Dogs and heart failure - can you tell me what you did?
April 1, 2020 1:28 PM   Subscribe

Our dear old pup has a pretty strong heart murmur that I think is trending into congestive heart failure. Can you tell me about your personal experience managing this? I’d also appreciate any resources for learning more about the prognosis.

Doggo in question is a chihuahua mix, a rescue with a sad background of abuse and neglect (but since his life with us, loved and spoiled to excess!) We’ve had him for ten years and he was anywhere from 2-5 years old at that time we brought him home. (So he’s about 12-16+ at this point). A few years ago, a vet heard a grade 2/3 murmur and more recently it’s progressed to a stronger grade 3 (4 is the worst, I believe?) Pup never had any symptoms and is really quite sprightly for a dog of his age.. No other health issues.

Lately, pup has developed an occasional sort of hacking cough and sometimes spits up whitish clear liquid. No difficulty breathing or struggling to breathe or any other signs of discomfort/unhappiness. He can still run and jump and play with other dogs in the park, chase squirrels, etc.

From what I understand, the cough is likely to be suggestive of heart failure. The vet told us that we could do an ultrasound of the heart to check, a chest x-ray, and put him on diuretics if heart failure is confirmed. Do you have experience with a dog on diuretics? Any idea how long a dog can be happy on those before they start to get very ill? He took ages to potty train and I fear he will be miserable running in and out to go all day. I also am fairly strongly in favor of promoting his quality of life rather than prolonging it for my sake, but if it’s just a pill a day and an extra trip outside that seems like it would probably be okay for him? Though in all honesty, I was told the testing would cost around $2000 initially and with routine follow-up scans (several hundred dollars each), which is really a massive stretch for me right now. He is a sweet and gentle soul who has been with us through so many challenges and I want to do right by him.

I would especially appreciate hearing any experiences about whether or not you chose to intervene in heart failure, what that looked like, and how it went for you. Also, if you have any knowledge of what it might be like if we don’t intervene now and just wait to see how it progresses, that would be appreciated, too.
posted by robertthebruce to Pets & Animals (7 answers total) 2 users marked this as a favorite
My wife's parents had a terrier mix who took furosemide for a couple of years and did okay with it. For the first year or so he was basically himself, but had to go outside more often, like 2-3 times at night and many during the day. When we watched him for days an sometimes weeks at a time, he seemed happy, but animals are also pretty good at hiding discomfort, so it's hard to tell for certain.

Over the last year or so of his life, we began to notice him declining, to the point where I think if it was our call we would have started to consider saying goodbye. More lethargic, less interested in food, etc. We were watching him at the end while the in-laws were out of town, and he was losing control of his functions, and we could just tell it was time. We ended up having to take him to be euthanized after a very difficult conversation with the in-laws.

These decisions are never easy, and there are no guarantees, of course, but based on what you've said here, it seems like intervening could give you some good times together. My one concern, having paid for a number of pet specialist visits, emergency procedures, etc. is that $2,000 sounds on the very high end of what I'd expect for the initial cardiac workup. Maybe it's more involved than what our pets have gone through, and I can reach out to my in-laws to confirm if you'd like, but you may wish to compare pricing at another vet, even if it involves some travel (though I'm guessing this isn't a great time for trying to find a vet that will accept new patients.)

My memail's open if you have any other questions. Best of luck to you and your furry friend!
posted by tonycpsu at 2:05 PM on April 1, 2020

Just someone who might soon be going through something similar. My 5 year old Boston has similar symptoms to your pup, and the poor quality of his congenital murmur is progressing to the point where we have a referral from his doc to go through testing at NCSU. You don’t say where you’re located, but our veterinarian explained that the battery of test should only cost around $600 and take the better part of an afternoon. Because of Covid, we can’t get up there anytime soon as his symptoms are not life-threatening. However, our vet did say that a lot of dogs do fine on Lasix and continue to live quite happy lives for the next few years, if not longer. $2000 for testing seems very high.
posted by sara is disenchanted at 2:48 PM on April 1, 2020 [1 favorite]

My 12yo dog was diagnosed with a heart murmur 2 years ago. He was on heart meds for a year, before being diagnosed with a liver tumor last year, he's now walking a fine line of half the heart meds he should be on, because they can interfere with his liver enzymes & a special diet & meds for his liver. He is still happy & seemingly healthy considering for his age, he spent this afternoon happily running around the backyard & barking at squirrels on the bird feeder even if his cataracts made seeing them difficult. In fact he is happier now than he was 2 years ago as his underlying conditions have been treated as he was very stoically living with both conditions that only got picked up due to 6 monthly blood tests.

He get's bloods taken every 3 months to monitor everything now and is only just due another ultrasound on his heart the last was done 1 year ago. Yes all the tests add up, financially, but we're lucky enough to be in a place we can afford it, the echocardiogram is expensive but ours only came to $1200 in total for all the initial tests & we went to a specialist for it as our vet didn't do them, this included blood work, xrays, ultrasound at the vets then echo with the full blood flow measurements etc at the specialist. So maybe ask around about that or talk to your vet about what exactly it includes. Now the liver biopsy was scary expensive but that's another story. Talk to your vets there are options and they understand the cost vs quality of life balance very well and may be able to come up with a compromise that fits your budget. We were also able to just pay for each test as it was done, which thanks to busy vets was roughly a month apart on each so instead of in a big lump sum,it spread the payments out further.

