Posted on Leave a comment

Diagnosing of congestive heart failure (CHF) in dogs

Early detection and treatment are key

Unfortunately, common clinical signs of congestive heart failure (CHF), such as coughing and difficulty breathing, are nonspecific and may mimic respiratory disease, making diagnosis difficult.

Following a series of key steps and using some of the latest diagnostic tools recommended by the Cardiac Education Group (CEG) and other cardiologists can help you identify and treat CHF earlier in canine patients.  The CEG recommends the following diagnostic tools as essential for diagnosing CHF:

Clinical history

Signalment is an important consideration when diagnosing congestive heart failure (CHF) in dogs. In particular, it is important to assess the following factors:

History: To obtain the most complete clinical history about a dog, ask the pet owner specific questions about the following factors:

  • Changes in attitude, behavior, and activity level: Exercise intolerance, depression, and fatigue are all signs associated with CHF.
  • Changes in breathing: Labored breathing or an increased resting respiratory rate can indicate CHF.
  • Changes in appetite and weight: These factors can also signal a heart problem.
  • Coughing: Include evaluation of onset and type of cough. Dogs with pulmonary edema have acute cough. Dogs with chronic heart disease have mild, intermittent cough.
  • Sleeping habits: Restlessness at night is commonly associated with CHF.
  • Previous evidence of heart disease: Heart murmurs or radiographic changes, such as an enlarged heart, can indicate heart disease.
  • Therapy: Consider any preceding treatments, including compliance with heartworm prevention programs.

Physical examination

Performing a thorough annual physical examination on your canine patients provides an excellent opportunity to evaluate dogs for the presence of heart disease. The following factors provide important clues to cardiac status and can help detect congestive heart failure (CHF) in dogs:

  • Weight and body condition: When cardiac disease occurs, cachexia (weight loss) is more likely to indicate CHF.
  • Respiration: Evaluate rate and effort of respiration. Although normal respiratory rates vary depending on breed, temperature, and weight, a presentation at the 2009 ACVIM forum indicated that a resting respiratory rate higher than 35/minute in a dog (at home) is highly suggestive of heart failure. Accuracy can be further improved by determining a baseline respiration rate and watching for subsequent increases in individual dogs. When the resting respiratory rate increases by 25% to 50% or is above 35/minute, a diagnosis of CHF should be considered.
  • Heart rate: CHF causes cardiac output to decrease, which in turn results in an increased heart rate. So, animals with relatively slow or normal heart rates (80 to 120 beats per minute) are less likely to have CHF than those with higher heart rates.
  • Jugular distension: Include examination of the jugular veins. The presence of abnormal jugular pulses (extending more than one-third of the way up the neck) can indicate CHF in dogs.
  • Mucous membranes and skin turgor: Evaluating mucous membranes in a dog provides an indicator of hydration status, peripheral perfusion, and tissue oxygenation.
  • Abdominal distension: Palpate the abdomen to check for abdominal distension, which can be caused by hepatomegaly or ascites.
  • Pulse abnormalities: Identifying arterial pulse abnormalities, such as hypokinetic (small stroke volume), hyperkinetic (large pulse pressure), and pulse deficits (arrhythmias) can help determine if a dog has CHF. Pulse deficits found in the femoral artery while simultaneously auscultating the heartbeat can be indicative of an arrhythmia.

Cardiac and pulmonary auscultation

Auscultation of the heart is used to detect abnormalities such as:

  • Cardiac arrhythmias—irregular heartbeat, tachycardia, or bradycardia
  • Heart murmurs—consider intensity
  • Extra heart sounds—gallops, clicks

Areas of auscultation in the heart should include the mitral, pulmonic, and aortic valves on the left thoracic wall and the tricuspid valves on the right thorax. A heart murmur often is the first detectable sign of heart disease. If a heart murmur is detected, thoracic radiographs (including calculation of a Vertebral Heart Score) should be done to determine if the dog’s heart is enlarged.

Auscultation of the lungs is used to detect the presence of normal bronchovesicular sounds or abnormal lung sounds, such as crackles and wheezes.

Thoracic radiographs

Thoracic radiographs provide information about heart size, status of pulmonary vasculature, and changes in the lungs to help differentiate left-sided congestive heart failure (CHF) from primary pulmonary disease.

Evaluating the size and shape of the heart silhouette on radiographs is a key step in diagnosing and assessing severity of cardiac disease in dogs.  Radiographic results should be used along with clinical signs and physical exam to determine if CHF treatment is indicated.

How to calculate Vertebral Heart Score (VHS)

Calculating a VHS for dogs from radiographic silhouettes can help veterinarians make cardiac assessments.

