Congestive Cardiomyopathy In Dogs
The heart has four chambers: two chambers at the top, the right and left atria and two chambers on the bottom, the right and left ventricles. The right side of the heart collects blood from the body and pumps it into the lungs, where the blood is oxygenated. The oxygen rich blood is then collected by the left side of the heart, and from there it is pumped out into the body’s various organs.
Congestive left-sided heart failure refers to a condition in which the left side of the heart is not able to push blood through the body efficiently enough to meet the metabolic needs of the body, and frequently results in blood pooling in the lungs. This is the most common type of congestive heart failure in dogs. Low blood output from the heart causes tiredness, exercise intolerance and fainting.
Dog Heart Disease Treatment
Treating heart failure is essential to improve muscle strength, control possible arrhythmia, and maintain normal blood pressure and adequate blood circulation.
It is also imperative to manage to heal excess fluids from the lungs, chest, and abdomen.
Again, treatment depends on your dogs specific condition.
If he is in respiratory distress, your dog must be hospitalized urgently.
He will then be placed under oxygen to be stabilized.
If the heart failure is due to mitral damage, your dog may be treated with Pimobendane , a positive inotrope that strengthens the contraction of the heart and improves blood circulation.
Prescribing a diuretic like furosemide significantly reduces fluid buildup in the lungs.
Finally, an ACE, an angiotensin-converting enzyme, like Enalapril is added to relax blood vessels and reduce hypertension while helping the heart to pump more efficiently.
Canine Congestive Heart Failure
Matthew W. Miller, DVM, MS, Diplomate ACVIM , and Sonya G. Gordon, DVM, DVSc, Diplomate ACVIM , Texas A& M University
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Profile Definition Congestive heart failure is a clinical syndrome associated with a cardiac lesion that results in an increase in venous pressure sufficient to cause a build-up of fluid within the lungs and/or abdomen and/or pleural space.
Signalment Species. Dogs of any age, sex, breed, or activity level can develop CHF.
Breed predilection. Breeds predisposed to degenerative valvular disease and dilated cardiomyopathy are most commonly affected. DVD is most common in small breed, older dogs. The prevalence is highest in cavalier King Charles spaniels, dachshunds, toy poodles, miniature schnauzers, and Chihuahuas. DCM is most commonly seen in older, large breed dogs. The prevalence is greatest in Doberman pinschers, Great Danes, Irish wolfhounds, boxers, and cocker spaniels.
Risk Factors The only established risk factor for CHF is development of either DVD or DCM.
Resolution of a radiographic infiltrate with a therapeutic challenge of furosemide is considered by many to be the gold standard for diagnosis of CHF
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Because Theyre Part Of The Family
Nearly 8 million dogs suffer from heart disease. Thats 10% of all dogs in the United States. And the older your dog is, the higher the risk. Up to 75% of senior dogs have some type of heart condition, and unfortunately, most go undetected.
Dont risk losing part of your family to an often treatable heart condition. If you have concerns, seek medical advice quickly. Our board-certified dog cardiologists are here to help.
Lifestyle And Diet Changes Are Also Key For Managing Chf In Dogs
Your vet will be able to tailor your dogs medicine to their needs, but meds are just part of the equation. Youll also want to ask your veterinarian about lifestyle changes that can help your pup live a full life while managing their congestive heart failure.
Vet visits. For starters, youll likely need to schedule more frequent check-ups. During these visits, your vet can track the progression of your pups CHF, and you can discuss any changes that may need to be made to their treatment plan.
Low stress. Its a good idea to reduce stress at home and try not to over-exert your pet. This could mean keeping them off the stairs, taking shorter walks, etc.
Diet. In the earliest stages, a diet that has lower levels of sodium in your dogs diet can help slow the progression of CHF and help eliminate excess stress on the heart. CHF isnt really preventable, but you can make sure youre not feeding your dog a grain-free diet, which has been linked to heart disease in dogs.
Supplements. In these early stages, specific supplements and antioxidants might help. While those supplements can generally be found over the counter without a prescription, make sure to consult with your vet before starting your dog on any supplement regimen. Although supplements and nutrition can help to some degree, ultimately your dog will need to be started on lifelong medications to help slow down the progression of CHF.
