Other Important Aspects of Heart Disease

Quality of Life

As a veterinarian, one of our key goals in heart disease and congestive heart failure is to optimize pets’ quality of life. Pets with heart disease may start acting differently or show changes in their normal activities. These subtle changes can be important to assess your pet’s quality of life. They can also be very helpful for your veterinarian to determine how well medications are working or if adjustments are needed.

We have developed quality of life questionnaires to help owners and veterinarians assess the quality of life for pets with heart disease. Fill out the quality of life questionnaire for dogs or cats and bring the completed form to your veterinarian to help guide the conversation about care of your pet. An absolute score on the Quality of Life questionnaire from a single visit might not be all that helpful, but the things that are bothering you and your pet will become clearer, and your veterinarian might be able to help improve the situation.

Tips for Giving Medications

Pets with heart disease, particularly those with congestive heart failure, can be on multiple medications. Getting your pet to take their pills can be difficult, particularly with cats. Therefore, it is important to find ways to safely and effectively give these pills to your pet. It is also important to avoid using foods that are high in salt or could be harmful to your pet. For tips on administering medications (including safe foods you can use), see our Nutrition page.

When to Seek Emergency Veterinary Care

Managing a pet with heart disease can be very stressful. Knowing when your pet may be in a crisis and need emergency medical care sometimes can be challenging.

If your pet has heart disease, be sure you know the emergency clinic closest to you. Save the emergency clinic’s phone number and address on your phone. Consider keeping a copy of your pet’s medical records and all current medications on your phone, in your car, or in a convenient place in your house.

The following situations represent a medical emergency and you should seek immediate emergency veterinary care:

• Your pet is having severe difficulty breathing or their gums are turning blue
• Your cat has open mouth breathing and looks uncomfortable
• Your pet is breathing very rapidly, more than 40 breaths per minute while at rest, and using extra belly wall motion to breathe.
• Your pet has collapsed or fainted, especially if fainting has happened more than once, or if your pet has a prolonged recovery time.
• Your pet is coughing up a frothy liquid
• Your pet is having a prolonged coughing fit and can’t seem to stop
• Your cat a sudden paralysis or sudden inability to use one or more legs
• Your pet with heart disease stops eating or has repeated vomiting and diarrhea

If your pet is in a medical emergency, try to stay calm. If possible, call the emergency clinic to let them know you are on your way and the symptoms your pet is experiencing.

If your pet is a large dog that is unable to walk, a long board or piece of wood can act as a makeshift stretcher to help move your dog to the car. If possible, have someone come with you on the drive to the emergency clinic who can monitor your pet during the drive so you can focus on the driving.

Keep in mind that your pet may be anxious, uncomfortable or confused. This could cause even the gentlest pet to act out and bite or scratch. Use care when handling your pet during an emergency. While you may want to hug your pet, this could cause further discomfort. Try speaking to your pet in a calm, soothing voice and remain near them.

Possible Outcomes for Heart Disease

While some heart conditions (for example some congenital heart diseases) can be resolved, most cannot be cured, and medical management is necessary for the rest of the pet’s life. Most pets’ heart disease can be well-managed with medications, dietary changes, and devoted owners. However, sometimes the heart disease can lead to other issues.

Recurrent Congestive Heart Failure 
One of the most common things that happen to pets with congestive heart failure is another episode of congestive heart failure! This can happen weeks, months, or sometimes even years after symptoms first occur. Over time most pets require adjustments to their medications to prevent heart failure from coming back. Close monitoring at home can help your veterinarian make medication adjustments when signs of heart failure (like difficulty breathing or coughing) start to come back. Sometimes your pet will need to stay in the hospital for a short time until they are breathing more comfortably.

Kidney Problems 
Some pets taking heart medications will develop trouble with their kidneys. Kidney problems often show up as decreased appetite, lethargy, or sometimes vomiting and diarrhea. When these symptoms happen usually the next step is to have your pet’s blood work checked. An elevation of the kidney values can cause animals to feel ill.

In many cases, adjustment of the heart medications can resolve or improve the problem. Sometimes the kidneys are so sick that your pet may have to stay for a short time in the hospital to help them feel better.

Sudden Death 
Unfortunately, because the heart is such an important organ, sudden death can occur in pets with heart disease. If your pet has had episodes of fainting (syncope), he or she is at higher risk for sudden death, but any pet with heart failure can die suddenly due to arrhythmias (abnormal heart rhythms). Boxers with arrhythmogenic right ventricular cardiomyopathy and Doberman Pinschers with dilated cardiomyopathy (DCM) are at high risk for fatal abnormal heart rhythms.

Sudden death can happen in both dogs and cats with almost any form of heart disease. While these situations can be very distressing, there is often nothing the veterinarian or owner could have done to prevent the pet’s death. Careful management and open communication with your veterinarian is the best way to ensure your pet’s heart disease is under control. Working with a veterinary cardiologist is another way to ensure all possible options and treatments have been considered in advance.

Arterial Thromboembolism (ATE) 
Cats with heart disease are at risk for developing blood clots within their hearts. These clots leave the heart and travel to the cats’ back legs (or elsewhere in the body) causing sudden paralysis (called arterial thromboembolism or ATE). If your cat can’t move its back legs and/or the legs feel cool or cold to the touch, seek emergency veterinary care. Some cats can recover with treatment and support, but unfortunately, some cats are so sick that they pass away on their own or the decision is made to put them to sleep.

Euthanasia 
While some cats and dogs with heart disease die suddenly, many times end of life decisions are made by their owners. This is a very personal decision, and the “right” time is different for everyone. If you are worrying that your dog or cat is not having a good quality of life, then you can talk to your veterinarian about whether it might be time to put them to sleep. While this is very difficult to consider, sometimes our pets are so sick that the choice is made to prevent suffering.

It is normal to feel worried or overwhelmed with the responsibilities of monitoring and treating your pet with heart disease. Our research shows that caring for a pet with heart disease can significantly impact some owners’ quality of life so it’s important to take care of your own physical and mental health.  It can be a difficult undertaking, but owners often feel that the experience of caring for their pet makes their relationship even stronger. Be sure to discuss your concerns with your veterinarian or if your worries or stress become overwhelming, consider talking to a mental health provider.