What is congestive heart failure?
Congestive heart failure (CHF) refers to the heart's inability to pump adequate blood to the body. There are many causes of CHF in dogs. The two most common causes are mitral valve insufficiency (MVI), also called a leaky mitral valve, and dilated cardiomyopathy (DCM).
CHF is fairly common in dogs over the age of 10 years; about one-third of dogs older than 10 have some degree of heart disease. However, not all dogs show clinical signs right away. Small-breed dogs are more often affected than large breeds.
With so many dogs at risk of developing heart disease in old age, it makes sense to consider ways in which nutrition may help keep these dogs as healthy and comfortable as possible.
What should I feed my dog with CHF?
To determine the best way to feed your dog with CHF, you must work with your veterinarian to determine whether your dog has other medical conditions. For instance, hypothyroidism, chronic kidney disease, and obesity are common health concerns in older dogs. Any or all these conditions may be present and can influence dietary choices for a dog with CHF. The key to success is understanding which disease takes precedence.
Hypothyroidism (low thyroid level) is diagnosed by simple blood tests and managed using daily, lifetime medication. Hypothyroidism can contribute to weight gain and obesity, reinforcing the need to test for this disease. When embarking on canine weight loss, it is important to use a nutrient profile that has been proven to promote weight loss and maintain muscle condition. This type of nutrient profile includes both restricted calories and higher dietary protein levels. There are several veterinary therapeutic diets designed with these goals, and any transition should take place gradually, over at least 10 days. Your veterinarian can make a specific recommendation based on the most current scientific evidence.
Chronic kidney disease (CKD) is often diagnosed in older dogs and can occur in conjunction with heart disease. There are a number of veterinary therapeutic kidney diets designed to slow the progression of CKD. The nutrient profile of kidney diets includes reduced or restricted dietary phosphorus, reduced protein, and enhanced levels of nutrients such as potassium, B-vitamins, and omega-3 fatty acids.
Veterinary therapeutic diets designed for dogs with heart disease have a nutrient profile that includes restricted dietary sodium and chloride, and enhanced nutrients that support heart function (such as carnitine and taurine). While some sodium restriction is reasonable, it is more important that dogs diagnosed with CHF eat an appropriate number of Calories each day, since the condition called cardiac cachexia can result in weight loss and muscle wasting.
"Omega-3 fatty acids may be added to some commercial veterinary diets,
or your veterinarian may prescribe supplements."
The omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) have been shown to play a valuable role in fighting inflammation in several disease conditions. Omega-3 fatty acids may be added to some commercial veterinary diets, or your veterinarian may prescribe supplements. The published dose for EPA and DHA supplementation in dogs with cardiac disease is 115 mg per kilogram of body weight.
Your veterinarian can calculate a Calorie goal for your dog’s daily needs. The long-term objective is to have your dog stay at a stable body weight and maintain a body condition score of 4, 5, or 6 on a scale from 1 to 9. If you have been free-feeding and are unsure of the exact amount of food your dog eats each day, it is recommended that you gradually switch to pre-measured meal feeding so you can record total Calories eaten at each meal. This process will allow you to manage your dog’s food intake, body weight, and overall quality of life.
Are there any other nutritional concerns for my dog with CHF?
Dogs diagnosed with CHF often must receive two or more medications each day. To ensure your pet gets those medications, you may need to use foods or treats other than the dog’s usual food at mealtimes. Work with your veterinary healthcare team to understand all your options and to make sure your choices do not contain an excessive amount of dietary fat or sodium.
Some pet owners choose to feed a homemade diet. In these instances, it is important to work with a veterinary nutritionist. Ask your veterinary healthcare team for a referral. Many people market themselves as “certified nutritionists”, but unless they have earned a college degree in animal nutrition, there are likely huge gaps in their knowledge and experience with formulation software.
Overall, the best nutritional plan for a dog with CHF is one that supports their daily energy needs, has balanced nutrients for all their medical conditions, and includes foods the dog will eat. While there are several veterinary therapeutic diets with beneficial nutrient profiles, these products are not ideal if the dog won’t eat them.
Home cooking may be preferred by the dog owner, but there are risks associated with feeding an improperly balanced recipe, as well as inadvertently high levels of sodium (many human foods contain excess sodium). Your veterinarian will help you determine the best approach for diet and feeding management at each stage of your dog's heart disease.