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Signs Of Heart Disease In Dogs
Heart disease in dogs is like many progressive diseases where it can take a long time for symptoms to develop. If your pup displays any of the following symptoms or behaviors, schedule an appointment with your vet to have them checked out:
Need help finding a vet in your area? No problem.
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.
Grade 1: Very soft murmur, often difficult to hear
Grade 2: Soft murmur but readily heard
Grade 3: Moderately loud murmur
Grade 4: Loud murmur
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
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.
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Conventional Treatment For Congestive Heart Failure
Conventional vets typically treat CHF with prescription medicines. This may be diuretics, which cause the kidneys to excrete extra water to clear out the excess from the lungs or abdomen. The problem is that this puts extra pressure on the kidneys, potentially harming them.
They may also prescribe drugs that make the heart muscle pump more strongly. The problem here is that these drugs sometimes put extra pressure on the valves and can cause more damage. Vets may also prescribe vasodilators to reduce the blood pressure. They open the blood vessels to allow blood to flow more easily.
Iavoid these medicines until theyre a dog needs them for palliative care.
But if your dog already has congestive heart failure, what natural options exist?
What Are The Symptoms Of Congestive Heart Failure
The most common signs of congestive heart failure are difficulty breathing and a persistent cough. These may seem like minor symptoms, but they point to something more serious. These only occur with left-sided heart failure, as they are caused by a build-up of fluid around the lungs.
Occasionally, an enlarged heart may also push against the trachea, causing irritation and coughing. This can occur with right-sided and left-sided heart failure. Therefore, coughing isnt necessarily always a sign of right-sided heart failure.
Dogs with heart failure often fatigue faster, as they are unable to deliver oxygen to their body efficiently. Excess panting, loss of appetite, a swollen belly, and pale gums are also symptoms of heart failure. Some dogs may even begin to lose muscle mass.
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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
How To Prevent Chf In Dogs
While most cases of heart disease are associated with age or genetic predisposition, there are two preventable forms of heart diseaseheartworm disease and diet-associated cardiomyopathy.
Heartworms are a blood-borne parasite, spread by mosquitoes. In order to prevent heartworm disease, your dog should receive year-round heartworm prevention. There are several forms of prevention available. Talk to your veterinarian to determine which option is best for your dog.
Diet-associated cardiomyopathy is still being researched, but one particular form of heart disease called dilated cardiomyopathy may be connected to the food a dog is eating and possible nutritional deficiencies. Talk to your veterinarian to ensure that your dog is receiving an appropriate, well-balanced diet.
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Types Of Congestive Heart Failure In Dogs
- Left-sided congestive heart failure: This causes pressure to back up in the vessels that pump blood into the left ventricle of the heart. Blood leaks through the mitral valve, which causes excess fluid to become congested in the lungs. Fluid accumulates in the lungs and leads to coughing, exercise intolerance, difficulty breathing, and a high respiratory rate.
- Right-sided congestive heart failure: This causes pressure to build up in the vessels where blood flows into the right atrium from the veins in the body. Rather than leaking through the mitral valve, blood leaks where it is pumped into the heart and becomes congested within the body. This pressure can lead to fluid buildup in the chest cavity, the abdomen , the liver, and even the limbs . These dogs can also experience difficulty breathing due to pressure around the lungs.
Is Heart Failure The Same As A Heart Attack
No, heart failure can lead to a heart attack. However, heart attacks are rather uncommon with dogs. Heart attacks are caused by death to the cells around the heart. Usually, this cell death is caused by oxygen deprivation by the obstruction of the blood vessels around the heart. Sudden deaths in dogs are sometimes attributed to heart attacks.
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What Are Symptoms Of Congestive Heart Failure In Dogs
There are several symptoms and signs of congestive heart failure in dogs. By keeping them in mind, you can speak to your vet about their presence in your dog and move forward with further diagnostics if required.
Since the set of symptoms for CHF may relate to a variety of other conditions and diseases, you should keep an eye on your dog to determine if they are going through any of these challenges. If your dog seems to have any issues that are associated with CHF, you should reach out to a skilled vet right away.
Sometimes, indicators of other conditions such as signs of anxiety in dogs can be mistaken for CHF. Getting a professional opinion lets you steer clear of these confusing diagnoses. Due to this reason, you should not compromise on reaching out to a vet.
Signs Of Heart Failure In Dogs
As you know, the heart is the most essential organ in the body.
