Congestive Heart Failure in Dogs: Signs, Causes, & Treatment

Four minutes
Jan 04, 2024

Heart failure is a syndrome — or group of symptoms — that results in the heart failing to circulate blood adequately throughout the body.1 One form of heart failure dogs can experience is congestive heart failure (CHF), which can be categorized further into two main types. Learn about the signs of congestive heart failure in dogs, its causes, and treatment.

What Is Congestive Heart Failure in Dogs?

Congestive heart failure is different from regular heart failure because, in addition to inadequately circulating blood, blood collects in certain internal organs — causing abnormal functioning and swelling.1

Types of CHF

There are two main types of CHF: left-sided and right-sided failure.2 Left-sided congestive heart failure (LS-CHF) occurs when some of the blood that should be pumped out of the left ventricle, and into the circulatory system, leaks back into the left atrium of the heart. It then gets congested in the lung’s blood vessels and can cause fluid to collect in the lung tissues, creating a pulmonary edema.2

Right-sided congestive heart failure (RS-CHF) occurs when blood returning to the right ventricle, for circulation into the lungs, leaks into the right atrium and backs up the circulatory system. Blood leaks out of the heart vessels into the abdomen vessels to relieve pressure. Some blood may also leak in limb vessels, creating a peripheral edema.2

Dogs may also experience biventricular failure when both ventricles aren’t working correctly.1

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Symptoms of Congestive Heart Failure in Dogs

Signs of congestive heart failure in dogs can vary based on which type of CHF is occurring. Left-sided congestive heart failure symptoms can include:1

  • Difficulty breathing or panting
  • Pale or blue-tinged gums
  • Coughing
  • Difficulty exercising
  • Fainting or collapsing
  • Low blood pressure and low heart rate

Right-sided congestive heart failure symptoms can include:1,2

  • Abnormal functioning of abdominal organs
  • Swollen limbs
  • Swollen abdomen (ascites)
  • Difficulty exercising

Unlike a heart attack in humans, heart failure is rarely an instantaneous event for dogs — although it’s possible.2 Congestive heart failure typically occurs over time, and it can progress to a level where the heart is too damaged to respond to treatment. Early signs may only be detected when your dog is exercising, such as in the early stages of CHF, but signs of a dog dying of heart failure may be noticed in the later stages, even when your dog is at rest or sleeping.1,2

What are the stages of congestive heart failure in dogs?

Congestive heart failure has four stages, and the severity of symptoms can increase with each stage.3

  • Stage 1 of CHF is when the heart’s function begins to weaken. Typically, you don’t notice external symptoms at this stage, but a vet may be able to spot something internally during a checkup.
  • Stage 2 may come with early signs of CHF — such as difficulty exercising, panting, or fatigue — as the heart becomes more damaged.
  • Stage 3 is when difficulty breathing or exercising may become more frequent, coughing can begin, and fluid may start accumulating in the lungs or abdomen.
  • Stage 4, or end-stage CHF, is when breathing can be difficult while resting, the abdomen or limbs may swell due to fluid accumulation, and gums can turn blue.

What Causes CHF in Dogs?

Heart failure can be classified into four groups based on how the heart is functioning: volume overload, pressure overload, cardiac inflow obstruction, and systolic myocardial failure (reduced contraction).1

Within these overarching classifications, there are different causes that can lead to congestive heart failure, including:1,2

  • Valves not working properly
  • Cardiomyopathy (disease of the heart muscle)
  • Irregular heart beat
  • Major blood vessels becoming narrow
  • Genetics
  • Trauma
  • Infections
  • High blood pressure
  • Hypothyroidism
Vet listening to a dog's heart with a stethoscope

Diagnosing CHF in Dogs

Since CHF occurs in stages and can be caused by many different factors, diagnosing it can require many tests. Vets may listen to your dog’s heart for irregular sounds or rhythm, listen to their lungs, and examine their veins and abdomen.2

Vets may also use diagnostic tests — like X-rays, ultrasounds, urine and blood tests, and electrocardiograms (ECGs) — to examine the heart’s health or see what other conditions are causing the heart failure.2

Treatment for Congestive Heart Failure in Dogs

Treating CHF depends on what’s causing the heart failure — that’s why tests are so important. While you may want to spare your dog from all the testing, a proper diagnosis can mean the difference between treatment that works or doesn’t. However, it should be noted that treatment won’t cure heart failure.

