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Heart Failure

Heart Failure Protocol for Dogs and Cats

Heart Failure in dogs and cats treatment options, recommended remedies and helpful information has been provided by certified Master Herbalist Philip Reich and certified Canine Nutritionist Maria Reich. Philip and Maria specialize in medical herbalism and nutrition for animals with conditions like heart failure. They approach this situation in a holistic manner with the main priority being the health and safety of your animal.

1. What is Heart Failure in Dogs and Cats?

Heart failure is a general term used to describe what is essentially a weak, ineffectual muscle. The muscle in this case is the heart of the dog or cat that can not provide an adequate blood supply to the body. A normal heart has strong, muscular walls that contract to pump blood out to all parts of the body. With heart failure the muscle of the heart slowly weakens and enlarges preventing the heart from pumping enough blood. Heart failure is called congestive heart failure when fluid builds up in various parts of the body.

Are there warning signs?

A warning sign, or precursor, of heart failure is an enlarged heart. This is due to the fact that because of some sort of damage to the heart muscle it has to work harder and as a result the heart muscle thickens to compensate for the extra work. However, this is just a stopgap measure and if what is contributing to your animal's heart disease is not controlled, over time the heart muscle will get weaker.

What are symptoms of heart failure?

Heart failure symptoms develop over time as the heart becomes weaker and unable to pump the blood your dog or cat's body needs. Symptoms of heart failure in our domestic animals depends on which side of the heart is damaged. If your pet has left-sided congestive heart failure they will display the classic signs of heart failure - decreased stamina, coughing or difficulty breathing (due to the enlarged heart pushing against the trachea) - because of fluid backing up into the lungs called pulmonary edema. With right-sided congestive heart failure fluid may accumulate in the abdomen or in the limbs known as peripheral edema. Symptoms of heart failure in dogs and cats include:

  • Coughing / shortness of breath when at rest / laying down
  • Coughing or wheezing when playing / exercising
  • Fluid buildup in legs / paws and/or abdomen
  • Excessive panting
  • Loss of appetite
  • Swollen belly
  • Pale or bluish gums
  • Generalized weight loss
  • Muscle wasting

What are the Primary Types of Heart Disease?

Left-sided congestive heart failure also known as mitral valve insufficiency (MVI) occurs when the heart contracts or pumps, instead of the left ventricle pushing the blood into the systemic circulation, some leaks through the mitral valve back into the left atrium and then it backs up into small blood vessels in the lungs. Fluid then seeps into the lung tissue resulting in pulmonary edema. This causes the classic signs of heart failure - coughing and fluid in the chest.

Right-sided congestive heart failure causes poor venous return to the heart. In other words, when the heart contracts or "pumps", instead of the right ventricle pushing the blood through the lungs for oxygenation, some leaks through the tricuspid valve (the valve between the right atrium and right ventricle) back into the right atrium. This blood backs up into the systemic circulation (the main circulation of the body) and consequently becomes "congested". As pressure builds in small blood vessels fluid is forced out and accumulates in the abdomen interfering with the function of the organs in these areas. The abdomen may fill with fluid, a condition called ascites. Fluid may also leak from veins in the limbs, causing  swelling, known as peripheral edema.

2. What are the Causes of Heart Failure in Dogs and Cats?

Heart failure in dogs and cats is most commonly caused by valvular insufficiency. This is very different from people in which the primary cause is usually coronary artery disease prompted by the buildup of fatty deposits called plaque that constrict blood supply to the heart. There can be a number of different causes of the damage to heart valves that include:

  • Chemical exposure from flea and tick products. Research has shown that chemicals in these products can damage the valves of your pet's heart
  • Low protein (or poor quality protein) diets that lead to weakening of this important muscle
  • Heart birth defects
  • Infection of the heart and/or heart valves
  • Diabetes
  • Thyroid issues
  • High blood pressure
  • Abnormal heart rhythm (arrhythmias)
  • Side effects of certain medications

3. Standard Veterinary Medicine Approach

Diagnostic Testing

There are a number of different testing methods veterinarians use to diagnose heart failure in dogs and cats that include:

