Congestive Heart Failure.
New Treatments for Congestive Heart Failure
by Debbie Eldredge, DVM
Congestive heart failure is when the heart weakens and can no longer work efficiently. The heart is a superb pump and when it fails, fluid tends to build up -- either in the lungs or the abdomen. There are many new and excellent medical drugs to help the heart beat more efficiently and steadily.
What I would like to touch on are some of the dietary and non-drug treatments which are coming to light. Realize though, that many of these treatments are just now being subjected to controlled studies to determine if they truly are helping dogs with cardiac problems. Some dogs with heart failure are classic couch potatoes -- overweight and not active. Obesity can harm your dog's heart in many ways -- just as in people. Hypertension, increased heart rates, and decreased exercise all can occur with obesity, sometimes turning a mild heart problem into a more serious one. Overweight dogs are also much more prone to respiratory problems, which just compound the whole situation. So keep Bowser trim! At the other end of the spectrum, we see what is called cardiac cachexia. These are dogs who are losing weight, including muscle mass.
Poor absorption of nutrients can lead to weakness, a poorly functioning immune system, and even less desire to eat. Dogs may lose their appetite from some of the medications they are taking. Or the decrease in oxygen to the gastrointestinal system (due to the heart disease) can, at the same time, limit their absorption of nutrients and cause a hypermetabolic state.
That means you have to pull out all the stops to get dogs with cardiac cachexia to eat the necessary nutrients. Warming food up, home-cooked meals and garlic powder (not garlic salt) all seem to help stimulate appetites. Dogs with congestive heart failure can also benefit from sodium reduction -- just like humans. Retaining extra sodium causes your dog to retain extra fluid and makes it harder for the heart to pump. Normal dog foods have about 0.47% sodium on a dry matter basis. For moderate sodium restriction, you want about 0.2%, and 0.1% or less sodium (dry matter basis) for very severe sodium restriction.
Your veterinarian can tell you which foods fit these descriptions, or you can call the pet food makers. While sodium-restricted pet foods has a reputation for being unpalatable, that is changing. Doing a gradual switchover from Fido's favorite food can be all that is required. Do beware of treats!
Many of these have quite a bit of sodium. Potassium is another dietary component that affects how the heart works. Too much or too little can have serious consequences. Dogs on certain diuretics should have their potassium checked periodically. Kidney problems can show up when dogs are on a wide combination of diuretics, sodium restriction and medications to enhance the pumping of the heart. Remember, never change your dog's drugs or dosages without first checking with your veterinarian. L-carnitine is a dietary supplement that shows promise for helping some dogs in heart failure. This is a component of fatty acid metabolism -- the way in which heart muscle gets its energy.
Originally, this was tried on Boxers with cardiomyopathy (a specific type of heart failure), and it seemed to help. It may take weeks to months to see an improvement, but it's safe.
Expense can be a factor for large dogs, but about40% of all dogs with cardiomyopathy seem to benefit from some extra carnitine. Taurine hit the news as a factor in cardiomyopathy in cats. Since the feline research, it's been tried in dogs with some notable successes. American Cocker Spaniels develop heart failure of a certain type which often responds quite well to a combination of l-carnitine and taurine. While that seems to be breed specific, Golden Retrievers with heart failure are now being studied in the hopes that taurine may help them, too. (Chicken is high in taurine.) Two promising nutraceuticals (nutrients which may have medical benefits, but are not prescription at this time) are fish oils (with high levels of omega-3 fatty acids) and Coenzyme Q. These are supplements which have been shown to help some people and are now being tried on pets. The advantage to many of these nutraceuticals is that they seem to be very safe -- so even if they don't help, they shouldn't hurt. If your dog is diagnosed with congestive heart failure, this will give you some additional therapies to discuss with your veterinarian. While the treatments mentioned above won't replace many cardiac drugs, they may help to increase the length and quality of your pet's life. And that's something we all strive for.