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Dog Congestive Heart Failure Medication The Ultimate Guide

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Your dog can suffer from congestive heart failure, just like a person. It’s not a specific disease; it’s a syndrome in which severe dysfunction fails the cardiovascular system to maintain the blood circulation. There are some specific signs that can develop as a result of heart failure.

What is heart failure?

It’s a complex condition that can develop from congenital heart disease in dogs. Depending on disease type, it can affect both the left and right sides of the heart, establishing respiratory signs and weakness due to:

Fluid retention: Congestion, which is also known as backward failure

Pump failure: Low cardiac output also known as forwarding failure

The heart disease can depend on age and breed, chronic heart failure management for degenerative mitral valve disease (DMVD) and dilated cardiomyopathy (DCM) which relies on a combination of a diuretic, angiotensin-converting enzyme (ACE) inhibitor, pimobendan with extra medications added as required.

Signs and Symptoms of Heart Failure

Some of the most common symptoms of heart failure are given below:

  • Feeling tired more often and even with less exercise
  • Shortness of breath with less exertion
  • Mysterious weight gain, especially the appearance of being bloated which is known as edema
  • Unwanted cough without cold or sinus infection along with the traces of blood in saliva
  • Constant panting
  • Breathing fast even in resting state
  • Fatigue
  • Blue-tinged gums
  • Distended abdomen
  • Collapsing

Types of Heart Failure

There are many reasons for congestive heart problems based on functional classification: impedance to cardiac inflow, systolic myocardial failure, pressure overload, and volume overload.

Impedance to cardiac inflow is a type of heart failure which results in a decrease in blood flow.

The leading cause of this disorder is external compression of the heart; diastolic dysfunction occurs in a stiff ventricle and reduces ventricular filling, tumors, and abnormalities to the physical structure of the heart.

The reduction in the ability of the heart muscle contraction is a systolic myocardial failure. It could be identified with echocardiography.

During the contraction of ventricles, there is reduced wall motion. The average blood flow could not be maintained if the reduction is significant.

It may be due to genetics, infection, trauma, drugs, poisons, electric shocks, heatstroke, and tumors. In some cases, there is no specific known cause.

Pressure overload is a kind of heart failure which results in long-term increases in stress to the heart wall during contraction.

It may be due to the obstacle of blood flow from the heart or high blood pressure in the whole body or the arteries of the lungs.

Volume overload heart failure occurs due to the high volume of blood in the ventricles, which increase the blood flow. Eventually, this may be a sign of congestive heart failure.

The heart diseases that result in volume overload myocardial failure includes valve disease (degenerative valve disease of the atrioventricular valves) left to right shunts, and high output states (those caused by hyperthyroidism or anemia).

What are the four stages of congestive heart failure?

There are four stages of heart failure: A, B, C, and D. when the patient’s condition move to the next stage, the chances of surviving for 5 or more years decreases.

Stage A

The individuals with stage A do not have dysfunction of the pumping activity of the heart but have a high risk of heart failure due to relevant conditions, e.g. chronic high BP, coronary artery disease, and diabetes.

Patient at this stage has no issue with the structure of the heart. They rarely experience any symptoms of heart failure but may have symptoms regarding their other conditions.

Stage B

At this stage of heart failure, structural heart disease develops, such as a reduction in the pumping function of the heart, which may lead to an inflamed left ventricle.

It may be due to a previous heart attack. However, patients with heart failure stage B remain asymptomatic.

Stage C

Patients at this stage will show the symptoms of heart failure linked to underlying structural heart disease, which include fatigue and breathlessness.

These symptoms occur due to problems with the squeezing function of the left ventricle or the pumping chamber of the heart.

Stage D

At this stage, patients have structural heart disease and display significant symptoms even if they are at rest.

It’s a severe stage and requires advanced specialized treatment such as mechanical circulatory support, continuous inotropic infusion to make the heart squeeze harder, hospice care, or cardiac transplant.

Congestive Heart Failure in Dogs

It is a term that refers to the inability of the heart to pump adequate blood to the body. There are numerous reasons sfor congestive heart failure in dogs. The common reasons are:

Mitral Valve Insufficiency (MVI): It’s a leaky mitral valve which is present between the left atrium and the left ventricle.

Dilated Cardiomyopathy (DCM): It’s a primary disorder of cardiac muscle, which results in the reduction of normal blood pressure through the vascular system.

Difference between the Right-Sided and Left-Sided CHF

Right-sided CHF

It causes poor venous blood return to the heart. When heart contracts, the right ventricle pushing the blood through the lungs for oxygenation, some blood may leak through the tricuspid valve (the valve between right atrium and ventricle) back into the right atrium.

This blood becomes congested when backs up into the systematic circulation. In the abdomen part, fluid accumulates and interfering with the function of the organs in these areas.

The abdomen fills with fluid, and this condition is called ascites.

Left-sided CHF

When the heart contracts, instead of pushing blood in the left ventricle, blood push into the systematic circulation.

