Donna partners with Dr. Cathy Alinovi, a retired veterinarian, to create
informative pet health articles.

Congestive heart failure can make your dog feel weak and

Congestive heart failure can make your dog feel weak and lethargic.

Will Keightley under CC BY SA 2.0 via Flickr

CHF in Dogs

If you’ve just been to the vet and found out your dog has congestive heart
failure (CHF), you are probably dealing with lots of conflicting emotions.
While a diagnosis of CHF is serious, if the condition is discovered and
treated early, the prognosis can be promising.

Dr. Cathy Alinovi, the retired owner of Healthy PAWsibilities, shares her
experience and expertise in the care and management of dogs with congestive
heart failure.

Are CHF and canine valvular heart disease related?

Dr. Cathy : The terms are not interchangeable but almost. Faulty heart
valves are the most common cause of congestive heart failure, but not the only
cause. Therefore, if your dog has valvular heart disease, then it has
congestive heart failure. However, a diagnosis of CHF does not mean your dog’s
heart valves are faulty. Another term for CHF is cardiomyopathy, which means
disease of the heart muscle.

What is CHF?

Dr. Cathy : If the heart’s job is to pump blood, then in heart failure,
the blood does not pump to the body as well as when the heart is healthy. When
the blood does not flow properly, it gets backed up somewhere. The backed-up
blood leads to fluid buildup in the tissues, and very commonly in the lungs.
This is where the term congestive comes from.

How Many Types Are There?

Dr. Cathy : The types of congestive heart failure (CHF) refer to what side
of the heart is failing. While we usually think of the heart as one organ, it
is essentially two pumps put together; the right side of the heart takes blood
from the body and pumps it into the lungs for oxygen, and the left side of the
heart takes blood from the lungs and pumps it out to the body.

In left-sided heart failure, which is the most common kind of heart failure,
the blood backs up and leads to congestion in the lungs. In right-sided heart
failure, the blood backs up and usually affects the liver, causing congestion

In small dogs, mitral valve failure is the most common cause of CHF. The
mitral valve is the valve between the small and large chambers on the left
side of the heart. In large breed dogs, CHF is usually caused by dilated
cardiomyopathy. This means that the muscle has stretched and grown weak
causing the inefficiency of heart pumping.

Why does my dog have CHF?

Dr. Cathy : There is an incredibly long list of reasons for heart failure
in dogs. Speaking in broad generalizations, the most common cause of right-
sided heart failure is heartworm infection either current or previously.

The most common cause of left-sided heart failure is a little harder to
pinpoint as genetics definitely has a role in left-sided heart failure as does
obesity. CHF can lead to high blood pressure; high blood pressure can lead to
CHF. Faulty heart rhythms can lead to CHF, and vice versa. Even kidney failure
can affect the function of the heart.

Will My Dog Have a Heart Attack?

Dr. Cathy : Heart attack tends to be a human issue more than it is for
animals. It is related to obstruction of the blood vessels in the heart. In
humans, this condition is called atherosclerosis, or arteriosclerosis, which
means hardening of the arteries. However, there are some cases where this can
happen in animals. For obese dogs that have fat in their blood vessels, a
heart attack is a possibility.

More common is a condition called syncope. Syncope means fainting due to a
lack of blood flow to the brain. The brain must have oxygen-carrying blood in
order to function; if the dog is doing too much too fast and its heart can’t
keep up, the brain says stop and makes the dog lay down by fainting. Once the
dog has enough blood flow, he will regain consciousness. This is very scary
for the pet owner to see.

Fainting or an to inability rest comfortably may be signs of

Fainting or an to inability rest comfortably may be signs of CHF

kaelin under CC-BY-SA 2.0 via Flickr

What Is the Prognosis for Dogs With Congestive Heart Failure?

Dr. Cathy : Untreated, the prognosis is not good. If caught early, then
the prognosis is good because there are excellent medications, diet, and
nutraceuticals to help the CHF patient.

