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Kidney Failure / Congestive Heart Failure
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Kidney Failure / Congestive Heart Failure

I have a 15 yr old female Pekeapoo who was diagnosed with congestive heart failure 8 yrs ago.  She has been on Digoxin (sp?) 3 X a day, Furosemid 3X and Enalapril 1 X.  Took her in for a health screen last nite.  Bloodwork/Urine finds bad.
BUN - 140    Creatinine  3.1   Phosphorus  8.8  Calcium  13.3
Doc says she is going into kidney failure because of the Furosemid and want me to cut back to 2x daily.  However, this will fill her lungs back up, start her coughing and possible serious heart failure.  We have a follow up on Thursday.

I am scared to death - what should I expect or what symptons should I be on the phone to the Vet for?  She looks fine on the outside.  How much longer does she have?

I'm not ready to let her go    : (
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Oh, I am so terribly sorry for you both.  I think it's time to face the fact that your peke is at the end of her life.  As you now know, treatments for one problem often contradict the treatment for another - as with the furosemid.  Even worse, there isn't a darn thing to do for kidney failure other than treat the symptoms as best you can.  Once kidney cells are destroyed, they cannot regenerate like other organs such as the liver can.  

When kidney failure reaches the last stages, you will notice a marked increase in nausea and vomiting and probably urinary accidents as well.  The nausea is from the toxins remaining in the bloodstream that the kidneys can no longer filter out.  

To maintain as much function as possible, add calcium to the dog's diet.  If you aren't an experienced "piller" now, you will be very soon.  Get some plain over-the-counter Tums - they are nothing more than calcium, but be sure to read the label to be certain there is nothing else included.  Give a half a Tums twice a day.  The calcium helps sweep out phosphorus from the body which is deadly to failing kidneys.  

Also add a cranberry preparation like CranAssure.  I used both Tums and CranAssure on my dog who died of kidney failure, and it did make a difference - particularly in the early stages.  The Cranassure helps sweep debris from the urinary system and the extra vitamin C is also helpful.

Hydration is extremely important, and yet another contrasting issue with congestive heart failure.  The kidneys need the extra water, but it may worsen the CHF symptoms.  

You may want to consider preparing your own dog food to keep as much phosphorous out of her diet as possible.  Most prescription dog foods for kidney failure are merely low protein.  The idea being that protein is metabolized in the kidneys; therefore, a low protein diet is necessary.  Studies over the past few years negate this idea.  It's not so much the protein that is the problem, rather that a more digestible form of protein is needed.  Scrambled eggs (with about 1/2 the yolk), yogurt, dark poultry meat and rice are some good options.  You'll probably want to add a low or no-phosphorus vitamin supplement as well whether you use a commercial prescription diet or make your own food.

Ultimately, nausea and vomiting will take over your dog's daily life.  The cheapest medication for nausea is reglan (generic name metoclopromadine).  While it is very effective, it is also processed in the kidneys and can cause some wild side effects like extreme nervousness and severe shaking.  Benadryl can take care of the side effects if this happens.  In my experience, once the kidneys reach the point of being unable to process oral reglan, the injectable version got around that problem.  I'm just glad my husband was able to do the injections at home.  :-)

I know I just bombarded you with a whole lot of information, and I hope you'll speak to your vet about how to balance treatment for the CHF and kidney failure as best you can.  Comfort measures are the best that can be offered now, and you'll need to know exactly what those are.

God bless you.  The next weeks and/or months aren't going to be easy, so enjoy the time you have left. :-(
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Thank you for that information

/me wipes the tears away
I gotta go hug a dog.......

Brandysmom
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    I know.  I've been through it.  :-(
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An update - Brandy and I went back for a follow-up yesterday and got some good news!  Her kidney levels dropped significantly!  Still high, but better.  She is breathing deeper and her eyes are watering.  She is not peeing as much too.  I thought she might have lost more weight, but she actually gained an ounce (not much but for a 6.2lb dog, its alot!)

I now have to cut back her Lasix at 1X a day to half of her normal dose.  I'm a lot nervous about this with her CHF.  But I can give her a dose if she has an episode.

Her favourite toy is an old sock.  She hasn't wanted to play with that for over a month.  Last nite, she pulled it out of the basket and wanted to play.  I cried happy tears on that!