  • Auscultation which is listening to the heart with a stethoscope. This is usually the vet's first step in diagnosing heart disease. Heart murmurs are detected by auscultation; the murmur's location and intensity helps determine its significance. The heart rhythm is assessed, and if there are concerns, the veterinarian may simultaneously palpate or feel the pulse to determine its strength and rhythm. Finally, the lungs are assessed, looking for evidence of changes associated with heart failure.
  • electrocardiogram (ECG) measures the electrical activity of the heart and allows accurate determination of both heart rate and rhythm. Any abnormal rhythms (arrhythmias or dysrhythmias) can be detected and evaluated.
  • Ultrasound examination (echocardiogram) utilizes ultrasound waves to evaluate the heart. The size and thickness of each heart chamber can be evaluated, and the effectiveness of the heart's contractions can be directly observed. Measurements can be taken to evaluate the heart's pumping efficiency.
  • Chest x-rays are taken to evaluate the size and shape of the heart and look for lung changes such as the presence of fluid
  • Blood and urine tests can give an idea of liver and kidney function that are often impaired in animals with heart disease.


Veterinary treatment will make use of medciations to help control symptoms your dog or cat is experiencing. These include:

  • Angiotensin converting enzyme (ACE) inhibitors. These drugs dilate blood vessels and moderate excess hormone activity that occurs with heart failure, resulting in less resistance in the blood vessels against which the heart must pump. These drugs have improved clinical signs of heart failure and prolonged survival in several studies. An ACE inhibitor may be the only drug needed early in the disease process. Adverse effects of ACE inhibitors could include vomiting or diarrhea, deterioration of kidney function, elevation of blood potassium levels, or low blood pressure (hypotension).
  • Diuretics are used to promote the loss of excess fluid in animals with congestive heart failure. The dosage varies depending on the clinical situation and the patient’s response, but generally the lowest dose that controls signs of congestion is used for chronic therapy. Adverse effects of these drugs are usually related to excessive fluid and/or electrolyte losses (especially potassium) resulting in dehydration and weakness.
  • Drugs that act to strengthen heart muscle contraction and also moderate excessive neurohormonal activity that occurs with heart failure and helps control certain heart rhythm abnormalities. The toxic effects of these drugs can be serious and even life threatening so the drug must be carefully dosed. Monitoring of the drug concentration in the blood is recommended. This is often done 7 to 10 days after starting the drug or after making a dosage change. The blood sample is taken 8 to 10 hours after a dose of the drug has been given. Reduced kidney function, dehydration, loss of lean muscle mass, low blood potassium levels, and certain drugs increase the potential for toxicity. Adverse/toxic effects can include heart rhythm disturbances, loss of appetite, vomiting, diarrhea, and depression.
  • Calcium channel blockers are used to help control certain heart rhythm disturbances and to promote heart muscle relaxation in hypertrophic cardiomyopathy (especially in cats). In dogs with atrial fibrillation (a rapid, irregular, abnormal heart rhythm) it may be used with other drugs to slow the rate of the heartbeat.
  • Beta-blockers that antagonize the effects of the sympathetic nervous system, and thereby slow the heart rate, reduce the heart’s oxygen demand, and help control certain heart rhythm disturbances. A beta-blocker may be used with other drugs to slow the heartbeat in dogs with atrial fibrillation. A beta-blocker may be useful in cats with hypertrophic cardiomyopathy as well as animals with certain congenital heart malformations. Adverse effects can include excessively slow heart rate, worsening of heart failure, low blood pressure, bronchospasm, depressed attitude, and possibly masking early signs of low blood sugar (especially in diabetics).

4. Natural Heart Failure Protocol for Dogs and Cats

The goal of our Natural Heart Failure Protocol is to support and strengthen this very important organ that is responsible for distributing oxygen-rich blood throughout the body and returning carbon dioxide loaded blood back to the lungs. When medications are used to accomplish this alone, the heart will never get healthier because drugs are used to replace the body's natural healing abilities. If the dog or cat's condition is serious enough where medication is required for their comfort, our protocol can play an important supportive role. If medications can be reduced when using our protocol this must be done in conjunction with your veterinarian so your animal can be properly monitored.

Core Recommendations Suggested products are included in the Core Heart Failure Package found below.

Our "Core Recommendations" form the backbone of our Natural Heart Failure Protocol for dogs and cats. They consist of the supplement recommendations we feel are the most important to provide to your animal companion for this condition. They are displayed individually or as a package at the bottom of this page along with other helpful products from which you may make additional selections. Pet foods can be purchased at your finer, local pet stores. If you desire more individualized attention please feel free to use our Consultation Form to provide detailed information about your dog or cat so we can better help you.