If they are just recommending diuretics are a pretty low risk option & the usual first choice med wise for blood pressure and even if they don't buy him years they'll buy him quality of life aren't super crazy expensive if you shop around and I'd totally do it again for any of my future dogs that might need it because of how much it helped.
posted by wwax at 7:31 PM on April 1, 2020 [1 favorite]

My 12 year old dog (pic) got diagnosed with a grade 4 murmur and severe congestive heart failure more than 2 years ago. He is still alive, and still has VERY good quality of life. He takes a lot of drugs every day, (two types of diuretics as well as several others-in our case it is 5 pills three times a day) and they aren't cheap, but it sounds like your dog has a less severe case than mine, so hopefully you wouldn't need as many different drugs.

Other than the monthly prescriptions, treatment hasn't been tremendously expensive--It definitely didn't cost $2,000 for the upfront testing, and I have only needed a few follow up scans in the last two years to make decisions about increasing or decreasing drug dosages--I'm not required to do any routine scans or testing or anything like that. So if you decide you want to treat this, it might make sense to shop around for a vet who will manage the medication with less required testing.

Also, I haven't noticed that my dog needs to go to the bathroom more often, though he does pee WAY more when he goes. Overall, the treatment for this hasn't been too bad, and his quality of life is still very good. The drugs made a huge difference--we absolutely would have had to put him down by now if he wasn't taking all of these drugs, but with them, he lives a very good life. Feel free to send me a message if you want more info!
posted by mjcon at 8:40 PM on April 1, 2020

I found my dog about 4 years ago - she was on a national motorway, severly injured and completely starved & dehydrated. She recovered, and as she was recovering she developed the hacking cough you mentioned. After several visits to various vets she was finally diagnosed wiht heart failure, pulmonary fibrosis, liver issues and a mamary tumour.

She is still alive and well, a lovely dog that seems perfectly OK with the exception of the cough which still pops up when she is excited. The two meds that clearly make a difference (as in, she changes dramatically if I don't give her one or the other fo a couple of days) are furosemid and pimobendan. She takes some other stuff for the liver, her lungs, and her tumour.

The combination with furosemid and pimobendan works wonders for her - I was convinced 2 years ago that she didn't have much more than a month or two, and yet here she is, being the cutest and sweetest and liveliest dog.
posted by doggod at 5:55 AM on April 2, 2020

Our lab pit cross had a heart murmur early in life and it got worse when she was around 11 and she got the hacking cough and fluid filling her lungs.

She was put on 3 meds, one for her heart, and one to help clear her lungs (furosemide?) which was a diuretic, and a 3rd med to supplement bladder control due to the diuretic. The lung one lead to lots of urination. She could no longer go 8 hours without peeing; my wife or I needed to take her out during lunch breaks during the day. The heart meds lead towards anxiety, so she didn't like straying too far from our home, but was fine with repeatedly walking the same street/stretch to get some walking in. Meds were about $110/month CDN average combined.

The vet said 3-6 months was likely. At a year she was still doing pretty good. She did have 2 fainting episodes while out on walks during the last month or two. Around month 13, we needed to up her dosage of the lung clearing meds to the max allowable. The peeing was ridiculous, and we needed to do an indoor pee-zone for night time and day-work. About a week later the hacking cough gave way to wheezing that gave way to a night of laboured breathing. She was on this dosage between a half-week and a week.

I thought I was taking her in for her final vet appointment, but there was apparently miscommunication, so they started doing emergency-ish work when we got there. Injections of some of her meds, plus needed monitoring since it was above rec. dosage, but thinking once her lungs were clear she might have a few last weeks. Sedation because she was normally anxious at the vets, and needed to be left there for the day of monitoring. I picked her up at the end of the day, and she was so stoned there wasn't any look of recognition in her eyes. After about 4 minutes in the car on the way home, she gave a yelp I'll never forget, voided herself, and went into what I now know as agonal breathing.

I did a u turn and went back to the vet, carried her in and said she needed to be put down, and they quickly agreed. They didn't take her to the "quiet room" that they have set aside, they took her to the emergency section. They couldn't find a vein, and kept trying different legs, and closer to the core until they finally did an injection either to the heart or on a major path to the heart. All while doing the agonal breathing and looking at, but not appearing to see, me as I tried to say sweet things. Horrible does not begin to describe this. It was probably only 3-5 minutes, but it felt like hours.

If I had it to do over again, as soon as she was moved to the maximum home dosage of the lung clearing meds, I'd have made her final appointment for 2-3 days from then, spoiled her rotten and not given her such a crappy last day. I did this successfully with the next dog we had to put down, and I want to never choose too-late for another pet ever again.
posted by nobeagle at 7:05 AM on April 2, 2020

Thank you all for sharing these experiences.
posted by robertthebruce at 3:00 PM on May 30, 2020

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