Cardiac Failure In Dogs

About 10% of all dogs have cardiovascular disease. Just like their human companions, the incidence of heart disease increases dramatically with age.

Cardiac failure in dogs occurs due to the heart's lack of ability to pump a sufficient amount of blood to other parts of the body causing fluid to back up into the belly or the lungs and, less frequently, other major organs.

There are a number of factors that can result in cardiac failure. CHF in dogs can either be congenital or acquired, although about 90% of cases are considered to be acquired. Almost 75% of older dogs have some form of heart disease. Congestive Cardiac failure itself is not a disease: it is a resultant condition of underlying heart disease.

Depending on the underlying cause of the condition, the signs of Cardiac failure can vary greatly.

Congenital:

• Intermittent Cough
• Heart Murmur
• Tiredness
• Exercise Intolerance

Cardiovascular:

• Increased Heart Rate
• Rapid Breathing (known as “tachypnea”)
• Respiratory Distress
• Fluid accumulation in the lungs (pleural effusion), within the lungs (pulmonary edema), and abdomen (ascites)

Inflammatory:

• Lack of appetite
• Fatigue
• Pale Gums
• Collapsing or Fainting
• Weight Loss

Toxic:

• Extreme Lethargy
• Wheezing
• Coughing
• Vomiting

Infectious:

• Diarrhea (sometimes bloody).
• Fever
• Labored Breathing
• Vomiting

Metabolic:

• Loss of appetite
• Weakness
• Abdominal Distention
• Weight Loss
• Lack of interest in exercise

Neoplastic:

• Weak Heartbeat
• No Appetite
• Weight Loss
• Exercise Intolerance
• Vomiting

Injury:

• Frothing at the mouth
• Sudden Coughing
• Collapse
• Slow/fast/erratic heart rate

The specific treatment depends on the underlying cause of the CHA.

• Congestive Heart Failure - An angiotensin-converting enzyme (ACE) inhibitor (benazepril, lisinopril, or enalapril), diuretics like spironolactone, furosemide, etc. Extra medications that might be used are sildenafil, valsartan/ sacubitril/, and torsemide.
• Patent Ductus Arteriosus: Lateral Thoracotomy (intercostal thoracotomy, Cardiac catheter-based (minimally-invasive surgery) occlusion, and Transarterial PDA coil embolization.
• Pericardial Disease: Pericardiocentesis, Partial or subtotal pericardiectomy.
• Atrial Fibrillation: Diltiazem, beta-adrenergic blockers such as atenolol, calcium-channel blockers such as diltiazem, and Digoxin (Lanoxin, Toloxin).
• Atrioventricular Block - Propantheline or Theophylline.
• Second-degree AV block and third-degree AV Block is Pacemaker Implantation.
• Ventricular Tachycardia – Mexiletine, Lidocaine, and Sotalol.
• Diuretics(water pills): To reduce fluid buildup in the body by eliminating extra fluid and salt. Spironolactone, Furosemide etc.

Keep in mind natural remedies may not clear the problem, but they may help to reduce some of the symptoms.

Herbs: Ginger, Hawthorn, Dandelion, Parsley, Cayenne.

Dietary Supplements: Carnitine-rich foods, L-Taurine, Coenzyme Q10, Magnesium, and Selenium, Vitamins A, B6, C, and E.

There are no dependable methods to prevent heart disease in dogs, particularly since few of the common types are hereditary. But you can take steps to help your dog live a healthy life.

Healthy Diet: Always feed your pup a healthy diet that includes Omega-3 Fatty Acids (fish oil) and Taurine (amino acid).

Adequate Exercise: Exercise is good for cardiac health. However, when your pup has been diagnosed with heart disease, make sure to limit strenuous exercises.

Parasite Preventatives: Flea and tick preventatives such as heartworm preventatives.

Dental Care: Dental diseases have a strong association with heart diseases, so dental health should be a top priority for pet owners.

Atrial Septal Defect: Boxer, Doberman Pinscher, Old English Sheepdog, Samoyed, and Standard Poodle.

Atrial Fibrillation: Newfoundland, Great Dane, Saint Bernard, Doberman Pinscher, Boxer, Irish Wolfhound, Mastiff, and other large breeds.

