Treatment of heart failure and cardiomyopathy
Care of dogs and cats with valve disease, cardiomyopathy and heart failure: from the first medication to stabilising acute breathlessness in our in-patient hospital. Treatment as an ongoing process with a schedule of check-ups.
What it involves
Heart failure is a condition in which a diseased heart cannot keep up with pumping blood and fluid starts to collect in the lungs (oedema) or in the body cavities. It is not one disease but the end stage of several: valve disease, dilated and hypertrophic cardiomyopathy, and congenital defects. Treatment has two aims: to delay the point at which heart failure appears and, once it has appeared, to keep the animal comfortable for as long as possible.
In the pre-symptomatic phase we use drugs that slow the remodelling of the heart, chosen on the basis of echocardiographic measurements. In the symptomatic phase we add diuretics, drugs that support contraction and drugs that dilate the vessels; in cats with HCM, drugs that reduce the risk of embolism. We adjust the doses on the basis of breath counts at home, X-rays and kidney tests, because heart drugs and the kidneys affect each other.
In acute decompensation (sudden breathlessness, pulmonary oedema) the patient is admitted to the in-patient hospital: oxygen in an incubator or oxygen cage, intravenous drugs, monitoring and minimal stress. Stabilisation usually takes 1–3 days. The lead veterinarian decides the extent of overnight supervision and, if overnight intensive care is needed, we refer the patient to a 24-hour animal hospital in Wrocław.
When it is used
We start treatment when the echo shows enlargement of the heart to the degree at which drugs have been proven to delay heart failure (in dogs with MMVD, stage B2), or when symptoms appear: cough, fast breathing at rest, breathlessness, fluid in the abdomen, fainting. Sudden breathlessness is a life-threatening emergency: during our opening hours, call and come immediately.
Indications: symptoms that should prompt a visit
- A dog breathes more than 30 times a minute while asleep and used to breathe more slowly.
- A dog coughs more and more often, cannot lie down flat and sleeps sitting up.
- A dog’s abdomen has become larger while the dog is losing weight along the back.
- A cat is breathing with its mouth open, using its abdomen, and is lethargic and hiding. Go to a vet immediately.
- A cat has suddenly lost the use of its hind legs, the legs are cold and the cat is crying out in pain.
- A dog being treated for heart disease has fainted or is weaker than usual.
- The gums are pale or bluish and the tongue has a bluish tinge.
Conditions for which we use it in particular
Diagnostics beforehand
We establish the diagnosis and stage on the basis of echocardiography, digital chest X-rays (pulmonary oedema, fluid, size of the heart) and blood tests: kidneys, electrolytes, NT-proBNP and, in cats, the thyroid. We measure blood pressure. In a patient that is struggling to breathe we limit diagnostics to the essential minimum (a brief ultrasound of the chest, oxygen) and carry out the full tests after stabilisation, because the stress of the examination can make the condition worse.
How it proceeds
Stable patient: a consultation with tests, starting drugs, learning to count breaths at home, a check-up after 7–14 days with a kidney and electrolyte test, then every 3–6 months with echo and X-ray as needed. We record every change of dose in the patient’s file and give it to the owner in writing.
Patient in decompensation: emergency admission, oxygen, intravenous diuretics, drainage of the chest if there is fluid there, and continuous monitoring in the in-patient hospital with infusion pumps. Once the breathlessness has settled, we switch to oral drugs and discharge the patient with a plan for a check-up after a few days.
Aftercare
At home: drugs at fixed times (some 2–3 times a day), daily counting of breaths during sleep with a record in a notebook or an app, unrestricted access to water, moderate activity without bursts of strenuous exercise, and a reduced-salt diet once agreed with the vet. Weigh the animal every 2 weeks.
Call immediately if the breathing rate during sleep exceeds 35–40 per minute, or if breathlessness, fainting, loss of appetite for more than a day or, in a cat, sudden weakness of the legs appears. Outside our opening hours, go to a 24-hour animal hospital.
Frequently asked questions
How long can a dog with heart failure live?
It varies greatly, from months to years, depending on the disease, its stage and how regularly treatment is given. We do not promise a specific length of time; we focus on comfort and regular check-ups.
Do heart drugs harm the kidneys?
Diuretics can put a strain on the kidneys, so we monitor them with blood tests and choose the lowest effective dose. It is a balance that we monitor, not a reason to stop the drugs.
Can treatment be stopped when the dog feels well?
No. The improvement is an effect of the medication; stopping it usually leads to a rapid return of pulmonary oedema.
Do you see an animal with breathing difficulty at night?
No — we are open Mon–Fri 9:00–19:00 and Sat 9:00–13:00. Outside these hours, go to a 24-hour animal hospital in Wrocław; once the animal is stable, we will gladly take over further care.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Do you have questions about the treatment of heart failure and cardiomyopathy?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.