Goals of Treating Heart Failure
A diagnosis of heart failure is devastating for the owner of any animal, and unfortunately most cases are progressive and incurable. The goals of treating, or at least managing, a dog in heart failure are to correct the underlying cause if it can be identified and to preserve the dog’s quality and duration of life for as long as reasonably possible.
Treating heart failure requires immediate stabilization of the animal. This almost always requires hospitalization. The medical team will take steps to reduce fluid retention in the dog’s chest and abdomen, while at the same time trying to prevent dehydration and low blood pressure, both of which can contribute to kidney failure. The veterinarian may administer oxygen, either in an oxygen cage or through a facial mask (depending on the dog’s size), to help it breathe easier. The next step in managing heart failure usually is to administer one or more diuretic drugs, sometimes called “water-pills,” to relieve fluid build-up. Diuretics must be selected carefully. Because heart failure is almost always progressive, frequent dosage modifications will be necessary as the dog’s condition worsens. One of the most common diuretics is furosemide, also known as Lasix. Furosemide reduces fluid accumulation by increasing the production and excretion of urine. A number of other diuretics can be used instead of or in addition to furosemide. Sometimes, potassium supplementation is necessary when giving diuretics.
A category of drugs called “ACE inhibitors” can help improve blood circulation and reduce fluid retention; these include enalapril, benazepril, ramipril and captopril, among others. Drugs that increase the heart’s contractility, such as digoxin, dopamine and dobutamine, can also help dogs with heart failure. Another medication, pimobendan, may also be prescribed, especially for dogs with heart valve or heart muscle disease. Other supplements may be recommended as part of the overall treatment protocol, such as vitamin B, taurine, carnitine and/or coenzyme Q.
If a large amount of fluid builds up around the heart and lungs, the veterinarian can insert a sterile needle into the dog’s chest to drain off some of the liquid. This process, called thoracocentesis, can relieve some of the dog’s respiratory difficulties, at least temporarily. Sometimes, surgery is an option to correct a physical abnormality that has contributed to heart failure, although this is not very common. Of course, the dog’s veterinarian is best one to discuss treatment options with its owners.
Owners can help manage their dog’s health by keeping an eye on its diet. Foods that are high in salt can exacerbate water-retention and should be avoided. A number of low-salt diets are commercially available over the counter or by prescription from a veterinarian. Owners should do what they can to reduce the amount of stress in their pet’s life, including keeping it in a warm, calm, soothing environment. Exercise should be restricted in symptomatic dogs.
A number of drugs can be used to relieve the discomfort of dogs suffering from heart disease. Unfortunately, unless the underlying cause of the condition can be cured, the long-term prognosis for dogs whose heart disease has progressed to heart failure is guarded to grave.