During this procedure, some blood may leaks through the mitral valve back into the left atrium, after this backs up into the lungs.

The fluid then seeps into the lungs tissues, which result in pulmonary edema. It may lead to coughing and difficulty in breathing.

This kind of heart failure is the most common form of CHF. Coughing and fluid in the chest are the most common causes of left-sided congestive heart failure.

Congestive Heart Failure in Dogs Prognosis

Unfortunately, there is no cure for congestive heart failure at this time, and primary treatment is aimed at improving quality of life.

The prognosis for dogs with CHF used to be reduced; the overall prognosis has vastly enhanced by the advances in medications which are used to treat the condition.

Lifestyle management and vigilant home care could help to extend survival from months to years.

The condition can be identified sooner, and treatment is started, it increases the chances of reaching your dog’s life.

It’s a bitter reality that this condition may put your dog’s life in danger.

Swift diagnosis and proper care and handling can reduce this danger and increase the life of your dog so that you and your pet can enjoy more with each other’s company.

The best thing that you can do for your beloved dog is that always follow your vet’s advice.

Make sure to bring your dog to the vet for annual checkups.

Take extra care of your pet and check whether his nutrition is right for him, including treats, exercise and additional care he may need to lead a healthy life.

Progression to Congestive Heart Failure

As heart function weakens, the fluid volume inside the heart and vasculature increases as a result of activation and upregulation of neurohormonal systems, for example, the renin-angiotensin-aldosterone system. This pathophysiology leads to increase:

  • Stretch of heart chambers
  • Preload
  • Hydrostatic pressure in vessels that stream the left and right atria

Its result is:

  • Pulmonary edema and congestion
  • Ascites with or without pleural effusion

Degenerative Mitral Valve Disease (DMVD)

It is the most common heart problem in dogs. Its clinical signs include:

Heart murmurs It because of mitral valve regurgitation which leads to left atrial and left ventricular dilation.

Progressive dilatation: The progressive dilatation of the left ventricle leads to systolic dis-functioning.

Significant left atrial enlargement: It leads to atrial arrhythmias.

Development of pulmonary hypertension: It can contribute to clinical signs like respiratory distress and syncope.

It’s not necessary that all dogs with DMVD have heart failure, which  characterized by pulmonary edema. The dogs with heart enlargement have maximum chances of heart failure, but only 30% of dogs with asymptomatic DMDV have clinical signs and require heart failure therapy.

Dilated Cardiomyopathy (DCM)

It’s the primary disease of the heart muscle, which  characterized by a relatively long asymptomatic stage (1 to 2 years). It may lead to sudden death or heart failure.

The changes associated with DCM include:

  • Reduction in the systolic function of predominantly the left ventricle
  • Dilatation of the left ventricle to a lesser degree, the left atrium because of systolic dysfunction and high preload
  • In a few dogs, mitral regurgitation, when the heart dilated enough due to the mitral annulus which stretched to the degree that prevents the mitral valves from effectively closing.

Arrhythmias is common in this disease, asymptomatic and symptomatic; both stages often require treatments. The most common symptoms are atrial fibrillation, , and ventricular tachycardia, ventricular premature complexes.

Cough: Caused by Respiratory Disease or Heart Failure?

It’s a common issue that does not necessarily indicate heart failure. It may relate to an enlarged heart compressing the airway or primary airway/ lungs disease.

With an average activity level and a good appetite in a dog, a chronic and cough that ends with a harsh gag is less likely to be related to heart failure. From main-stem, bronchial compression cough can occur before the onset of CHF and often persists after active pulmonary edema, which has been resolved with diuretic therapy.

Here are some useful questions regarding the problem of cough:

  • Is the cough harsh?
  • How long cough or respiratory symptoms been present?
  • What are the dog’s appetite and activity level?

Some Important Tips for Diagnosis & Management

Here are some tips for optimizing heart failure diagnosis and management in dogs. It provides the additional information needed for the diagnosis of congestive heart failure.

Consider Patient Signalment

Age and breed are valuable when considering sensible differential diagnoses for the kind of sickness responsible for heart failure.

Dogs who are less than two years of age are more likely to have a congenital heart disorder. On the other hand, middle-age to older dogs are more likely to have an acquired adult-onset disease.

Some specific breeds predisposed to particular disease processes.

Specific examples include:

  • The occurrence of DMVD in Cavalier King Charles spaniels increases with age at the same time, when all is said in done, DMVD happens at a younger age in this breed as compared to different breeds.

A mitral murmur can become evident at over after four years old, yet in spite of the early period of the beginning, rate of progression is reportedly no different than progression rate in other breeds.

  • In Doberman, the lifetime risk for DCM is approximately 60%, about half of all pinchers cause this disease.

The chances of asymptomatic DCM in Doberman pinchers increase with age and peaks around seven years. However, sometimes the condition  seen in dogs as young as three years of age.

Be a Detective: Ask Detailed Questions

Take some time to get complete information from the patient’s history and physical examination, which includes the details that may help to determine whether the dog has heart failure and why it may have occurred.

