What is congestive heart failure?
Congestive heart failure (CHF) occurs when the heart is unable to effectively pump blood to the body and lungs. This causes a back-up of blood, increased pressure in blood vessels, and ultimately leakage of fluid. Fluid may accumulate in the lungs (pulmonary edema), around the lungs (pleural effusion), or in the abdomen (ascites). This fluid accumulation is congestive heart failure.
What causes CHF?
CHF happens when the heart cannot keep up with the volume it needs to pump. This can occur due to several disease processes including leaks in heart valves (degenerative valve disease), poor heart muscle contraction (dilated cardiomyopathy), and poor heart muscle relaxation (feline cardiomyopathy), among other disease processes.
How is CHF treated?
The primary goal of treating CHF is to decrease the rate and amount of fluid accumulation and thereby improve symptoms. The cornerstone of treatment is diuretics (‘water pills’) that cause increased fluid excretion. ACE inhibitors are also commonly used to help increase fluid excretion. Your pet is likely to drink and urinate more with this treatment. To ensure adequate hydration, free access to ample water is encouraged. As both of these medications make the kidneys work harder, it is important to perform periodic blood work to ensure the dose is correct for your pet. In addition to diuretics, other medicines may help your pet. Pimobendan is a medication that helps the heart pump more efficiently, and may be indicated in certain types of heart disease.
Control of CHF is a dynamic process. New medications will likely be added, and doses will need to be adjusted over time and tailored to your pet’s specific needs. Close communication and periodic rechecks with your veterinarian is recommended to keep your pet happy and comfortable. Prognosis is highly variable depending on the underlying cause for CHF, but on average, most pets have good quality of life for 8-12 months after diagnosis.
What should I monitor at home?
It is important to become familiar with your pet’s normal sleeping respiratory rate. Often, the first indication of early worsening of CHF is an increase in the breathing rate when sleeping, and early detection of CHF can help avoid a hospital stay. Your pet’s respiratory rate should be less than 40 breaths per minute when sleeping. However, any consistent or progressive elevation from your pet’s baseline rate should be cause to alert a veterinarian. There are several free iPhone applications (ex. Cardalis) which can help keep track of respiratory rates.
You should also monitor for cough, lethargy, fainting, or decreased appetite, and contact a veterinarian with any concerns.
What if I have concerns after business hours?
If you notice a consistent increase in your pet’s respiratory rate or effort and your pet is taking Lasix, you may give ONE extra dose of Lasix immediately and contact your veterinarian. If your pet worsens, or does not improve within 30 minutes, you should visit an emergency room. If your pet has never taken Lasix and you notice increased respiratory rate or effort, you should visit an emergency room right away. If your pet is ever experiencing respiratory distress, you should visit an emergency room right away.