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My dog has congestive heart failure. What now?

Although there is no cure for the common causes of heart failure in dogs, there are treatments available that can greatly improve and extend your dog’s life.
If your dog has been diagnosed with heart failure and clinical signs are visible, it is likely that your veterinarian will recommend a treatment program.
Your dog’s treatment program will vary according to your dog’s individual needs and the type and stage of heart disease.

CHF Treatment Considerations
It is important to remember that treatment for CHF does not cure the disease, but it can help your dog resume a more normal life.

Your veterinarian may recommend one or more of the following medical treatments:

Diuretics are medications to remove excess fluid buildup from the lungs or abdomen, eg, furosemide.

ACE inhibitors, or inhibitors of angiotensin-converting enzyme, are a group of medications that open up constricted blood vessels and are used primarily in the treatment of hypertension and congestive heart failure. Commonly prescribed ACE inhibitors are enalapril, benazepril, and ramipril.

Inodilators are medications that both increase myocardial contractility and open up constricted blood vessels, reducing the workload on your dog's weakened heart. Currently, there is only one dual-acting inodilator available, Vetmedin® (pimobendan) Chewable Tablets.

There are a number of other medications that your veterinarian may recommend for the treatment of your dog's heart failure. These will depend on the specific needs of your dog.

Also, your veterinarian will closely monitor your dog's medication(s) to determine if adjustments need to be made.

Always consult your veterinarian if you notice any change in the behavior or activity of your dog, particularly during the first few days of treatment.

Important safety information: VETMEDIN should not be given in case of hypertrophic cardiomyopathy, aortic stenosis, or any other clinical condition where an augmentation of cardiac output is inappropriate for functional or anatomical reasons. The safety of VETMEDIN has not been established in dogs with asymptomatic heart disease or in heart failure caused by etiologies other than atrioventricular valvular insufficiency or dilated cardiomyopathy. Use only in dogs with clinical evidence of heart failure. The most common side effects reported in field studies were poor appetite, lethargy, diarrhea, dyspnea, azotemia, weakness, and ataxia. If side effects should occur, pet owners should contact their veterinarian. Please refer to the Full Prescribing Information here.
VETMEDIN is a registered trademark of Boehringer Ingelheim Vetmedica GmbH, licensed to Boehringer Ingelheim Vetmedica, Inc.

Cardiologists' Recommendations
Just like in human medicine, veterinarians look to experts in their field for guidance, especially in specialty areas like cardiology. These experts often join together in groups to discuss important topics and developments in their particular area of veterinary medicine.

The American College of Veterinary Medicine (ACVIM) is a trusted source in the veterinary community. They formed a consensus panel of experts in the specialty of cardiology and created guidelines for the diagnosis and treatment of valvular heart disease.1 These guidelines were then shared with other members of ACVIM to gain additional input.

What Are the Latest Recommendations?
2009 ACVIM Guidelines for the Diagnosis and Treatment of Valvular Heart Disease

The latest guidelines created a whole new classification system to describe the four basic stages of heart failure in dogs:

  • Stage A includes dogs at high risk for developing heart disease but currently show no obvious signs

  • Stage B includes dogs that have a heart murmur but have not developed other signs of heart failure

  • Stage C is for dogs that are showing visible signs of heart failure or have shown signs in the past. These dogs are recommended to receive standard therapy for heart failure.

  • Stage D is reserved for dogs that are not responding to standard therapy and need advanced treatment options

Your vet can use this system to determine whether your dog has heart disease and how far along his or her disease has progressed. The guidelines also list treatment options that are appropriate at each stage.

If you have a dog that is at risk for heart disease, the guidelines encourage you to bring him or her to a vet for a screening. The experts stress the importance of diagnosing dogs at risk of heart failure as early as possible, sometimes even before symptoms develop.

What Is Standard Treatment for CHF?
VETMEDIN® (pimobendan) is recommended for dogs at the first sign of CHF1

The 2009 ACVIM guidelines encouraged veterinarians to add VETMEDIN to their standard treatment for CHF in dogs. The experts agreed that VETMEDIN should be used at the start of clinical signs (known as Stage C).

The recommended standard treatment for dogs with CHF should include:

  • Furosemide

  • Pimobendan (VETMEDIN)

  • ACE inhibitor

VETMEDIN is a versatile, first-line therapy for the treatment of CHF due to AVVI or DCM.

  • VETMEDIN can be used with other therapies for CHF

  • VETMEDIN can be used in dogs with mild, moderate, or severe CHF

  • VETMEDIN is proven in clinical trials to lengthen life and improve quality of life in dogs with CHF

  • VETMEDIN was well tolerated with few adverse events

Caring for Your Dog with CHF
Visiting your veterinarian

It is likely that your dog will be put on long-term medication after being diagnosed with heart failure, so your visits to the veterinarian may need to be more frequent at first. However, once your dog’s condition has stabilized with treatment, you can expect to resume a more regular and potentially less frequent visit schedule.

The objective of successful treatment is to make your dog feel better and live longer, at the same time as minimizing unexpected problems and emergency visits.

If your dog’s condition changes noticeably at any time, you should consult your veterinarian immediately.

Diet and exercise
Your veterinarian may recommend dog food that is nutritionally well-balanced and suitable for a dog with a heart condition. Some degree of sodium (salt) restriction may be recommended for some patients.

Ask your veterinarian about treats and “people food,” such as cheese and meat, as many foods will not be suitable for a dog in heart failure. Avoiding high sodium (salty) foods is often recommended.

Exercise is important, but it’s recommended that you consult your veterinarian about the type, level, and frequency of exercise for your dog. If your dog collapses or seems weak during activity, you should consult your veterinarian immediately.

Additional Care
The most important thing you can do for your dog with heart disease is to watch it closely. Monitor your dog’s appetite, behavior, and level of movement. Be sure to alert your veterinarian of any changes in your dog, such as weight loss or increased water consumption.

Respiration rates are an additional method of monitoring your dog’s health. Counting your dog’s breaths per minute can help you assess your dog’s lung function and overall health.

When your dog is resting or sleeping, count the number of breaths he or she takes in 15 seconds. Multiply that number by 4 to get the number of breaths per minute. If the “resting” respiratory rate increases by more than 20 percent over 2 to 3 days, contact your veterinarian.

Remember that there is no substitute for the personalized care your dog receives from the veterinarian, so always seek professional advice.