Congestive Heart Failure

With its ability to onset at any age, in any breed or gender, congestive heart failure (CHF) is one of the most serious canine and feline heart conditions. Congestive heart failure is characterized by the heart’s inability to circulate enough blood to meet the body’s demands. Because the heart muscle becomes weakened as a result of CHF, the health of other organs suffers, including that of the liver, kidneys, and lungs.

CHF can be caused by several different abnormalities in the heart which result in inefficient blood flow. This causes blood to back up in different areas of the body. Disease of the left side of the heart causes blood to accumulate primarily in the lungs. Right sided heart failure results in blood backing up in the vena cava and jugular vein, which causes fluid to accumulate in the liver and abdomen. Once fluid begins to accumulate in abnormal areas, additional symptoms like difficulty breathing, coughing, or abdominal swelling are noticed.  As heart failure progresses, the heart muscle becomes increasingly damaged and less efficient.  Subsequently, it tries to beat harder and faster which causes further damage. This becomes a perpetual cycle of damage to the heart muscle unless successful therapeutic control of the heart failure is achieved.

A pet with mild congestive heart failure can continue to function for months, even years, without exhibiting any severe outward signs of something being wrong; therefore, it can be difficult for an owner to tell that a serious cardiovascular condition exists.  Many owners attribute less energy or abdominal swelling to their pet just getting old.

Early signs of congestive heart failure: 

  • Bloating
  • Coughing during increased activity
  • Decreased activity level
  • Easily tiring
  • Fainting
  • Lack of appetite
  • Pacing and restlessness before bed
  • Rapid breathing
  • Unexplained weight loss

Diagnosis of congestive heart failure

Identifying the cause of congestive heart failure is often an involved process. Diagnosis begins with a full physical examination, during which the veterinarian can find key indicators of congestive heart failure.  Some of these include the crackling sound of fluid in the lungs when breathing, abnormal pulses, an abnormal heart rhythm, a muffled sounding heartbeat, or a heart murmur. Following the physical, there are several tests the veterinarian may perform:

  • Blood pressure measurement – high blood pressure suggests CHF
  • Echocardiogram (ultrasound of the heart) – allows the veterinarian to visualize valvular deformities, cardiac muscle-wall thickening, and valvular leakage
  • Electrocardiogram – measures electric impulses of the heart and demonstrates cardiac arrhythmias
  • X-rays – can depict fluid build-up in the abdomen or lungs. Can also show an enlarged heart

Depending on specific indicators, other tests can be performed, including a heartworm test in dogs and evaluation for hyperthyroidism in cats. A complete screening blood panel is also recommended to evaluate the health of all of the other organs in the body.  Of particular concern is the health of the kidneys since the treatment for heartworm disease is very stressful on the kidneys.  In most circumstances, treatment becomes a balancing act of dehydrating the patient enough to alleviate symptoms of heart failure but not enough to result in kidney failure.

Treating congestive heart failure

While there remains no cure for congestive heart failure, the ability to treat its symptoms depends on the severity and causes. The goal of treatment is to enable a pet’s body to compensate for its enlarged heart, thus preventing further damage. Most often, CHF is treated on an out-patient basis unless breathing is extremely difficult, in which case a pet may need to be placed on oxygen therapy and held overnight.

There are several medications that might be prescribed to help improve a pet’s quality of life. Depending on the amount of fluid retention in the body, a diuretic may be necessary to aid with removing excess fluid from the body tissues. Alongside a diuretic, various vasodilators can improve blood flow, while other drugs can improve the strength of the heart. Prescriptions are written on an individual basis, and the veterinarian will determine which medications are best for your pet’s needs. Usually, it is beneficial for all CHF sufferers to limit their sodium intake, so a prescription diet with reduced sodium levels may be recommended. As with all chronic conditions, recheck examinations will be necessary to evaluate the effectiveness of treatment and control undesirable side effects of the medications.

If you have any questions about congestive heart failure or would like to discuss any health concerns with our staff, contact our office today.

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