Additional diagnostic tests

Serologic tests

Serum biochemistries, PCV/TS or complete blood count (CBC) panels, and urinalysis should be completed in all dogs prior to initiating any treatment for congestive heart failure (CHF).

NT-proBNP is a new blood test for cardiac disease in veterinary patients. NT-proBNP is released in proportion to stretch and stress in the heart and is used to assess the severity of heart disease. Patients in heart failure have significant elevations of NT-proBNP, adding useful diagnostic information in the evaluation of patients with compatible clinical signs. Studies have also shown that elevated NT-proBNP levels are seen in patients with impending heart failure and in those with a poorer prognosis.

Echocardiography and electrocardiograms

Echocardiography is useful in determining a definitive diagnosis of the underlying structural disease as it provides a quantitative evaluation of heart chamber size, wall thickness, and the dynamic changes that occur during the cardiac cycle.

In addition, the electrocardiogram (ECG) is the only diagnostic method that provides specific information about the etiology of an arrhythmia. The ECG is a good follow-up test when a cardiac arrhythmia is discovered during a routine physical exam.

Posted on Leave a comment

Dilated cardiomyopathy (DCM) in dogs

dcm normal heart

DCM is the second most common cause of canine congestive heart failure (CHF), following atrioventricular valvular insufficiency (AVVI). DCM is a disease of the heart muscle that causes loss of myocardial contractility. The heart becomes weakened and enlarged and cannot pump blood efficiently, resulting in decreased cardiac output and tissue perfusion.

dcm normal heart

DCM can have a quick onset and progresses rapidly in dogs. The preclinical disease phase can vary from months to years, but the disease progresses more quickly than AVVI. Treatment with pharmaceuticals is the most effective intervention and focuses on controlling preload, afterload, and contractility.

NormalHeart DCMheart in dogs

Breeds at risk for DCM

Breeds at risk for DCM

DCM primarily affects middle-aged, and large- or giant-breed dogs. Breeds most susceptible to DCM include Afghan Hound, American Cocker Spaniel, Boxer, Dalmatian, Doberman Pinscher, English Cocker Spaniel, Great Dane, Newfoundland and St. Bernard.

You can buy Vetmedin for heart treatment here:

Vetmedin 10 mg (30 tabs)

Vetmedin 10 mg (50 tabs)

Vetmedin 10 mg (100 tabs)

 

Vetmedin 5 mg

 

Vetmedin 1.25 mg (30 tabs)

Vetmedin 1.25 mg (50 tabs)

Vetmedin 1.25 mg (100 tabs)

 

You can buy another product with the same active ingredient (Pimobendan) – PimoPet

PimoPet 2.5 mg (30 tabs)

PimoPet 2.5 mg (100 tabs)

 

PimoPet 5 mg (30 tabs)

PimoPet 5 mg (100 tabs)

Posted on Leave a comment

Signs of congestive heart failure (CHF) in dogs

Vetmedin pimobendan for dogs

In the early stages, signs of atrioventricular valvular insufficiency (AVVI) or dilated cardiomyopathy (DCM) are most likely to be subclinical. This preclinical phase can last for months or years. However, as the heart deteriorates and cardiac output decreases over time, AVVI and DCM ultimately lead to congestive heart failure (CHF) in dogs.

Vetmedin pimobendan for dogs

Common clinical signs of CHF that may appear as AVVI or DCM progresses include:

  • Coughing
  • Changes in breathing
    • Difficulty breathing
    • Shortness of breath
    • Increased respiratory rate
  • Changes in behavior
    • Lack of energy
    • Depressed or withdrawn
  • Exercise intolerance
    • Reluctance to go for walks
    • Tires easily
  • Poor appetite and weight loss
  •  and fainting
  • Restlessness, especially at night

As soon as clinical signs of CHF appear, therapeutic intervention is indicated. No cure for CHF exists and surgical intervention is rarely practical in canine patients, so therapeutic goals focus on improving clinical signs and prolonging life.

You can buy Vetmedin here:

Vetmedin 10 mg (30 tabs)

Vetmedin 10 mg (50 tabs)

Vetmedin 10 mg (100 tabs)

 

Vetmedin 5 mg

 

Vetmedin 1.25 mg (30 tabs)

Vetmedin 1.25 mg (50 tabs)

Vetmedin 1.25 mg (100 tabs)

 

You can buy another product with the same active ingredient (Pimobendan) – PimoPet

PimoPet 2.5 mg (30 tabs)

PimoPet 2.5 mg (100 tabs)

 

PimoPet 5 mg (30 tabs)

PimoPet 5 mg (100 tabs)