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CHF is unfortunately very common — almost 75% of elderly dogs have some form of heart disease

The essentials

  • Congestive heart failure is not uncommon, especially in elderly dogs
  • While there is no cure, it is treatable
  • Symptoms can be hard to spot in the early stages, but a timely diagnosis is important

What is congestive heart failure (CHF)?

Congestive heart failure (also called CHF) is the medical term for when the heart is unable to pump enough blood to the body. Both humans and animals — including our dogs — can develop CHF, and it’s not uncommon. According to Pet Health Network, approximately 10 percent of all dogs (and 75% of elderly dogs) have some form of heart disease, and CHF is a condition that results from heart disease. It can cause an increase in pressure and fluid around the heart that can cause major health issues for your pup.

There are two types of congestive heart failure: right-side CHF and left-side CHF.

Right-side CHF. This happens when blood leaks back into the right atrium from the right ventricle rather than being pushed through the blood vessels of the lungs and becoming oxygenated. It causes the main circulation system to get congested with backed-up blood and fluid, which accumulates in the abdomen. This can cause a build-up of fluid in your dog’s limbs (medically known as peripheral edema), as well as a build-up of fluid in your dog’s abdomen (medically known as ascites).

Left-side CHF. This is the more common type of CHF. Blood from the left ventricle leaks back into the left atrium. Basically, the left side of the heart gets overwhelmed, causing fluid to leak into the tissue of the lungs. This can cause coughing and difficulty breathing (medically known as pulmonary edema).

Are dogs of certain breeds or advanced age more prone to CHF?

While it’s possible for your dog to be born with a heart defect that causes CHF, your four-legged loved one could also develop it later in life.

Small breeds are more likely to develop congestive heart failure, specifically toy poodles, Pomeranians, dachshunds, and cavalier King Charles spaniels. But some giant breeds are also prone, including St. Bernards, Newfoundlands, and Great Danes.

Of course, just because your dog isn’t one of these breeds doesn’t mean that they can’t or won’t develop CHF, but owners of these breeds of dogs should keep a special eye out for the warning signs, especially if you have an older dog.

Signs of congestive heart failure

There are a number of common signs and symptoms that can indicate congestive heart failure in its different stages:

  • Coughing
  • Excessive panting
  • Difficulty settling down before bed
  • Lack of appetite
  • Trouble breathing
  • Fast breathing, even when resting
  • Reluctance to exercise
  • Getting tired more easily/fatigue
  • Weight loss
  • Blue or gray-tinged gums
  • Distended abdomen (due to ascites)
  • Collapsing

👉If you notice your dog showing any of these symptoms, make an appointment with your vet.

The earlier CHF is caught, the better. Even if your pup is only showing a few of the minor symptoms, it’s worth a call to the vet. It could point to a larger problem that needs treatment, even if it turns out to not be congestive heart failure — it may be dilated cardiomyopathy (DCM), valve disease, or another heart problem. Plus, it’s always better to be safe than sorry.

Four stages of congestive heart failure 

There are four stages of congestive heart failure. Different symptoms and clinical signs are more common to specific stages.

Stage One. This is the very beginning of deterioration. During this stage, you probably won’t be able to tell your pet has CHF based on shown symptoms. However, a vet may notice something during a checkup, such as hearing a heart murmur when listening to your dog’s chest with their stethoscope, or while treating another issue that could help indicate CHF in this early stage.

Stage Two. At this point, you may start to see minor symptoms such as panting, shortness of breath, slowed respiratory rate, and fatigue. If you notice these signs over the course of days or weeks, it’s definitely a good idea to call your vet to set up an appointment.

Stage Three. A dog experiencing this more advanced stage of CHF will likely show heightened levels of fatigue, chronic coughing and/or wheezing, and breathing difficulties.

Stage Four. This is the final stage of CHF, where your dog might find breathing hard even while resting. You may also notice more alarming symptoms such as swollen limbs, a distended abdomen, or even blue-tinged gums, all signs of heart failure.

👉 The earlier you catch CHF, the better your dog’s outlook is regarding treatment options and quality of life.

Causes of congestive heart failure 

A number of different factors can contribute to your dog developing CHF over the course of their lifetime.

Dogs can be born with a defect that causes CHF, but that’s more rare — only 5% of all canine heart disease is considered congenital. Some congenital heart diseases that can cause CHF include:

  • Atrial septal defect, when there’s a hole in the heart.
  • Patent ductus arteriosus, the failure of a blood vessel to close normally at birth.

However, it’s more common for dogs to develop CHF during their lifetime due to one (or a combination of) the following issues mentioned below.

