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Heart failure

Debs

Member
Well apart from my introduction post this is my first so, hello! :)

I wanted to ask some advice about our eldest Cavalier George who has congestive heart failure. He is 8 yrs old and was first diagnosed with a murmur just 18 months ago so it has progressed very quickly. He is on Vetmedin, Cardalis, Frusemide and Digoxin - the latter because he has a very irregular heartbeat. He doesn't cough too much these days but his breathing is very heavy and the slightest thing makes him a lot worse. He has episodes where it is obviously too uncomfortable to lay down and he has been know to stand for 4-5 hrs. He is fairly bright in himself though we think the past few days he's had a bit of a bug and has a very runny tummy which he had some antibiotics for yesterday. Now the main problem is he has been continually losing weight (last Sat he was 9 kg, last night he was 8.6 kg and he's been going down for quite a few months) and is just not eating well. He has always been 'fussy' and we haven't given in to him in the past but obviously now we are trying to tempt him with all sorts of food and he's just turning his nose up except for chicken, he was eating pasta as well until the end of last week but refuses that now and just recently has also refused the chicken, though when he does eat he seems hungry? Does anyone have any ideas of what we can give him as he really does need more than just chicken - when he decides to eat it! We have tried raw, Naturediet, tinned dog food, fish, mince beef/lamb to name a few and we need to be careful he doesn't have anything salty. He had some blood taken yesterday and they are going to test for a whole lot of different things including if the Digoxin levels can be increased slightly so it could be if they find something they can treat he may feel better and start eating more but we don't hear back until tomorrow. Also if anyone has any ideas of any supplements we can give him to help in any way that would be great. Thank you :)
 
Hi Debs

I'm sorry you're having to nurse George through CHF. One of my Cavaliers was in CHF for 18 months (Meg was also 8), and you worry and fuss about them all the time! The one thing that my Meg would eat in the last months of her life with CHF was chicken - but just a thigh or breast cooked in the oven and hand fed warm from a saucer held close to her nose! It is difficult in this situation for dogs to drop their head to eat, even if their food dish is raised a bit. If he will eat it, I would keep George on chicken; he's using very little energy of the sort that produces an appetite, though keeping breathing is exhausting and uncomfortable, especially with a lowered head. A runny tummy will have contributed to his weight loss - is he managing to drink enough, to replace lost fluid? Again, Meg couldn't lower her head to drink, so I used a syringe in the side of her mouth to keep her levels up. Let us know what his blood test brings up.

:flwr: Kate, Oliver and Aled
 
I've been told by friends with dogs with poor appetites (mostly from cancer) that shots of vitamin B-12 often help appetite. Many inject their dogs regularly. If your vet is OK with that, it might be worth a try.
 
Thank you for the supplement link Rod, I'll have a look. Will mention the B-12 to the vet, thank you.

You are right Kate, you do worry and fuss all the time! George has been tempted with all sorts recently but will only eat the chicken and that's just some of the time. We do him fresh every day and have been hand feeding but sometimes he'll take a piece and then spit it out so it's obviously not up to his high standards! The vet though his runny tummy could be a bug so he had some antibiotics on Mon but now thinks he may have a chest infection so has given him an antibiotic injection that will last 2 wks, the more expensive way to do it but at least it means we don't have to try and get even more tablets down him! His fluid intake is good, unfortunately that could be because the test results indicate George is now showing signs of kidney failure. The results also show his Digoxin levels are high, though only just, so we are taking him off the Digoxin for a couple of days and then he'll go back on half the dose he's on now, his phosphorous levels were also high as was his white blood cell count, which is why the vet thinks he has an infection. The good news is he's not anaemic and there are no signs of toxicity from the Digoxin plus George isn't vomiting. We will monitor him for a couple of days and then see where we are. He has been a little brighter since Mon but is struggling a little this evening, hopefully he'll settle down soon and manage some sleep.


 
Sometimes you can't win - you give frusemide to stop fluid building up in the abdomen and lungs but it damages the kidneys! I know that at the moment you are doing all you can to keep George going and comfortable, but my experience, having lost two Cavaliers with CHF, is that they will tell you very clearly when they have had enough. It's a particular look that makes it much easier to take the decision to help them on their way. I hope that point hasn't yet arrived for George, but in the end it comes down to quality of life and doing the most loving thing for them.

Thinking of you:hug:

Kate, Oliver and Aled
 
It is frustrating knowing the meds you give could cause damage in other area but also the fact those meds are doing a good job where intended. My husband and I were talking yesterday about trying to decide when the right time is, George still has a wag in his tail, gets excited when hubby comes home but sometimes he does look like he's so fed up with it all. We lost our Rosie to cancer at just 7 yrs of age 2 yrs ago but at the time our then vet had us believing it was a gastro problem that could be sorted and I think if we had known about the cancer we would have let her go earlier, her last evening she had a fit but before that she had been looking at us in way that suggested she had had enough, we misread it which I'll always regret. We also lost our 9 yr old last year to cancer though thought he had Cushing's until about an hour before we said goodbye, again, if we had know we would probably have said goodbye sooner. I just don't want to leave it too late with George but sometimes he seems like he's coping well, other times he doesn't - he ate a good portion of chicken for breakfast this morning and seemed bright but is now struggling to lay down as he's obviously uncomfortable and he looks so frail and ill - it's the worse thing to have to decide, we did it a couple of months ago for one of our cats (also cancer) but feel that time we made the right decision at the right time so hope that's how it is with George. He is such a sweet and gentle soul and we don't want him to go through more than he can cope with. We shall see how he does over the weekend.

Thank you :)
 
I sometimes think, when people talk so easily about legalising euthanasia for humans, do they know what they are asking for? It's agonising enough to have to make the decision for a dog or cat, wondering if the timing is right or could we do more to keep them alive comfortably - but doing it for a parent, spouse or child? I'm grateful I shall never have to do it for a human, dogs and cats are bad enough!

Kate, Oliver and Aled
 
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