Do history support heart disease and heart failure?

  • Is there a history related to heart disease?
  • Is congenital heart disease more likely? For instance, in middle age to old age dog, is the murmur a relatively new finding suggesting an acquired disorder? From the time when the dog was a puppy which suggests undiagnosed congenital heart disease?

Do the physical examination exists to support heart disease and failure?

  • A left apical systolic murmur is a characteristic of finding in dogs with mitral regurgitation from DMVD and a loud murmur more likely with advanced disorders.
  • A rapid heartbeat is most often a sinus tachycardia is associated with epinephrine and increased sympathetic drive in heart failure.
  • Are they other symptoms of potential heart problems including a gallop or arrhythmia?
  • Dogs may have supraventricular arrhythmias as the atria increase in sizes such as premature beats, bursts of supraventricular tachycardia and fibrillation.
  • Pulses may be weak, irregular, or occasionally absent. The S3 gallop can heare in dogs with DCM associated with the rapid ventricular filling into an enlarge, inferior contracting and relaxing ventricle.

When to Test?

Thoracic radiographs and serum biochemistries are complementary:

Radiographs are critical for assessing respiratory signs and monitoring heart failure therapy. Thoracic radiographs give information on measures of heart size, specific chamber enlargement, pulmonary vessel size, and pulmonary patterns. Abnormalities that support CHF have:

  • Left atrial enlargement
  • Pulmonary venous enlargement
  • Perihilar interstitial to alveolar pattern from pulmonary edema.

During the initial stage of coughing or decreased exercise tolerance, radiographs are the best way to confirm the presence of venous congestion and pulmonary edema.

The radiographs indicate the bronchial compression because of the enlarged left atrium and rule out alternative diagnoses such as pulmonary neoplasia or pneumonia.

When congestive heart failure suspected, diuretic therapy could be initiated before thoracic radiography if the patient is dyspneic.

Echocardiography is a powerful tool; know when to perform it:

It can establish the kind of heart disease and identify complicating factors such as pulmonary hypertension, systolic ventricular dysfunction, intracardiac shunts, atrial tears, and pericardial effusion.

Echocardiography can also be identified by anatomic abnormalities and assess function, but it cannot diagnose the presence of congestive heart failure.

It is not typically necessary until a dog is clinically stable. However, it could provide useful information to guide treatment protocols and especially helpful when the response to heart failure therapy is not meeting the expectations, and additional treatment may be indicated.

When Recommending Therapy, Comorbidities and Drug Interactions and Adversative Effects

The most common acquired two heart diseases in the dogs are DMVD and DCM. The recommended heart failure treatment includes various medications, typically furosemide, pimobendan, and an ACE inhibitor.

Adult dogs are likely to have a concurrent systemic disease like kidney disease, protein-losing disorder, hyperadrenocorticism, and arthritis that are necessary to consider when making treatment recommendations.

It is necessary to consider the patient’s medical history, current medications, potential adverse effects of cardiac medications, and drugs interactions,

  • Diminished glomerular filtration rate in a pooch with kidney sickness might be a concern when ACE inhibitors, diuretic treatment, and nonsteroidal anti-inflammatory medications.
  • Electrolyte concentrations influenced by ACE inhibitors and diuretics.
  • Aspiratory hypertension can develop in canines with DMVD, protein-losing diseases, and hyperparathyroidism.

Make Commendations for Home Care That Considers the Pet’s and Care Taker’s Quality of Life

The owners involved in monitoring their dog’s heart disease:

Set up a recheck schedule to check disease progression, potential adverse impacts of prescriptions, patient personal satisfaction, and any difficulties looked by the owner. Recheck assessments for a canine in heart failure are frequently prescribed every 2 to 4 months, or sooner if drugs are balanced or clinical decompensation happens.

Educate owners about clinical signs that demonstrate their canines need therapeutic consideration, including cough (new or intensifying), breathing trouble, anorexia or retching, and torpidity or breakdown.

Encourage owners to record resting or sleeping breathing rates at home. Many pooches have a breathing rate of fewer than 35 breaths/minute, regularly in the mid-teenagers to mid-twenties.

A raised breathing rate that is repeatable within the hour, particularly if the pooch has breathing trouble or a decrease in appetite or activity level, should provoke therapeutic consideration.

Some additional points are as follow:

  • Ensure the dog eats and takes its medications properly. Make recommendations for a proper diet and advise the owner to avoid salty foods and treats when possible.
  • Set level of activity expectations which vary from every dog. Light activity is acceptable and encouraged if it enhances the quality of life, but strenuous activity needs to be avoided.
  • When making treatment recommendations consider the owner’s lifestyle. For example, therapy gives more than twice daily may be difficult for the pet owner.

Bottom Line

Plan your dog diet routine according to your veterinary doctor. You must avoid things which are dangerous to your dog ‘s health.

Congestive heart failure is a disease but you can reduce the side effects of this health issues by taking measures according the vet recommendations

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