Scroll to Continue

Read More From Pethelpful


Why Does My Cat Sit on My Stuff?


Tips for Home Care for Your Vomiting Cat When You Cannot Visit the Vet


The Top 10 Fastest Dog Breeds

How Common Is CHF?

Dr. Cathy : It is one of the more common older dog diseases.

Dobermans are predisposed to CHF

Dobermans are predisposed to CHF

Are Certain Dog Breeds Predisposed?

Dr. Cathy : Dobermans and boxers commonly get dilated cardiomyopathy.
Small and toy breeds of dogs are most commonly affected by mitral valve
failure and, thus, CHF. However, this group of disorders affects many, many

Boxers are another breed with predisposition to

Boxers are another breed with predisposition to CHF

What Can I Do to Protect My Dog?

Dr. Cathy : Because so much about CHF is genetically determined, there’s
only so much you can do to protect.

However, consistent exercise, great nutrition, proper administered prevention
against heartworm disease, and weight control will do a lot for your dog.

What Are the Symptoms of CHF I Should Be Watching For?

Dr. Cathy : The first sign is a subtle, occasional cough, which sounds
just like a little heh sound from time to time. By the time other symptoms
become more obvious, your dog may be in the advanced stages of congestive
heart failure. These signs are:

  • Fainting
  • Exercise intolerance
  • Inability to lay down to sleep
  • Serious frequent cough
  • Restlessness at night

How Do Vets Diagnose CHF?

Dr. Cathy : We use a combination of tools to get to the underlying
problem. These tools will include listening to the heart with a stethoscope,
chest x-ray, blood pressure, ultrasound of the heart, and/or an ECG.

An ECG stands for an electrocardiogram, which is a measure of the electrical
function of the heart. Potential blood work will look at overall kidney
function, electrolytes, and a heartworm test.

Diet, exercise and regular vet checkups are the best prevention against

Diet, exercise and regular vet checkups are the best prevention against CHF

What Treatments Are Available?

Dr. Cathy : There are many medical treatments available, and several are
very similar to what humans with heart disease take. A great diet that is low
in salt and processed foods is the beginning of any CHF treatment.

Additionally, there are pills to lower blood pressure and others to get fluid
out of the lungs or liver. There are pills to decrease scar tissue formation
in the heart. In addition, of course, reasonable amounts of exercise can be
beneficial. The heart is a muscle and it does need exercise; however, it just
needs to not overdo it when it is in serious condition.

What Side Effects Can These Treatments Cause?

Dr. Cathy : The most common problem is with the diuretics, which are the
pills that help get the excess fluid out. These pills, frequently called Lasix
(furosemide) or a water pill, can cause the side effect of losing too much
salt from the blood.

The dissolved salt in the blood is what helps our nerves and muscles function.
This is why the CHF patient needs routine monitoring at the vet’s office to
make sure things don’t get out of hand and we figure it out too late.

Alternative Options for Treating CHF




Compound Dan Shen



Real food diet

Sufficient water

Vitamin D

Zhen Wu Tang

Are There Alternative Treatment Methods?

Dr. Cathy : Diet and sufficient water intake are two of the best
treatments for CHF. Any dry dog food is full of carbohydrates, which the body
can turn to sugar and fat, and this will put the heart at a disadvantage.

Real food where the dog owner controls the salt intake is the best first step
for the canine CHF patient. Additionally, there are some great nutraceuticals
that can help.

CoQ10 is a well-known supplement used in both humans and dogs to decrease
blood pressure 10 to 15 points. While vitamin D is not essential to dogs like
it is to humans, judicious supplementation of vitamin D can help some canine
patients. One caveat when looking at vitamin D is because it is fat-soluble it
is possible to give too much so pet owners must be careful.

There are also some great herbal blends to help treat CHF. I prescribe Zhen Wu
Tang as an herbal diuretic because it does not have the potassium (salt)
depleting side effects of furosemide. Borneol, alone or in a combination
called Compound Dan Shen, can help greatly with an irregular heartbeat.