I love her sooo much!
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I meant to reply to your original message, but never did...I'm sure excited about your good news...Makes for a good day, too, doesn't it? This very situation has happened to my little guy.  By rotating his lasix, I have been able to cut his elevated kidney levels in half. His at one time were also in the very high range, but they are HALF of what they were, now. I didn't actually cut any dose out, I rotate....One day he gets his 3, next day 2, next day 1 & then I start over....This has worked for 6mos., now....He is due his 3mo. bloodwork in 2wks. and we'll go from there...Just wanted you to know that your not alone. I'm glad you and your baby are having a good day....I understand, completely!!!!!!Karla
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Well that news makes for one Happy Halloween!  Congratulations on the great news!  :-D
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Well, it's been 4 weeks and not alot of progress has happened.  3 weeks ago, she was completely taken off her Lasix.  She has done well with this.  She did have an episode that scared the **** out of me.  We went on our daily walk.  She got overly excited.  When she got to her first pee spot, she squated and then went all flat out and passed out.  I ran her back home and gave her a dose of Lasix.  She was quite disoriented for about an hour, but then was ....ok.She has been gaining weight and her skin lesions (from her skin being posioned from all the medication) are lessening and her BUN levels have improved immensly.
But.... went back for a check up last nite, excited that she seemed heavier and healthier, only to find ou ther BUN levels had almost doubled and she was severly dehydrated.  She lot 1/2 lb (for a 7lb dog, that's alot)
Long story short, now we are on a weekly subcutaneous fluid therapy, still off the Lasix.  I don't know how I can get her anymore fluids - she's on a kidney diet that I mix with chicken broth and has water bowls all over the house.  She is tinkling fine.
Remember that she will be 15 in January.  I am taking it 1 day at a time.  I am scheduled for a hysterecemy on the 18th and want her on my bedside during recovery.

Anyone have any additional ideas I can do for hydration?  Anyone going thru the same thing?

I am scared to death
Brandysmom  : {
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If your feeding Dry food (Kidney diet), switch to CANNED. Canned will help immensely with hydration. Also, make sure the chicken broth is low/or No Sodium. Sounds like your doing a great job with her.....Good luck with your surgery and give Brandy a kiss from me.....Good luck, I wish you both well!         Karla
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Thanks Karla - she is on prescription canned KD food.  I heat it up in the microwave for 10 secs and add low sodium chicken broth.

Thanks for the encouragement!  We begin our thrice weekly trips tomorrow!  Oh yea.... and I sooo ready for my surgery!

Carole
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You are really doing a great job with the heavy nursing duties.  I remember this time last year taking it day by day with Chica.  It's so hard to believe that energetic, clown of a personality is now gone.

Balancing CHF and failing kidneys is like walking on razors over a shark-filled tank.  I really am amazed Brandy has made it this far.  That's a testament to your excellent nursing.  Best of luck with your surgery.  I hope it's going to be done laparascopically.  Mine was the open hyst and WOW did it knock me for a loop!
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Hi Brandy,

I put my 15 yr old down yesterday. CHF and then the kidneys were failing. I worry that I didn't do enough and that my vet didn't try harder to save him. He said since he couldn't
give more lasix there was nothing to do. He never mentioned trying to get liquid other ways.

Bogart was breathing very heavy yesterday and had a heart rate of 220. His gums were gray. But he slept thru the night prior to and was not listless. He was struggling to breathe but I think something more could have been done like you are doing.

What is Brandy's heart rate? Are her gums and tongue bright pink still?

Bogart was diagnosed 60 days ago with MILD CHF. Put on all the drugs. I'm saddened that he didn't last longer. What went wrong? I did the research right away and had too much faith in the drugs -- which is so unlike me. But, I have a heart condition and the drugs work fine for me.

I am so sorry now that I didn't do the herbs along with the drugs. Check into them if you
haven't already.

