What is pulmonary hypertension (PH)?

Pulmonary hypertension is high blood pressure in the lungs. Usually PH occurs secondary to another disease process, but rarely it can be primary (idiopathic).

How is PH diagnosed?

Echocardiography (heart ultrasound) is required for diagnosis. Possible causes of PH include heartworm disease, chronic lung disease or lower airway disease, and blood clots in the lungs. Your doctor may recommend diagnostic tests including but not limited to: heartworm testing, chest x-rays, and sometimes blood coagulation testing or advanced imaging studies of the lungs (CT scan).

What are the treatment options for PH?

Patients with PH may appear asymptomatic, but when PH becomes severe most experience symptoms including lethargy, weakness, trouble breathing, and fainting. Some dogs also experience fluid accumulation around their lungs or in their abdomen (right heart failure). Treatment for PH includes medications to help dilate the blood vessels in the lungs. If right heart failure occurs, medications are used to help slow fluid accumulation. Some dogs with recurrent fluid in the abdomen require period removal of this fluid with a needle (‘belly tap’) to keep them comfortable. In most cases PH cannot be cured, and patients with PH require life-long medications and period rechecks with a cardiologist to keep them comfortable.

Prognosis for PH is extremely variable depending on the underlying cause. Some patients may live long-term with good quality of life, but others experience rapid progression and cannot breathe comfortably despite medications.

What should I monitor at home?

It is important to become familiar with your pet’s normal sleeping respiratory rate and effort. 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 aps (ex. Cardalis) which can help keep track of respiratory rates.

You should also monitor for cough, lethargy, fainting, abdominal distension, or decreased appetite, and contact a veterinarian with any concerns.