Heart failure: failure of the heart to pump and
HEART FAILURE distribute blood appropriately leading to tissue
hypoxia.
Congestive Heart Failure: cardiac dysfunction
(CHRONIC VALVULAR HEART DISEASE) resulting in increased venous /cappillary pressures
which then cause edema or effusions.
STAGE D 80% of dogs that develop CHF will only survive
1.5-2 years from diagnosis.
Chronic, home based therapy:
Furosemide to effect: Some will increase to TID 80% of CHF in dogs is due to Mitral Valve disease.
dosing
Left heart failure: life threatening condition caused
Or switch to torsemide if no longer adequately by venous congestion in the lungs caused by
responsive to furosemide . Dose at 5 to 10% of increased left atrial pressure. This pressure occurs
furosemide dose (0.1-0.3mg/kg q 24hr) for dogs when the left ventricle can't adequately fill or eject
whose response to furosemide in hospital was not blood.
great.
Common conditions in dogs and cats leading to left
Measurement of creatinine, BUN, lytes 12-48 hours sided CHF:
after increased furosemide or torsemide dose 1. Myxomatous mitral valve disease: causes
increased LA pressure . Most common in
ACEI : continue or start 0.5mg/kg po bid Cavaliers, Chihuahas, Min Pin, Yorkies and other
small breed dogs
Pimobendan increased by some to a third daily 2. DCM (dilated cardiomyopathy): causes
dose at 0.3mg/kg increased LA pressure. Most common in : Dobies,
Boxers, Danes, G sheps, Labs and other
Spironolactone 2mg/kg po q12-24 (better large and giant breed dogs
aldosterone antagonism) 3. HCM: (hypertrophic cardiomyopathy)
Thickening of the left ventricle. Most
Some may use additional afterload reducing agents commonly affects cats: Maine coon, Persian and
with hydralzaine or amlodipine. American domestic shorthair
If Afib is present, diltiazem +/- digoxin titrated to Right heart failure: increased pressure in the vena
achieve heart rate control (< 125bpm) cava and right atrium and pulmonary vessels.
This can be due to:
Sildenafil 1-2mg/kg po q8 hours to address 1. myocardial failure: DCM, pulmonic insufficiency
pulmonary hypertension and clinical signs (blood leaks back into the RA from the pulmonary
secondary to exertion and ascites management arteries)
2. Volume overload into RA from valvluar
Cough suppressants and bronchodiolators as regurgitation or obstruction: Tricuspid
needed for intractable cough insufficiency (blood leaks back into RA as it's
supposed to move into the RV) or obstruction
Diet to maintain weight, restrict sodium intake, (Pulmonic stenosis or heart worms blocking
supplement if needed potassium (more common w/ pulmonary arteries)
torsemide); monitor serum magnesium if needed. 3. Increased myocardial stiffness: pulmonary
hypertension, constrictive pericarditis or
pericardial effusion
Classically right sided heart failure leads to ascites.
On physical exam, you may notice bounding jugular
veins and a distended abdomen.
Pulmonary hypertension can cause poor cardiac
output and syncope. Dogs with chronic pulmonary
disease (cough) can develop pulmonary hypertension
from the secondary fibrosis and airway disease.
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