Heart Failure Vitamin Supplement for Dogs and Cats Core Recommendation #1 - Daily Multi Plus

Our Daily Multi Plus is formulated with organic, whole foods that are extremely important to an animal's nutritional needs but are often missing from the majority of canine and feline diets. This special formula provides the enzymes, probiotics, prebiotics, glandulars, vitamins, minerals, antioxidants and phytonutrients that are so beneficial to the body's daily maintenance and repair needs for healthy aging. In this formula you will find the vitamins, minerals and antioxidants recommended by the veterinarian community for this condition - only in an organic, whole food form!

Heart Failure Herbal Remedy for Dogs and Cats Core Recommendation #2 - Heart Tonic

This formula contains herbs that have an amazing supportive role for the heart. It provides natural, whole-food nutrients that have similar actions to many of the drugs vets prescribe for this condition. The difference is that Heart Tonic will also help to strengthen the heart without the numerous drug side-effects. This formula is safe to use in conjuction with medications, when they are necessary. Your veterinarian should be aware that you are using this formula as medication dosages will often be able to be adjusted lower or possibly even eliminated in certain instances.

Heart Failure Glandular Supplement for Dogs and Cats Core Recommendation #2 - Heart Glandular

Nutrients from supplemented glandulars travel to the corresponding gland in your dog or cat to support that organ with natural, whole-food nutrients. This is very important as studies have shown that natural nutrients are much better utilized by the body than their synthetic copies. This glandular tissue is a great natural source of carnitine and taurine among numerous other amino acids and nutrients that support heart health.

Highly Recommended

Biopreparation for Dog and Cat Heart Failure BioPreparation Microalgae Formula

This special blend of four unique algae was developed by a Russian Scientist, Dr. Michael Kiriac after decades of research. It is grown in controlled hydroponic conditions so it is the purest microalgae supplement on the planet. Its thousand of nutrients are so bioavailable they do not have to be digested, they easily pass through the digestive tract and feed cells on a cellular level to greatly benefit a weak heart muscle. BioPreparation can cross the blood brain barrier to feed the brain, support the hypothalamus to help balance the entire endocrine system and even cross the blood retinal barrier to nurture the eyes. This could be considered another Core product and is highly recommended for those animals with heart failure. Select the F3+ Forte for this condition.

Addison's Disease Diet for Dogs and Cats Whole Food Nutrition

With a serious condition like heart disease, in which the body needs the highest value nutrition possible so it has the energy necessary to heal itself, we highly recommend a raw food diet. Raw food is how carnivores, like canines and felines, have evolved to eat and they do best on a high protein, low carbohydrate diet. This is, unfortunately, the opposite of how most pets are fed since the majority of commercial diets are low protein with 50% or more carbohydrates.

In addition, kibble diets are harder for an animal to digest and this is the last thing your pet needs at this point. Since maintaining lean muscle is very important to those dogs and cats with heart failure without the right nutrition that is easily digested, absorbed and metabolized your animal will have a more difficult time getting better. If a raw food diet is not your cup of tea, the next best thing would be a cooked, whole food diet. There are now many quality premixes to choose from to which you can add your own raw or cooked meat. If you decide to make a homemade diet please research the proper way to do this and make sure to add a calcium source like our Seaweed Calcium. For a quick and easy way to add high-quality protein to your pet's diet take a look at our Whey Protein Isolate. For more information read our articles How to Feed Your Dog or How to Feed Your Cat that can be found in our Education section.

Chia Seed Oil for Dog and Cat Heart Failure Chia Seed Oil

Our organic chia seed oil is the richest plant-source of omega 3 fatty acids. It also has the highest ratio of anti-inflammatory omega 3's to inflammatory omega 6's when compared to flax and hemp seed oils. It is also a sustainable, environmentally-friendly alternative to fish oil. Chia oil can help to not only lower blood pressure but also to keep blood vessels healthy which is important for a struggling heart muscle.

Systemic Enzymes for Dog and Cat Heart Failure Systemic Enzymes

Our systemic enzymes contain a highly-researched, custom blend of enzymes that will work to keep blood vessels clear of plaque buildup. In addition, this superb formula contains an enzyme called nattokinase that is a specialized enzyme tincluded to help control the buildup of fibrin in blood vessels that will benefit the heart by maintaining healthy blood pressure.


What does it mean to have an enlarged heart? Retrieved from

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5. Natural Remedies for Dogs and Cats with Heart Failure

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