with heart disease or congestive heart failure, please visit our Nutrition tab.
Usually once a pet has congestive heart failure, they require life-long medications. Sometimes treatment is started during a short stay in the hospital, and other times your veterinarian will feel comfortable starting treatment at home.
Medications that are commonly used to treat congestive heart failure include diuretics like furosemide and spironolactone, ACE inhibitors like enalapril, benazepril or lisinopril, and a drug called pimobendan. Pimobendan increases the strength of contraction of the heart and has been shown to prolong survival of dogs with congestive heart failure.
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Signs Of A Dog Dying Of Heart Failure
If your dog has just been diagnosed with congestive heart failure, you likely have many questions about what this means for their future.
CHF is a serious condition that cannot be cured, but can be managed over time with proper care.
So how do you know if your dog is beginning to suffer in their condition?
In this article we will discuss the details of CHF in dogs, and help you understand the signs of a dog dying of heart failure.
Management Of Recurrent Acute Signs
If decompensated heart failure returns, the patient should be admitted and diuretics given intravenously to regain control. A higher dose of furosemide may be needed and is often achieved by increasing the frequency of administration to 3 times daily or more. If the dose of furosemide starts to exceed 3 to 4 mg/kg q8h, furosemide resistance may be present. At that point, options include adding another diuretic, such as a hydrochlorothiazide, to achieve sequential nephron blockade.
Alternatively, the more potent loop diuretic torsemide can be prescribed. The starting dose is generally obtained by taking the total daily furosemide dose and dividing it by 10 that total daily dose of torsemide is divided to be given PO twice daily. For example, if a dog is receiving a total daily dose of 100 mg furosemide, the dose of torsemide would be 5 mg PO q12h.15
After switching diuretics, renal parameters and electrolytes should be checked in 5 to 7 days.
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How Do Dogs Develop Congestive Heart Failure
Left-sided heart failure is the most common cause of congestive heart failure in dogs. This is typically due to mitral valve disease, dilated cardiomyopathy, hypertrophic cardiomyopathy, and congenital heart defects like a patent ductus arteriosus. These heart diseases cause the heart to be unable to pump blood efficiently to the rest of the body. They may also raise the blood pressure in the veins causing fluid to leak out into other tissues or body cavities.
Congestive heart failure may also be a hereditary condition in dogs. Read below for a list of the most common causes of canine CHF.
- Chronic valve disease– This can occur when the heart valves degenerate and eventually fail to function properly. This can lead to an increased heart load and eventually CHF.
- Dilated cardiomyopathy – The condition is a frequent cause of CHF in certain breeds of dogs. Dilated cardiomyopathy is characterized by the enlargement of the heart that causes weakening and thinning of the hearts muscular walls. When this happens, the heart is unable to pump adequate amounts of blood throughout the body.
- Mitral valve insufficiency – This can happen when the mitral valve between the hearts left atrium and left ventricle, becomes leaky.
- Defects in the walls of the heart
- Abnormalities in heart rhythm
- Fluid in the pericardium
- Increased blood pressure
Chronic Treatment Of Congestive Heart Failure In Dogs
Chronic treatment of patients with CHF shifts from trying to control pulmonary edema to trying to negate deleterious effects of neurohormonal stimulation. The aim of chronic CHF treatment is to increase longevity of the patient, as well as improve quality of life. As a result, treatment for chronic CHF generally involves the use of 4 medications: furosemide, pimobendan, an angiotensin-converting enzyme inhibitor, and spironolactone. These drugs are usually continued indefinitely. Other drugs may also be required.
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How Veterinarians Diagnose Congestive Heart Failure In Dogs
Diagnosing congestive heart failure will start with listening to the heart and lungs with a stethoscope. Most dogs will have a heart murmur which will be graded in severity from 1 to 6.
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Grade 1: Very soft murmur, often difficult to hear
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Grade 2: Soft murmur but readily heard
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Grade 3: Moderately loud murmur
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Grade 4: Loud murmur
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Grade 5: Very loud murmur that can be heard with the stethoscope, barely touching the chest. The vet can feel a vibration through the chest wall over the heart
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Grade 6: Very loud murmur that can be heard with the stethoscope of the chest . The vet can feel a vibration through the chest wall over the heart
If your veterinarian suspects CHF, he or she will likely want to perform a chest X-ray/radiograph to check for heart enlargement or evidence of fluid on the lungs . Electrocardiogram may also be used to assess the rate and rhythm of the heart.
At this point, your veterinarian may refer you to a veterinary cardiologist for more specialized testing such as an echocardiograph or ultrasound of the heart. An echocardiograph is the most useful tool to identify the source of a murmur, the likely cause of CHF, and a measurement of the hearts ability to pump blood.