Congestive Heart Failure
Issue Description
Heart failure is a clinical syndrome that describes the end result of severe heart disease. Heart disease is always present when heart failure is present;
however, heart disease can be present and never lead to congestive heart failure.
Congestive heart failure (CHF) occurs when high diastolic pressures in the
heart "back up" into the veins and capillaries causing fluid to leak out of these vessels (edema).
Heart failure is the end-result of many different
cardiac and pericardial (the sac that surrounds the heart) diseases.
These include, but are not limited to:
Decreased myocardial contractility (a weak heart muscle) which is commonly seen with dilated cardiomyopathy.
Valvular regurgitation (leak in one of the four heart valves) as seen with mitral and tricuspid regurgitation.
Increased myocardial stiffness impairing the heart's ability to fill with blood as seen in feline hypertrophic cardiomyopathy.
Other Names
CHF
Causes
There are many causes of heart failure in dogs, including:
Birth (congenital) defects of the heart
Degeneration of the heart valves
Heart muscle disease (cardiomyopathy)
Heartworm disease
Diseases of the pericardium (the lining around the heart)
Irregular electrical rhythms of the heart (arrhythmia)
Dogs of any age and any breed can develop heart failure. There is certainly a predisposition for heart failure caused by cardiomyopathy in giant canine breeds
Symptoms
Although some of the early stages of heart failure in dogs have no visible signs, heart failure can be diagnosed through a clinical evaluation by a veterinarian.
Dogs with mild to moderate heart failure typically experience heart enlargement, coughing, lethargy and difficulty breathing. Severe heart failure is characterized
by difficulty breathing (even at rest), fainting, profound intolerance to exercise, loss of appetite and weight loss.
Diagnosis
Veterinarians diagnose canine congestive heart failure with electrocardiograms to detect heart abnormalities. An ultrasound may also be useful to show the enlarged
size of the heart. A chest x-ray will also be useful in diagnosis.
Treatment
The primary goal of treating CHF is to manage the clinical signs by reducing the formation of edema and effusion and to increase cardiac output (delivery of blood to
the tissues). A variety of therapies are available and will be tailored to meet your pet's current needs.
The most commonly prescribed medications include
digitalis glycosides, diuretics, and ACE inhibitors. Different medications may also be prescribed depending on your pet's underlying heart disease and severity of
the heart failure. A sodium restricted diet may also be recommended along with restricted exercise. Please keep in mind that heart failure therapy is dynamic and
will necessitate regular checkups with your veterinarian to ensure your pet's needs are being met.
Prognosis
As stated earlier, dogs in the early stages of canine congestive heart failure will show no symptoms. By the time the dog starts to show symptoms, the condition will
be in the later stages. Dogs in the later stages of canine congestive heart failure rarely live longer than a year. Many dogs will pass away within six months of
diagnosis.
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