Congestive Heart Failure
We all may have suffered from a broken heart at one point in our lives, but when our pet has an actual broken heart, it can lead to congestive heart failure (CHF).
What Is Congestive Heart Failure (CHF)?
Congestive heart failure (CHF) is a condition that occurs secondary to the heart not pumping properly. When the heart can’t pump efficiently, fluid accumulates in or around the lungs. The lungs can’t fill with oxygen properly, and the pet starts to breathe abnormally. There are many diseases of the heart that can occur, such as valve disease, arrhythmias, and congenital defects. However, when a pet goes into congestive heart failure, they should be evaluated by a veterinarian immediately.
Symptoms
Congestive heart failure can occur rapidly. If it does, pets develop difficulties in breathing. You may notice that they’re using more of their abdomen when breathing or their neck is stretched out (as they’re doing everything they can to get more oxygen). If CHF comes on more slowly, you may notice coughing, exercise intolerance, lethargy, decreased appetite, weakness, and/or collapse.
To monitor your pet’s normal respiratory rate, watch them breathe when they’re sleeping. The respiratory rate should stay below 40 respirations/minute, but this can vary slightly from animal to animal. To count the respiratory rate, watch the chest wall rise and fall; this is one respiration. With time, you’ll become aware of what your pet normally looks like when breathing and what abnormal breathing would look like. If you see any of the signs listed above, have your pet evaluated by a veterinarian.
Causes
There are many causes of congestive heart failure (CHF) including progressive heart conditions, drug toxicities, infection, and other causes. Animals in CHF may have respiratory distress from fluid in the lungs or around the heart, a heart murmur, fainting/collapse, shock, or paralysis if a clot has formed. Procedures to diagnose CHF include thoracic radiographs, echocardiogram, ECG, and blood pressure measurement.
Diagnosis
Many tests will likely need to be performed to evaluate for heart disease and CHF. Radiographs of the chest will evaluate if there is fluid in or around the lungs, as well as the heart and blood vessels size. An ultrasound of the heart (echocardiogram) can evaluate what the heart looks like structurally and how it’s pumping. An EKG will help evaluate for arrhythmias. Blood work will help evaluate for abnormalities that could be contributing to heart disease, as well as evaluate kidney function, which comes into play when we discuss treatments for CHF.
Treatments
Treatment for CHF is two-fold:
- Stabilize the animal if it is in congestive heart failure crisis.
- Maintenance therapy to manage the disease and prevent another crisis.
Initial therapy is aimed at decreasing the fluid in and around the heart and lungs. Diuretics and vasodilators may be used; the chest and/or pericardium (sack that holds the heart) may need to be drained physically with a needle. Long term management may include diuretics and vasodilators to prevent fluid buildup and keep heart rate/blood pressure at a normal level, positive inotropic drugs that improve the ability of the heart to beat, anti-arrhythmic drugs, and dietary management with low salt and weight control.
Prognosis for congestive heart failure truly depends on the cause. If there is an underlying structural problem, survival time may be a year; however, each pet is different. What’s most important is monitoring your pet for signs and seeking care from your veterinarian.