Looking for answers..
Jane from Chicago
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I'm so sorry to hear about Bogart, Blye.  Brandy was first diagnosed with CHF 8 years ago.  I thought she had a cold as she kept coughing all the time.  Her heart rate started going out of this world and it was then that I decided to take her to the Vets.  See, she was my Mother's dog and me and my husband have always been Cat People.  They are usually self-sufficient and, needless to say, I really didn't know what to look for in a sick dog.  Once we got to the vets, she was quite bad off.  Dr Howard (whom I will forever be indebted to for saving her life) had to give her nitroglycerin pills to jolt her back.  After many days of EKGs, ultrasounds, bloodwork, we started our daily reigm of meds.  One of her Dr's was a holistic vet.  She actually did not recommend anything because of her condition.  So you needn't worry that you could have done more herbally.  Even her groomer said she thought Brandy would have passed 3 years ago - can't believe she's still hanging on  : )
Her current sleeping breath rate is usually around 16 - 24 breaths per minute.  Dr. Howard said to be alarmed if it gets higher than 36 BPM.  Her gums and tongue are still pink, but the whites of her eyes (that you normally don't see - that the Peke in her) are bloodshot red.
Don't know when the next bloodwork will be scheduled.  I assume after the new year.  The Dr. has assigned his Vet Tech to be my personal 'doctor' that I don't like.  He cannot (or will not) answer any questions I have - like why are her eyes blood red.

Blye, I know this is not much solace for you, but our situation has been building for 8 years.  Lucky for you, Bogart didn't have to suffer all the tests and meds for a long period of time.

You are in my prayers.
Carole and Brandy
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I appreciate your condolences and prayers. I am really a wreck.

Sounds like you have had an attentive doctor. Bogart's breaths per minute were mid
40 mostly. The day I took him in they were over 50. He also weighed 13 pounds.

The fact that Brandy's gums are pink is a good sign. Bogart was definitely loosing oxygen, and therefore, loosing the pink color.

I continue to wonder if it was his time. It all happened so fast. He was doing so well and
then all of a sudden he had a setback. The lasix is toxic and will cause the kidneys
to fail. I knew that and was very careful with his dose; cut back after he seemed to
be doing well. What puzzles me is that once the blood work indicated kidney failure, my Dr. did not attempt to do what yours is doing... Get off the lasix completely and
try something else.

Most of Bogart's signs were good. He was drinking lots of water, peeing, BM's and not
listless. When I took him in he was barking and wagging his tail. His breathing was
a concern as I said, but all of it had just happened within 24 hrs. I listen to you talk
about 15 yr old Brandy's care and have to wonder if I was cheated. I just wasn't prepared to hear "put him down". I really just brought him there to get a shot or something...to get
him a boost. He never came home.

It's so hard knowing what to do at the moment of despair. In retrospect, maybe I should
have got a second opinion.  I guess I'll be thinking... maybe I should have...for a long time.

Brandy is lucky to have you. Believe me, I know the work and expense involved in tending to a sick dog.  

Take care,
blye

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Not sure if anyone is still reading this trail but it popped up in my google search so I thought I would add my $.02. I have a 14yr old cocker mix in the end stages of congestive heart failure (CHF). We had her in the ER four days ago after what appears to have been a spell of hypoxia (lack of oygen to the brain). ER Doc gave her a large dose of liquid lasix which helped out some. She is currently on Benzapril, Furosemide, Spironolactone, and Pimobendan (and had been on nitroglycerin). We got her home from the ER not much better than when she went in. That morning and into the next day, her gums and tongue were gray, she hardly moved, and there was no appetite whatsoever. We took her to the cardiologist the next day and the cardiologist said that there was no more to be done and that when the appetite stopped, that was her way of telling us she was ready (three days ago from this writing).

Since we had her in the ER and the cardiologist, we've taken to a big eye dropper as a water delivery system. Basically, we fill the eye dropper full of water and put it in front of her and she drinks it almost like she is nursing. We fill her up in the morning, mid-afternoon, at dinner time, and before we go to bed. She gets as much as she wants and then some. Initially, we had to force feed her (the person above mentioned that CHF will teach you how to get your dog to take pills -- if you have a good method, you might want to try to force feed water and food if you have to -- grits and mashed potatoes have worked very well for us). Her appetite has now started to come back (very finicky but eating nevertheless) and she will freely drink water again. She has been able to stand up and carry herself (at all is good but much better than the past few weeks), and her gums and tongue are pink again. We have been fortunate not to have to combat kidney failure at the same time but we have been using the rotating lasix idea as mentioned above which seems to be keeping her abdomen swelling down which in turn makes her more comfortable and willing to eat which in turn keeps our ability to deliver nutrition going. It has only been four days since we were at the point where the ER Doc was telling us that if it was her dog she would put her down but now our little old cocker mix has bright eyes, is alert, has good stools, and appears to be living comfortably. It has been a good few days and I am hopeful we'll get a few more.

CHF is a very hard way to watch an old friend have life move on from their body but there are ways to manage it. I recommend finding a good cardiologist and watching what works for your dog as they are all different. Godspeed to all of those who read after I write this and hopefully our approach may be of some assistance to you.