The 5 most common causes of congestive heart failure in dogs

  • Heartworms. They can block heart valves or even an entire heart chamber, causing the heart muscle to thicken, heart enlargement, lead to valve disease, and cause other serious damage.
  • Parvovirus. This highly contagious virus is (thankfully) preventable with a vaccine, but if your dog catches it, it could potentially infect the heart muscles.
  • Bacterial infections. Bacteria that get into the bloodstream can cause swelling in the lining of the heart or heart valves. Luckily, good dental health and proper teeth brushing can help prevent this from happening.
  • Nutritional deficiency. A good diet and regular exercise are incredibly important to a dog’s overall health. Poor nutrition over the course of your dog’s life can cause CHF or potentially make CHF worse when caused by other factors.
  • Genetics. Some dogs are just predisposed to developing heart failure later in life due to their genetic makeup (this is not the same as a congenital defect).


What to expect from your vet visit

Taking your pup to the vet for any reason can be overwhelming and scary, but knowing what to expect can help cut down on both you and your dog’s anxiety.

A vet visit to diagnose congestive heart failure is a little different than your typical check-up because special diagnostic tests are required.

First, your vet will need a full history for your dog — especially if this vet hasn’t been your dog’s primary care veterinarian for long. Your vet will want to listen to your dog’s breathing and heartbeat, too.

Don’t be surprised if a number of these tests are performed:

  • Blood and urine tests. Dogs with heart diseases frequently also have liver and kidney problems, so testing blood and urine for those issues can help when deciding what medications are safe to use for your dog.
  • Chest x-rays. These will help the vet see the size and shape of the heart, as well as any abnormalities in their lungs (such as fluid build-up).
  • Electrocardiogram. You may hear this called an EKG; this test can detect any issues with your dog’s heart rate and rhythm.
  • Ultrasound. Your vet may call this an echocardiogram, or ECG. Basically, this test gives the vet a look at the shape, size, and movement of your dog’s heart. It can also help your vet figure out if your pup’s heart is pumping blood like it should be, and what medications would be best to help slow down the progression of CHF in your dog.
  • Heartworm antigen test. Because heartworms are a common cause of CHF, signs that your dog has or has had heartworms can help a vet diagnose CHF.

Without running these tests, your vet won’t be able to fully determine which stage of CHF your dog is in, which is important for tailoring a treatment plan. The cost for these types of tests can vary and may cost less if you have insurance, but dog owners should expect to spend at least a few hundred dollars on testing.

How to treat heart disease and CHF in dogs

Unfortunately, there is no cure for CHF. But it is a manageable health issue, especially when caught early. Your vet will put your dog on a specific treatment plan that is specifically catered to them, depending on which stage of CHF your dog is experiencing. Here are some of the ways the disease can be treated.

ACE inhibitors. Common angiotensin-converting enzyme (ACE) inhibitors are enalapril, benazepril, and captopril. These prescription medications can help reduce blood pressure and improve heart function. That can relieve stress to the heart while helping slow the progression of CHF.

Diuretics. Diuretics get the kidneys going, which can help get rid of fluid buildup in the lungs and belly. They will cause your dog to have to pee much more than usual, as it pulls fluid out of your dog’s body. Make sure to take them outside as often as you can, or allow them to have easy access to use the bathroom. Otherwise, you may notice new urinary accidents in the home. This medication often referred to as a “water pill”, will also cause your dog to require more water intake as they lose fluids by urinating.

Vasodilators. These types of medications can help relax blood vessels, which decreases pressure on the heart. Your dog’s cardiologist might pair vasodilators with a positive inotropic drug, which increases the force that your dog’s heartbeats to help increase blood flow to the lungs and body.

Lifestyle and diet changes are also key for managing CHF in dogs

Your vet will be able to tailor your dog’s medicine to their needs, but meds are just part of the equation. You’ll also want to ask your veterinarian about lifestyle changes that can help your pup live a full life while managing their congestive heart failure.

Vet visits. For starters, you’ll likely need to schedule more frequent check-ups. During these visits, your vet can track the progression of your pup’s CHF, and you can discuss any changes that may need to be made to their treatment plan.

Low stress. It’s a good idea to reduce stress at home and try not to over-exert your pet. This could mean keeping them off the stairs, taking shorter walks, etc.

Diet. In the earliest stages, a diet that has lower levels of sodium in your dog’s diet can help slow the progression of CHF and help eliminate excess stress on the heart. CHF isn’t really preventable, but you can make sure you’re not feeding your dog a grain-free diet, which has been linked to heart disease in dogs.

Supplements. In these early stages, specific supplements and antioxidants (such as coenzyme Q10 and vitamin E) might help. While those supplements can generally be found over the counter without a prescription, make sure to consult with your vet before starting your dog on any supplement regimen. Although supplements and nutrition can help to some degree, ultimately your dog will need to be started on lifelong medications to help slow down the progression of CHF.