Congestive Heart Failure in Dogs Treatment Plan

Congestive heart failure (CHF) occurs in dogs when their heart is no longer able to keep up with the circulatory demands of the body. CHF is characterized by fluid build-up within the lungs (pulmonary edema), the abdominal cavity (ascites), or the chest cavity outside of the lungs (pleural effusion). Dogs with CHF have an underlying heart disease, and their body cannot compensate for the condition. Specific plans for congestive heart failure in dogs treatment are different for every pup and based on their individual needs.

Treatment for Congestive Heart Failure in Dogs: What to Expect

Treatment for Severe Cases of CHF in Dogs

In sudden, severe cases of CHF, your dog will need to be hospitalized. A dog in this scenario may be coughing, weak, fainting, and in respiratory distress. The treatment plan will be focused on reducing fluid build-up within the body, providing supplemental oxygen, and relieving anxiety. You can expect your pet to have an intravenous catheter, typically in one of their legs, and for them to be housed in an oxygen chamber in the hospital.

Your dog will be given a diuretic, usually furosemide. Furosemide increases fluid excretion, helping to remove fluid from the lungs and causing the dog to pee large quantities. Diuretics for dogs are the most important therapy for patients with pulmonary edema, secondary to CHF.

Other medications your pet receives will be aimed at improving the function of the heart, reducing the work the heart does to pump out blood to the rest of the body, and helping your pet to relax. Dogs who must be hospitalized for CHF are often in the hospital for one to four days.

Treatment for Milder Cases of CHF in Dogs

Some cases of CHF come on slowly and don’t present as dramatically. You may notice coughing, exercise intolerance, and faster breathing while sleeping. These dogs should be evaluated by a veterinarian but can often be managed on an outpatient basis.  

If your dog is developing CHF, the veterinarian will want to perform chest X-rays and an echocardiogram (ultrasound of the heart), which is the best way to determine what is causing heart failure. You may be referred to a cardiologist for an echocardiogram and management of your pet’s disease. Drug dosages may change over time as your dog decompensates, and additional medications may be started at the discretion of your veterinarian or the cardiologist. Do not make changes to your pet’s medication without consulting a veterinarian.

Your veterinarian may recommend monitoring your pet’s breathing while they sleep. An increase in resting respiratory rate is one of the earliest clues that your dog is decompensating. To monitor resting respiratory rate, count how many breaths your dog takes over 1 minute while they’re sleeping. If you notice that your dog’s resting respiratory rate is consistently over 30 breaths in a minute, schedule a follow-up with your veterinarian. If your dog normally has a lower respiratory rate, like 15 breaths in a minute, and you’re noticing this increasing over time, you can also schedule an exam with your veterinarian rather than waiting for this number to hit 30.

Heart Medicine for Dogs

Whether the condition is acute or chronic, congestive heart failure treatment in dogs always involves heart medicine. While your dog may be given additional medications if hospitalized, these are the medications you can expect to continue at home:

• Furosemide. Diuretic given orally every 12 hours to reduce fluid build-up.
• Pimobendan. Given orally every 12 hours, usually on an empty stomach. Pimobendan for dogs helps the heart contract more effectively.
• Enalapril or benazepril. Given orally once or twice daily. These medications belong to a class called ACE inhibitors. They dilate blood vessels, which reduces how hard the heart must work to pump blood. These medications additionally decrease blood pressure, as well as sodium retention.
• Spironolactone. Usually given once daily by mouth. This is a mild diuretic that is often given as an add-on to furosemide.

Your dog may start additional medications over time, particularly if they’re not responding well to the typical medications. In dogs who have abnormal heart rhythms (arrhythmias), additional medications (mexiletine, sotalol, digoxin, diltiazem) may be given.

Cost to Treat CHF in Dogs

The initial diagnosis of CHF, which typically includes chest X-rays, bloodwork, and an echocardiogram, will likely cost $1,000 to $1,500.

If your pet needs to be hospitalized, a cost estimate is $1,500 to $4,000. This includes:

• Initial stabilization, including catheter placement
• Oxygen therapy
• Injectable medications
• Around-the-clock monitoring

Oral medications for continued management at home can cost around $50-$200/month. This cost will be on the higher end if your dog is large. Pimobendan for dogs is often the most expensive of the at-home medications, but it should not be skipped if recommended by your veterinarian. 

How Long Can Dogs Live With Congestive Heart Failure?

While congestive heart failure in dogs can have a dramatic presentation, the good news is that dogs who stabilize typically do live for another six to 14 months with medications continued at home. On occasion, some patients live over three years. Dogs whose symptoms cannot be controlled or worsen despite hospitalization have a poor prognosis. 

Keeping Dogs With CHF Comfortable

In order to keep your dog comfortable after being diagnosed with CHF, your veterinarian should discuss any recommended lifestyle changes with you. 

Recommendations may include:

• Eliminating strenuous activities, such as ball-chasing or going for runs
• Discontinuing physical activity if your pet seems tired or sluggish
• Going for short, leashed walks
• Switching to a moderately sodium-restricted diet. There are prescription diets available that are designed for dogs with heart disease
• Using additional supplements such as omega-3 fatty acids, carnitine, and taurine. These may be beneficial and are unlikely to cause harm. However, they are not regulated by the FDA and should always be cleared with your veterinarian 

Congestive Heart Failure: When to Choose Euthanasia

This is a difficult decision that many pet parents will face. When the dog reaches Stage D or “end-stage” heart failure, they will typically have severe symptoms that do not respond to medications. If your dog is coughing up foam, has difficulty breathing, is unable to exercise or play, has a distended and uncomfortable abdomen, and is not responding to medications, it may be time to consider helping your dog pass peacefully. Your veterinarian is the best person to consult with on euthanasia decisions.