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Reading the posts about your dog with CHF has been very helpful. Our little guy, Abe, is a 13 year old Boston Terrier that we rescued almost 3 years ago, although now I think he rescued us because it was such a joy to teach him that people loved him and what treats, toys and walks were. He was like a kid in the candy store.

When we got him he had a neck injury from having a collar left on for years and he still has a bit of a "ring" around his neck so because he was already older and had this injury we now feel it hindered us finding out sooner because our vet shrugged off his heart murmer and breathing issues. So we only found out he had CHF one month ago and he's in severe failure. He suddenly developed a bloated look, along with more trouble breathing so we demanded an Xray. Since then he's been taking Lasix, enalapril, and as of 10 days ago Vetmedin. He seems to do really well for 7-10 days with each adjustment of meds and then gets worse.

We went to the cardiologist yesterday and the ultrasound shows that his valves can no longer close completely so the blood backs up. The cardiologist changed the meds around a bit and wants us to "give it 4 days or so" to see if there is any improvement. Unfortunately with each passing day he gets more picky about food and although he drinks a fair amount, he eats almost nothing which makes us really worried. His gums have been greyish for most of the month and the vets felt blood work wouldn't make any difference at his stage.

We know he's near the end and I think I knew even before we found out he had CHF. We know that he'll really suffer if we don't help him "go to sleep" but it is the hardest thing to come to grips with. We definitely don't want him to suffer because he is our child but it is so hard to say goodbye and "pick a date" for this type of thing and none of the vets seem to be willing to say...it's time right now...or make it within the next week or two. We ask but they don't give a straight answer. The only good thing is he hasn't had to suffer through the meds for very long and we're told that although this disease will cause some discomfort that he isn't in any actual pain.

I hope you'll all pray for my little guy and know that my heart goes out to you as well. Although this has been a horrible thing to try and deal with, we're also very happy that we've had some time to research the disease and start to say goodbye.
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I also find some insight from all your experiences and stories of the best treatment for your dog with CHF.  My white pekingese at 10.5 lbs is 10.5 yrs old and will be approaching 11yrs in June, but as of 1/29th I noticed he was coughing uncontrollably and then would vomit mainly viscous saliva.  His stomach was definitely extended and being the sweetheart that he is, Fei would hide under furniture during his coughing spells to not show you he's in agony.  I brought him to the vet that night and after hearing a heart murmur, an x-ray was conducted showing white the vet said was MILD CHF.  So the treatment began... bloodwork, x-rays to determine if there's existing fluid build up and meds.  He was initially given Vetmedin, soloxine, keycotuss and enalapril.  
Fei's coughing was still occurring primarily in the morning and in the evening.  His appetite wasn't great, but I could entice him to eat w/ a big of crumbled freeze-dried chicken liver on his dry Nutro senior diet kibble.  He's drinking lots of fluids.

After a week of these meds, I told the cardiologist his coughing is not really improving so he was given lasix for four days, his coughing got worse and was told to be completely off of them.  A week went by, Fei was doing actually great.  Mild cough again in the morning and evening (2-3 short coughs) and he was back to playing with his many tennis balls and walking around with his tail wagging. But in that week, he had two urinary accidents while he was sitting down- as if he didn't even know he peed.

A week later, this past Monday 3/31 he had an uncontrollable coughing spell, hard and fast breaths and was very lethargic, tongue & gums were slightly gray and he's stomach was swollen.  I brought him to the ER and they said he was in congestive heart failure and a liquid lasix, nitro was given to him to stabilize the condition.  They also kept him in an oxygen box for the remainder of the night until he was transported ,again with oxygen, to the cardiologist where a heavier dose of lasix and continued oxygen treatment was administered.

After another overnight stay, the next day Fei was taken off oxygen and monitored before I was able to bring him home yesterday.  Now his current medication consists of: vetmedin 2X, enalapril 2X, lasix 3X, soloxine 2X and torbutrol 2X day.  

This morning was his first day home and I'm on "high" alert for any signs of coughing, rapid heart rate, diarrhea, etc. Today he has loose stool and another urinary accident, which after researching what others have said, I'm worried if this is a sign of kidney disease.  Fei just started taking lasix and the cardiologist told me last week that his bloodwork looks "normal" and "good."  What is causing his urinary accidents? I'm just worried there's something the vet is not catching.

