What to Know About Your Dog's Big Heart

STORY AT-A-GLANCE

• When your dog’s heart is unable to function normally due to heart disease, fluid can build up in the chest or abdomen, causing coughing, swelling (edema), and tiredness that often looks like signs of aging
• Congestive Heart Failure (CHF) is not a death sentence. With early detection, veterinary care, and smart lifestyle changes, your dog can live a full, comfortable life by your side
• The top causes of CHF are valve disease (leaky heart valves) and weak heart muscles, but heartworms, infections, certain cancers, and even poor diet can also raise your dog’s risk
• From acupuncture and CBD to antioxidant-rich meals and gentle walks, natural approaches can help your dog feel better and can reduce their need for medication
• You know your dog best and close monitoring is key. Watch for changes like breathlessness, restlessness, or pale or blue gums, and seek veterinary care immediately if you see these signs

With each beat, your dog’s heart pumps oxygen and nutrients through their body, supporting everything from wagging tails to long walks in the park. But when the heart struggles to keep up with this critical job, your dog may develop a serious condition called congestive heart failure (CHF).

Hearing the words "heart failure" can be scary. But here is the good news — With the right knowledge, early detection, and proper care, you can give your dog the best chance at a longer, more comfortable life.

What Is Congestive Heart Failure (CHF)?

Congestive heart failure does not mean your dog’s heart has stopped working. Instead, it means the heart is not pumping blood as efficiently as it should. This poor performance can cause blood to back up in the body, which leads to fluid leaking into the lungs, around the lungs, into the belly, or even into the limbs.¹ This is where the term "congestive" comes from — it is all about fluid congestion.

The heart is like a dual-sided pump, with the left and right sides managing blood flow to different areas of the body. The right side of the heart receives blood from the body and pumps it to the lungs for oxygenation and carbon dioxide exchange, and the left side of the heart receives blood from the lungs and pumps it back out to the body. When either side fails, problems can show up in different parts of the body.

CHF can affect the left side, the right side, or both sides of your pet’s heart. Left-sided heart failure is the more common form. When the left side of the heart weakens, it cannot push blood effectively out to the rest of the body. As a result, blood backs up into the lungs and fluid leaks out into or around the lungs. This leads to symptoms like:²

• Fluid buildup in the lungs (also known as pulmonary edema)
• Fluid buildup in the space around the lungs (also known as pleural effusion); this is more commonly seen in cats than in dogs, but can happen in any species
• Frequent coughing, especially at night
• Wheezing or labored breathing
• A noticeable drop in stamina
• Loss of interest in walks or playtime

Dogs with left-sided CHF often appear out of breath and may pant heavily even when resting. This can also look like restlessness; these pets have a harder time breathing when laying down, so even when they are tired, they may be unable to rest or sleep well. If your dog used to be active and suddenly is no longer able to handle mild activity, don’t brush it off as just "getting older." This could be one of the earliest signs of trouble.

As for right-sided CHF, which is much less common, the right side of the heart can no longer keep up with circulating blood properly. Blood backs up into the body rather than the lungs. This might cause:

• Swelling in the belly (also called ascites or abdominal effusion)
• Puffiness in the legs or feet (peripheral edema)
• Pressure on the organs of the abdomen, leading to discomfort and poor organ function
• Visible veins in the neck or bulging skin in the abdomen

Right-sided CHF can make your dog look bloated or swollen, and in some cases, they may struggle to lie down comfortably because of the pressure buildup in their abdomens (bellies).

When heart failure goes untreated, it often progresses to affecting both sides of the heart. The result is a more complicated mix of symptoms that can make your dog feel worse over time. That is why early diagnosis and treatment are so important.

What Causes Congestive Heart Failure in Dogs?

Just like people, dogs can experience a variety of heart conditions that eventually lead to CHF. The two most common underlying issues are:

1. Mitral valve insufficiency (MVI) — This is the top cause of CHF in dogs. The mitral valve helps control blood flow between the left atrium and left ventricle (the upper and lower chambers of the left side of the heart respectively). Over time, it can become weak or damaged, allowing blood to leak backward from the left ventricle into the left atrium with every heartbeat. This places pressure on the left atrium causing it to dilate, and eventually this can lead to backup of blood and accumulation of fluid in the lungs. MVI is especially common in smaller breeds and older dogs.³
2. Dilated cardiomyopathy (DCM) — This condition involves a weakening and over-stretching of the heart muscle. The heart becomes enlarged and flabby reducing its ability to contract effectively. This leads to poor blood circulation through the body and can cause fluid accumulation in the abdomen or legs and skin. DCM is more common in larger breeds like Dobermans, Boxers, and Great Danes.⁴

While these two diagnoses are the most common, several other conditions can also lead to CHF, such as:^5,6

• Congenital defects (dogs born with abnormal heart structures)
• High blood pressure
• Heartworm disease
• Infections of the heart lining and valves (endocarditis)
• Tumors affecting heart function
• Fluid buildup in the sac around the heart due to infection, cancer, or other causes (pericarditis, pericardial effusion)
• Trauma or injury to the chest
• Other systemic infections or chronic inflammatory conditions
• Pregnancy

Sometimes, it is not the heart itself but the system around it that causes stress. When tiny blood vessels lose their flexibility — such as from poor diet, inflammation, or aging — the heart has to work harder to push blood and maintain circulation. Over time, this strain can damage the heart muscle and valves.