In addition to addressing underlying conditions that may be causing heart failure, the goal of treatment is to improve heart function, control blood pressure and heart rhythm, improve blood flow, and reduce the amount of blood entering the heart before it contracts.1 Treatment for CHF in dogs can include medications, lifestyle and nutrition adjustments, surgery to withdraw excess fluid from affected areas, and cough suppressants.

Due to the fact that treatment depends on the cause, the cost of treating congestive heart failure in dogs can vary widely.

How to comfort a dog with congestive heart failure

Depending on the stage of CHF, your dog’s quality of life can vary. While early stages may not affect their quality of life too much, later stages may impact it greatly. It’s important for you and your vet to evaluate how well your dog is living and their level of comfort over time, especially after a diagnosis.

Proper treatment can go a long way when it comes to how comfortable your dog is. You can also adjust their level of activity based on what they’re capable of doing, reduce stress or anxiety as much as possible, and feed them a heart-healthy diet based on your vet’s recommendations.1

How long can a dog live with congestive heart failure?

Dogs who get an accurate diagnosis and receive proper treatment may be able to live a normal life for months to years.2 However, your dog’s age, health, and response to treatment can impact their prognosis.

The stage of CHF, severity of symptoms, and your dog’s quality of life can eventually bring about a hard question: When should you euthanize a dog with congestive heart failure? While there’s no definitive answer, talk with your veterinarian. Along with your everyday observations at home, your vet can use test results to help you evaluate your dog’s quality of life.

MetLife Pet Is Here To Help You Care for Your Dog

No one wants to see their pet suffer — and congestive heart failure can be a difficult condition for you and your dog. Fortunately, MetLife Pet Insurance can help. With our customizable dog insurance policies, you can get reimbursed for covered expenses. This can make it easier to get your dog the diagnosis and treatment they need to give them the best prognosis.

MetLife Pet also offers grief counseling4 for when tough decisions are made, as well as burial and cremation coverage. We’re pet parents too, and so we strive to make a difficult time just a little easier for you. Don’t force yourself to choose between your best pal’s care and your budget. Enroll in a dog insurance policy today and be more protected for tomorrow. Get started with a free quote.

A MetLife Pet Policy May Help Cover Heart Failure Costs

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**As with any insurance policy, coverage may vary. Review our coverage and exclusions.

1 “Heart Failure in Dogs,” Merck Veterinary Manual, 2022

2 “Congestive Heart Failure in Dogs,” VCA Animal Hospitals

3 “Congestive heart failure in dogs,” BetterPet, 2022

4 Grief Counseling services are provided through an agreement with TELUS Health, an unaffiliated third-party service provider. Grief counseling services provided by TELUS Health are separate and apart from the insurance provided by MetLife. Not available to NY residents.

Coverage issued by Metropolitan General Insurance Company (“MetGen”), a Rhode Island insurance company, headquartered at 700 Quaker Lane, Warwick, RI 02886, and Independence American Insurance Company (“IAIC”), a Delaware insurance company, headquartered at 11333 N Scottsdale Rd, Ste 160, Scottsdale, AZ 85454. Coverage subject to restrictions, exclusions and limitations and application is subject to underwriting. See policy or contact MetLife Pet Insurance Solutions LLC (“MetLife Pet”) for details. MetLife Pet is the policy administrator. It may operate under an alternate or fictitious name in certain jurisdictions, including MetLife Pet Insurance Services LLC (New York and Minnesota) and MetLife Pet Insurance Solutions Agency LLC (Illinois).

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