This is much comfort to read other previous comments that similar medications were administered to your dog w/ CHF.  I can't help but become paranoid that I can loose him anytime, so I don't want to leave his side.  And if I do, as I'm doing now being upstairs typing this, I make sure one family member is nearby so Fei knows he's not alone.  

My main concern as of this morning is his lack of appetite and energy.  Is his medication making him ill?  Does anyone have any suggestions what is best to feed a dog with CHF that lacks appetite?  With his meds, I wrap them in boiled chicken breast, which he eats a bit but I'm afraid some backup plan is needed to get him to eat.  

We all know the inevitable is going to happen someday, but I also do not want to see him suffer.  The first episode that led to the ER was heartbreaking enough to see him go through a state of panic that I rather take on his pain instead.  Reading all your comments has ease my mind a bit, but I'm not letting him go without of fight.  I tell myself not to be selfish and only prolong his life as long as the vet is telling me that he is NOT suffering.  A previous post mentioned that they do not want to be the one to determine the day their dog dies, I couldn't agree more.  Making that call will be difficult, but where do we have that talk with the vet... is it worth keeping him here with me while the onset of kidney disease may arise.  

I don't know what to do.  I am afraid and scared to death that he suddenly leaves me behind or that I can't get him to the vet in time and watch the most horrific event happen before my eyes during I'm transit.  I've stressed my concerned to the cardiologist very clearly and he told me that that when Fei stops "responding to the lasix" then we may have to make that decision.  I want all my family members present so Fei knows how much we all love him.  

I've been assured that the kidney disease takes a while to develop so the immediate focus is still on CHF- fluid build up and cardiac arrest.  At this point, I guess Fei's medication treatment is still not stable and after the severe episode Monday, I don't want any emergencies.  Right now, my entire life revolves around Fei's well-being, but I'm also trying my best to not ignore my 8 yr old Yorkie, Murphy in the process.  He'll be getting his annual senior checkup tomorrow.

I'm praying for everyone that is going through this same ordeal as I.  I wake up several hrs to make sure Fei is breathing peacefully and snoring.  There's nothing I can do at this point but worry until his condition is stabilized.  

Any feedback as to how to get my dog to eat would be greatly appreciated as well as other key pointers.  I'm going to discuss with the cardiologist about rotating his daily dose of lasix to prevent the onset of kidney disease and look into KD/HD canned diet.  

Does anyone have an emergency kit/ advice that they found to be useful if a coughing episode occurs?  How often do you get another bloodwork done?  What's the ideal breathing rate?  Again I'm going to ask the cardiologist the same questions, when he has the time to return my phone call, but it would be nice to hear from others experience with their own specialist/vet what they recommend.    

Thank you all for reading my post.  

Fei's panic-stricken mom,
Mimi


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Finding something Fei will eat is likely to become more difficult as the CHF progresses. I know for sure that the Enalapril makes there stomach upset.
My little Boston is still hanging on but each week seems slightly worse than the previous and we've had a lot of rain and grey days here in NH and that seems to make him feel worse. We know his days are running out and even though we don't want to see him cross the Rainbow Bridge, we don't want him to suffer. Our vets tell us that CHF causes more of an uncomfortable feeling than actual pain but obviously, as the fluid builds up it creates more discomfort (they tell us it's like feeling really, really bloated and short of breath all the time) which I have to say, doesn't sound that great to me. Not for days and weeks at a time.
Anyway, as for food; we've found that chicken and beef are the favorites. He still wants treats on occasion but won't eat any kibble at all. He also has always refused canned dog food. His favorite food is the skin from a roasted or boiled chicken and it always makes him feel better. Then comes steak, hamburg etc. If he won't take his medicine in a soft treat then we put it in small home made meatballs (just hamburg). Our vet said having some raw hamburg wouldn't be bad for him so about half the time he gets his meds in raw hamburg...which is almost always eats really well.
We've found that some of the meds seem to change the taste of the food you mix them with so we find that we have to switch foods every few days so that he doesn't think it's "poisoned" with meds. :-)
BTW the meds almost always give the dogs diarrhea and at the very least, soft poop.
We've also found that he improved when we did hover around him. I think we were freaking him out at first because he was used to us leaving him alone for a couple hours at a time so he could rest. This was really hard for me until I realized he got better when he was back on his normal routine.
He does occasionally have an accident but it's normally after he's been sleeping for awhile. We got some of those puppy training pads and he will go on that. If he asks to sleep on our bed we put down a waterproof pad with a small blanket on top to protect everything.
My thoughts are with you and I hope I've helped a little,
Angie
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Hi there!  Miss Brandy is still hanging in there.  After reading all the posts, I am thankful to see that her CHF is not affecting her like your precious babies.
We are completely off the floursimide.  I am giving her SubCu treatments 3 times a week, but I think I may go 7 days now.  Her backside is very taunt and she is very dehydrated.
Looking at her, sometimes you would neve know something was wrong with her.  She reverts back to a puppy - dancing and prancing about, but then is extremely tired afterwards.  Our daily walk distance has been cut in half as I end up carrying her back because she just gives out.
We have stopped going to the vet for bloodwork, as we know what the outcome is.  I have finally given in to knowing her days are numbered.  Every morning means checking Brandy to make sure she is still breathing and rejoicing that she is.
My husband and I  are not looking forward to 'that day'.  Thank you for this website as it has awarded me with a wealth of knowledge and solstice for the upcoming times.