It may be hard to believe, but both acupuncture and chiropractic make the body
and thus the brain work better; a better functioning brain leads to better
heart function.

Massage, while less effective, can also help. I have one patient whose blood
pressure goes up when she has pain so when I treat the pain I fix the blood
pressure. There are many alternative options to help your baby feel better and
they work well coupled with regular western medicine.

What Role Do Diet and Exercise Play?

Dr. Cathy : These both do wonders in humans; they will do wonders in the
canine CHF patient as well.

The heart is a muscle so exercise will help it be strong. However, the
exercise should be moderate, not done at a breakneck speed. It should be like
a gentle, steady trot and it should be daily.

A diet consisting of low salt (therefore not kibble) ingredients, real meat,
and plenty of fluids will decrease blood pressure in the CHF patient.

How Can I Tell the Difference Between Kennel Cough and a Cough Caused by


Dr. Cathy : The kennel cough sound has a hack, almost like a honk,
afterwards. The CHF cough sounds more like a dry, single cough. (See video
below for a great example of the difference in the sound of these two coughs.)
Both kinds of coughing are worse after exercise. The CHF cough is also very
common at night.

What Do I Need to Know About Caring for My CHF Dog?

Dr. Cathy : The big thing is the quality of life. Without treatment, your
dog suffers. With treatment, your dog can have great quality for quite a while
and gets some of that puppy-like behavior back.


This veterinary medical information is based on information provided during a
telephone interview with a professional, qualified, retired veterinarian.
However, it is provided for educational purposes only. It is not intended to
replace the advice of your own veterinarian. Always seek your veterinarian’s
advice about your pet’s health.

While this information is periodically researched and updated (under the
guidance of veterinary input) in the attempt to be timely and factual, no
guarantee is given the information is correct, complete, and/or up-to-date.

Recommendations as to therapeutics, diagnostics and best standards of practice
in the veterinary industry and/or opinions between professionals may differ or
change as technologies and information changes. You should not use this
article as your sole source of information on any matter of veterinary health
or attempt to self-diagnose or treat your pets as the information herein may
not be appropriate for your pet. The safest option for you and your pet is to
rely on the advice of your veterinarian to diagnose and recommend the best
treatment options.

This article is accurate and true to the best of the author’s knowledge. It
is not meant to substitute for diagnosis, prognosis, treatment, prescription,
or formal and individualized advice from a veterinary medical professional.
Animals exhibiting signs and symptoms of distress should be seen by a
veterinarian immediately.

Questions & Answers

Question: What should I do if my dog bleeds while urinating?

Answer: You should consult your personal vet whenever you see blood or
other signs of unusual urinary tract functions. The information presented in
this article is offered for educational purposes only. It is not intended to
replace or substitute the advice of a qualified veterinarian.

© 2014 Donna Cosmato

Share your experiences with dogs and CHF

Jesse on October 21, 2018:

My dog is in end stages (I believe) of CHF. She lost her appetite. Spends most
of her time sitting and any exertion results in fainting and now she is having
painful seizures. At what point do I put her down? I don’t want her to suffer.
We will be talking/visiting our vet tomorrow. Are seizures normal?

Emilia on September 19, 2018:

CHF is terrible for a pet and the owner. I really don’t know, if my dog is in
pain, but his troubles are visible, and I see how uncomfortable he is. He
rarely coughs, but completely lost his appetite; he refuses to eat. It’s been
almost a month, and there is only a little improvement, but not with his
heart…unfortunately. He had also a Colitis at the top of his heart failure,
and that seems to be better, but he still does not want to eat and barely
wants to do anything… he just lies there or sleep, only goes to pee a few
times, comes back and lies again. This is heart wrenching to see him like
this… I don’t know how long it may take to get him better, if that’s even
possible, or how long his heart will keep beating, but it is (I started to
think) not fair to him. He is 13 years old…maybe it’s his time to go…I’m
so devastated.