Sick Sinus Syndrome: Dachshund, West Highland White Terrier, Boxer, Miniature Schnauzer, Cocker Spaniel.

Myocarditis: Any breed but often medium to larger dogs.

Ventricular Tachycardia - More common in Doberman Pinscher and Boxer.

Valvular Disease - Boxer, Cavalier King Charles Spaniel, Chihuahua, Cocker Spaniel, Doberman Pinscher, Lhasa Apso, Old English Sheepdog, Toy poodle, Samoyed, Schnauzer, and Yorkshire Terrier.

Pericardial Diseases - Afghan Hound, Boxer, Bulldog, Boston Terrier, Doberman Pinscher, Golden Retriever, French Bulldog, Old English Sheepdog, Saluki, Samoyed, Standard Poodle, and Weimaraner.

1. Causes:

• Cardiac Causes: Arrhythmias, congenital heart defects (especially Canine Dilated Cardiomyopathy, patent ductus arteriosus, Pulmonic Stenosis), Heart muscle disease (such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy, etc), myocarditis (inflammation of the myocardium), Pericardial disease, valvular diseases such as severe valve leakage and enlargement of the cardiac chambers (chronic degenerative mitral valve disease), trauma to the heart muscle (such as a dog being hit by a car), and age-related changes.
• Non-cardiac Causes: Inflammation of the pancreas, severe anemia (low red blood cell count), gastric dilatation-volvulus (stomach twists around filled fills with large amounts of air), low blood magnesium, neurologic disease (i.e. brain tumors), diseases of the spleen, liver or GI tract, muscular dystrophy, endocrine disease (i.e., of the thyroid gland, adrenal glands); anesthetic agents, toxins and medications.

2. Types:

Left-sided Congestive Heart Failure:

This is the most common type of CHF in dogs. Dysfunction in the left ventricle - the main pumping power source of the heart is gradually weakened.

Right-sided Congestive Heart Failure:

This is caused by dysfunction in the right ventricle and its inability to pump an adequate amount of blood to the lungs.

Biventricular Failure:

This happens when both the left and right ventricles are not functioning properly.

3. Mortality:

The untreated cardiac failure shows clinical signs usually within 6 months. Dogs with CHA have a more than 50% mortality rate by one year of age if left untreated.

After congestive heart failure has developed due to various causes, Life expectancy is variable and it is typically around 6-14 months. Very few dogs have PDA small enough that congestive heart failure eventually does not occur.

4. Diagnosis:

• Routine Hematology, Urinalysis
• Serum Chemistry Profile
• Electrocardiogram
• Cardiac Ultrasound
• Echocardiography

5. Prognosis:

When detected early and given appropriate treatment for the underlying causes of CHA, most dogs live a normal life. Unless there are complications from already developed heart failure or other heart defects, there is rarely any need for medications in the future.

Time to visit the vet clinic for an examination, if you notice any of the following:

• Labored Breathing
• Rapid Breathing (known as “tachypnea”).
• Abnormal Pulses
• Loud Heart Murmur

• Diets elevated in protein (>100 grams per 1000 calories) at least 30% meat-based protein (on a dry matter basis) is recommended.
• PDA dogs’ ability to excrete sodium in their urine is markedly reduced. Sodium or salt should be limited to help reduce fluid accumulation.
• Foods that tend to be high in salt should be cut off. Snack foods (crackers, chips, pretzels, etc.), pizza, bread, cheese, other dairy products, etc.
• Omega-3 fatty acids (fish oils) and amino acid foods/supplements.
• Vitamin E and Co-enzyme Q10.
• Carnitine, B Vitamins, and Magnesium.
• Maintain ideal body weight and Fresh food can be a very healthy option.

It’s never pleasant to hear your dog has heart defects. The prognosis for CHA dogs depends on the severity of underlying conditions. Many CHA dogs can live normal lives if they are without any other complications. Dogs with mild symptoms can be managed with medications.

It is significant to also treat any coexisting, underlying structural heart disease or outside of the heart diseases that are contributing to the abnormalities in heart function.