Carole and Jim
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We have a Pug that will be 13 yrs old in August. Last September she was diagnosed with CHF.  The Vet put her on vetmedin and lasix and told us our Pug would likely die in less then one year. Well, here it is July and she is doing okay. She gets one half of a 5mg vetmedin pill twice a day and she gets one half of a 50mg lasix pill twice a day.

I HIGHLY suggest a product called "Pill Pockets" for giving dogs their pills. Even when our Pug is having a low appetite day she still gobbles up the pill pockets like they are her favorite food in the world. They run about $7.99 for a 30 count package but you can find good deals on ebay.

Our pug used to run around the entire house and would sleep in bed with me and my wife. She was house trained and had only had one or two accidents in her life (once she was trained as a puppy).  A few weeks before she was diagnosed with CHF she started having accidents in the house almost every day.  It was usually #2 and not urine for some reason. Her meds (or perhaps it's her CHF?) cause her poop to be soft and to crumble into a million pieces so cleaning it off carpet is pretty much impossible.

Because of this our Pug has to be in a crate when inside.  It pains me greatly but our pug quickly got used to it.  

I do worry all the time that the end could be near.

In June 2008 I had to have my 15 yr old Blueheeler/Australian sheppard mix put down after a long battle with multiple issues, the biggest one being bad arthritis in her hips ( at the end she couldn't stand up and would poop and pee on herself )

I found a vet online that came to my house and put her to sleep. Luckily my dog was on pain meds so she was was already very drowsy and in a sleep like state before the injection. Still, that whole process floored me for a long time. I'm still not over it. Only a few months later we got the news that our other dog (The Pug) had CHF.

I often wonder if I have the stomach to put our Pug down if the time comes.  My wife can't handle it emotionally(I don't blame her) so it's left to me. I pray that if our Pug leaves us that it will happen naturally at home while she is sleeping. Calling the vet to come over and put our other dog to sleep is not something I wish to experience a 2nd time. I'm also tormented by the possibility that our pug could live well beyond what the vet claims OR she could be gone tomorrow. The uncertainty of it all drives me crazy!

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Reading these posts have given me some hope!

I just found out today that my Boston Terrier has a severly enlarged heart - waiting to talk to the cardiologist tomorrow about the best course of medications.  Looking back, some of the signs were there but I keep wondering if I could have done more, sooner.  I feel like this came out of nowhere....

He's a rescue and we've only had him for just over two years - I feel like we're just starting to get to know each other and I'm completely gutted by these events.  He is sleeping comfortably now that we've figured out the best way to prop him up, and he still eats with gusto just not as much as he usually eats - I even got a little tail wag tonight - so I'm trying to stay positive.  I'm just wondering if things will ever feel "normal" again?
s.
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I would advise anyone giving expensive meds to their pets to checkout online companies. Vets typically markup the price of meds by 40% or more.  I used to get vetmedin from my vet for $84 (50ct bottle) and now get it for $58 online.

People Doctors are not allowed to sell you medicine because they have a conflict of interest. Animal Doctors have the same conflict of interest but are allowed to sell you meds anyway.