CHF can affect dogs of any age or breed, but some breeds are more likely to develop it due to genetics or body type. These include Cavalier King Charles Spaniels, Doberman Pinschers, Boxers, Great Danes, Cocker Spaniels, Poodles, Chihuahuas, and Miniature Poodles. But even if your dog is not on this list, it is smart to watch for the signs — especially as your pet ages.

Symptoms of Congestive Heart Failure

Symptoms can vary depending on which side of the heart is affected, but here are the most common ones you might notice:

• Persistent cough (especially during or after lying down or sleeping)
• Panting heavily when not hot or labored breathing; this can manifest as the pet standing with neck extended and elbows out
• Fainting or collapsing episodes
• Decreased energy or stamina
• Swollen belly or limbs
• Restlessness or pacing at night
• Pale, bluish, or gray gums
• Loss of appetite
• Weight loss or muscle-wasting

If something seems off about your dog, even if the signs are subtle, it is worth checking in with your veterinarian.

How Is CHF Diagnosed?

Early detection is key to proper management and treatment, so if your pet shows symptoms, bring them to a veterinarian immediately. Your veterinarian will use various tools to evaluate your dog’s heart health, such as:

1. Stethoscope exam (auscultation) to listen for murmurs and abnormal heartrate or rhythm.
2. Radiographs (X-rays) to look for heart enlargement or fluid accumulation in or around the lungs.
3. Echocardiogram (ultrasound of the heart), which gives an inside view of the heart in action, and allows the veterinarian to take measurements of the heart structures.
4. Electrocardiogram (ECG), which tracks the electrical activity of the heart.
5. Blood and urine testing, which allows your veterinarian to assess for other conditions and to monitor kidney and liver function.
6. Heartworm test — To rule out parasites that may strain the heart.

Your veterinarian might also ask you to monitor your dog’s resting respiratory rate (RRR) at home. This involves counting how many breaths per minute your pet takes while sleeping. A consistent rise in RRR can signal early CHF, even before coughing or fatigue begins.⁷

Conventional and Natural Ways to Treat CHF

Treatment depends on the underlying cause of the CHF, how severe it is, and your dog’s overall health picture. In many cases, a combination of medication(s), diet, lifestyle changes, and sometimes natural therapies offers the best results. Your veterinarian may prescribe one or more of the medications listed below. However, many of these medications can impact the kidneys, so constant monitoring is crucial:

• Diuretics — Help reduce fluid buildup in the lungs or abdomen.
• ACE inhibitors — Relax blood vessels to ease the workload on the heart.
• Pimobendan — Known as an inodilator, this is a drug that strengthens heart contractions and improves efficiency by also relaxing blood vessels and easing the heart’s workload.
• Beta blockers — These are used to reduce blood pressure and help manage arrhythmias (abnormal heart rhythms due to abnormal electrical activity through the heart).
• Oxygen therapy — For emergency breathing support in severe cases.

If your dog is in the early stages of CHF or you prefer a more natural route, here are some options to explore — with your holistic or integrative veterinarian’s guidance:⁸

1. Acupuncture and acupressure — These modalities can stimulate blood flow and support the body’s natural healing on an energetic level. Some dogs see dramatic improvements in energy, breathing, and even reduced murmur grades.
2. Cannabidiol (CBD) oil — Cannabidiol from whole-plant hemp extract has helped some dogs reduce coughing, improve energy, and decrease doses of medications. Always consult your veterinarian, choose a pet-safe brand, and start with low doses.
3. Herbal and nutritional support — Hawthorn strengthens heart contractions and improves circulation, while dandelion is a natural diuretic that is gentle on kidneys. Another calming herb called Motherwort supports the heart during stress. Your veterinarian may also prescribe Traditional Chinese Veterinary Medicine formulas, which are powerful and balanced natural medicine for healing and management of heart disease.

Remember, when choosing any of these natural remedies, always work with an integrative veterinarian to create a safe, effective supplement plan.

Proper Nourishment for a Dog with CHF

Feeding your dog the right, species-appropriate food may help prevent CHF or slow its progression. Whole, fresh foods nourish the cardiovascular system in ways that processed kibble simply cannot.

Ideally, feed your pet meals that include heart healthy choices like omega-3-rich fish (sardines, mackerel, and anchovies), antioxidant-rich berries (blueberries, cranberries, and açai berries) and cold-steeped green tea. Lean proteins like turkey, chicken, or rabbit and vegetables (spinach, kale, broccoli, and carrots) are also good for your pet’s heart.

Consult with your veterinarian about a balanced, homecooked style diet and about giving your pet supplements such as Coenzyme Q10 (CoQ10), taurine, L-carnitine, magnesium, thiamine, Vitamin C, and potassium.

Exercise Is Good, but Don’t Overdo It

Exercise is essential for dogs, as it helps keep their body and heart strong. However, too much can be harmful for CHF patients. To avoid your pet overexerting themselves, opt for short gentle walks instead of hikes and avoid strenuous play or running. Use a harness instead of a collar and allow your dog to rest as often as needed. Avoid walking during hot and humid days if possible.

Your Dog Can Live a Full, Rewarding Life, Even with CHF

CHF is a life-altering condition, but as long as it is managed properly, your pet will be able to live normally. Stick to your veterinarian’s plan, monitor symptoms closely, and follow up regularly. Your pet will likely need to have medications, herbs, supplements, or diet adjusted over time. Some dogs live months or even years beyond diagnosis, especially when CHF is caught early.

You are your dog’s best advocate, so make sure to stay alert, ask questions, and take action early. Remember — you do not have to do this alone. Your integrative veterinarian can help you to navigate this journey with care and confidence. Because at the heart of it all is your dog — and their heart deserves the best.

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