Its role is to pump blood through the arteries to distribute it to each organ.
In short, a closed circuit that allows the body to function properly.
The heart is a muscle that is made up of four chambers:
- the left atrium
- the right ventricle
- the left ventricle
The right atrium receives the oxygen-deprived blood and sends it to the right ventricle which propels it to the lungs for it to oxygen again.
It then returns to the left atrium which sends it to the left ventricle to propel it to the rest of the body through the aorta.
The atrium and left ventricle are separated from the right atrium and ventricle by valves that prevent blood from deviating from its path.
The problem is often here when your dog gets cardiac as he gets older.
These valves degenerate and lose their original shape.
Depending on the affected valve, the dog may have left heart failure if the mitral valve is affected or right heart failure if the tricuspid valve has failed.
When blood is pumped from one chamber to another, the defective valve tends to push blood back into the starting chamber.
And since the circulatory circuit is closed, this failure causes pressure in the chambers which leads to increased pressure in the muscles of the heart.
The heart, therefore, begins to pump harder to keep sending blood through the body, which explains the congestion of heart failure.
But the heart can overcome this increase for a while.
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Heart Failure Congestive Heart Failure And The Failing Heart
Any heart with a reduced ability to contract is considered a failing heart. Almost any dog with heart disease that leads to chamber enlargement or increased wall thickness has a failing heart, but the body usually is able to compensate in other ways for these physical changes. As a result, the dog has no signs and is not in heart failure or congestive heart failure.
Heart failure and congestive heart failure are medical syndromes in which a dog exhibits signs related to a complex interaction between a failing heart and the blood vessels.
In heart failure, the blood flow is insufficient to supply organs with enough oxygenated blood for proper function. Depending on the degree of severity, signs of heart failure may appear while the dog is at rest, during mild exertion, or during moderate or extreme exercise.
In congestive heart failure, blood dams up in organsusually the lungs but occasionally in the bodys other major organsand causes the congested organs to function abnormally, become swollen with fluid, or both.
Systolic myocardial failure is a general reduction in the ability of the heart muscle to contract. This can be identified with echocardiography . There is reduced wall motion during contraction of the ventricles. If the reduction is significant, normal blood flow cannot be maintained. It may be caused by genetics, trauma, infection, drugs or poisons, electric shock, heat stroke, or tumors. Some cases have no known cause.
How To Recognize The Symptoms Of Pulmonary Edema In Dogs
Your dog appears weak, coughs frequently, and his breathing is accelerated.You hear crackling sounds with each breath and he seems to be gasping for air with his mouth open.He also presents an intolerance of any effort.
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Stages Of Canine Congestive Heart Failure
Heart failure in dogs is divided into several stages, which correspond to the severity of disease. These stages include:
Stage A: Dogs that are at risk of heart disease but not yet showing signs of heart disease.
Stage B: Dogs with evidence of heart disease but no evidence of congestive heart failure. Stage B is further divided into two substages:
- Stage B1: There are no visible heart changes on radiographs or echocardiography.
- Stage B2: There ARE visible changes to the heart seen on radiographs or echocardiography
Stage C:This stage includes dogs with current or previous signs of heart failure.
Stage D:Dogs with ongoing signs of heart failure that are not responding to standard medical treatments
Four Stages Of Congestive Heart Failure
There are four stages of congestive heart failure. Different symptoms and clinical signs are more common to specific stages.
Stage One. This is the very beginning of deterioration. During this stage, you probably wont be able to tell your pet has CHF based on shown symptoms. However, a vet may notice something during a checkup, such as hearing a heart murmur when listening to your dogs chest with their stethoscope, or while treating another issue that could help indicate CHF in this early stage.
Stage Two. At this point, you may start to see minor symptoms such as panting, shortness of breath, slowed respiratory rate, and fatigue. If you notice these signs over the course of days or weeks, its definitely a good idea to call your vet to set up an appointment.
Stage Three. A dog experiencing this more advanced stage of CHF will likely show heightened levels of fatigue, chronic coughing and/or wheezing, and breathing difficulties.
Stage Four. This is the final stage of CHF, where your dog might find breathing hard even while resting. You may also notice more alarming symptoms such as swollen limbs, a distended abdomen, or even blue-tinged gums, all signs of heart failure.
The earlier you catch CHF, the better your dogs outlook is regarding treatment options and quality of life.
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