Congestive Heart Failure

Congestive Heart Failure is a condition where the heart no longer works as an effective pump.  Because of this, fluid begins to back up and accumulate in the lungs, chest or abdomen.  There are a variety of causes for CHF, which vary based between cats and dogs, and sometimes between breeds of dogs

What are the symptoms?

Most dogs with congestive heart failure develop cough, weakness and weight loss.  Exercise intolerance; being unable to perform their normal activities without becoming tired or winded, is a hallmark.  Depending on the type of heart failure, difficulty breathing or swelling of the abdomen may also be present.

How is it diagnosed?

Heart failure is diagnosed by physical exam and xrays.  A physical exam may reveal a heart murmur or arrhythmia (abnormal beat), pale gums, weak pulses or distended abdomen.  Xrays often (but not always) show an enlarged heart and fluid accumulation in the lungs, chest cavity or abdomen.  Ultrasound of the heart (echocardiogram) can give more specific information about the heart’s exact problem and degree of dysfunction.

Is it curable?

Like in people, most causes of heart failure are not curable, but can be treated with medications.

Is it painful?

In most cases, heart failure if not considered painful.  However, ongoing cough and any difficulty breathing can seriously affect quality of life if not treated effectively.

What treatments are available?

Most pets with heart failure are treated with medications.  To simplify, the medications may be aimed at controlling fluid build up (diuretics), decreasing the work load on the heart (variations of blood pressure medications), limiting arrhythmias or controlling cough.  In addition, dietary management (judicious salt restriction) and nutritional supplements (anti-oxidants and others)  can be helpful.

Like many other pets with chronic disease, many patients with heart failure can benefit from acupuncture, laser, massage and therapeutic exercise.

What should I expect?

Unfortunately, heart failure is usually a progressive disease.  The course of the disease depends on the underlying cause, and can be somewhat predictable.

In cats and large dogs heart failure is usually secondary to cardiomyopathy (heart muscle disease) and typically progresses quickly once diagnosed.  Pets with cardiomyopathy may not respond well to medications.

In small dogs, heart failure is commonly secondary to valvular insufficiency  and the progression is often slow.  These pets often respond well to medications and can live with good quality for many years.