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Hang in there.....Yes, normal can return!!!  Once he's on the meds. and gets the fluid off his lungs, you'll probably not have to prop him up...  ;)  They work that good!!!  Dogs can live many many years with heart problems. Sometimes the meds. will need adjusting but you'll recognize the symptoms and know what to do. Let us know about the cardio. visit and thank you for adopting.......Karla
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Avatar_f_tn
Hi, I have a similar issue as you had about a year ago. I have 2 Pomeranian dogs. The male started having trouble with breathing and coughing about 2 years ago and his hearth seemed to be beating irregular. The vet we were using at the time said he was having CHF and prescribed the below cocktail of medication. Unfortunately this hasn't helped the coughing all that much or the irregular heart beat. Just today we noticed blood in his urine. This scared us since one of the possible side effects of Lasix is kidney failure. He isn't vomiting and is urinating regular and not in places he shouldn't be. We're hoping this isn't kidney failure but possibly a stone. We have been feeding him the below basic diet. Does anyone have suggestions on blood work, tests we should do, diet and so on to help strengthen the dog and reduced his intake of the below drugs or eliminate some all together? Could the above suggestion about adding 1/2 tab of tums to the diet for calcium have adverse effects with stones? Any help on this would be great! Thank you.

The vet gave us the below list of meds...
Enatril - 5mg twice a day
Aminothylline - 1/4 tab (30mg) twice a day
Lasix (Salix - Furosemide) - 4mg twice a day
Torbutrol - .8 mg twice a day
Vetmedin - 1.25mg twice a day
Amoxicillin - 100mg once a day.

Diet
Main: Chicken or Buffalo or Turkey or duck with potato 2 - 3 times a day about 1 - 1 1/2 cups a day.
Snacks: Pieces of chicken.
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1444105_tn?1284365745
Thank you everyone for the information. I have just returned from the vet and fund out this morning that my 12 year old Golden Retriever-Lab called Topaz has an enlarged heart and Kidney stones.
Because of the heart condition the vet doesnt want to put him under general anesthesia for kidney stone surgery.
I live in New Delhi and the resources are limited. However, I am doing the best I can and praying for a healthy and happy dog.
I know it sounds strange but I am not praying for time, I just want Topaz to be happy and comfortable.
So far, he has shown no signs of discomfort. He vomits only rarely (maybe once a month at most) and has always been a somewhat lazy (but healthy) dog. His breathing is normal and so far no tummy swelling or anything.

Now that I know what the problem is Im going to keep a strict watch.

Any recommendations on home-made food for him? There is canned and dry dog food available but I'd rather give him freshly cooked meals at least once a day and maybe Dry food good for the heart once a day.

I have never lost a dog (well, not since I was 10) and this is the first time Ive had to take care of an unwell dog. Im scared and emotional. Its hard to stop crying but I know I have to be strong and more than anything else give my dog all the positive energy I can.

Topaz is fine right now. No issues. No symptoms. So I know with good care I can give try to keep him as healthy  and happy for as long as I can.

Im only 25 and really Ive had Topaz half my life. Im not ready to let him suffer and leave alone even think about how long he has.

I pray for all of your little ones as well. And thank you for all the information.

Much love,
Siya
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462827_tn?1333172552
Hello Siya & welcome.....Copy your exact question and post it as a NEW one....You are more likely to get responses that way, as opposed to tacked on to this long thread....Karla
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Avatar_n_tn
I have a pug that turned 14 this month. Exactly two years ago(Sept 2008) we took her to the vet because she had been coughing a lot and barking at night. They listened to her chest and took an x-ray. They said she had fluid in her lungs or something and diagnosed her with CHF. They prescribed one half of a 5mg vetmedin pill twice a day and one half of a 50mg Salix pill twice day. We use something called pill pockets so she takes her meds with no problem (pill pockets are a bit expensive though ($8 for a bag of 30 pockets).

Anyway, they estimated that she had perhaps 6 months to live. Well, it's been two years and she is still with us. She is comfortable but tires easily.  She still gets her dose of vetmedin and salix pills every day.

Being told she probably had only 6 months left really sucked. I think we might have enjoyed the past two years more if we didn't worry every day might be her last.

Anyway, i thought this story might be comforting for people who have recently been told their dog has only weeks or a few months left to live because of CFH.  You might end up like us and have your dog live long past what the vet expected.

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Avatar_m_tn
im so sorry my baby boston terrier i had for nine years he was my adoption day present so he meant lots to me well i found out he had congestive heart failure oh my goodness i didnt take it well at all at the time i had a job so i would make up excuses just to stay home with him ...i moved out of my parents house and i couldnt take him with me ...i didnt even get to say goodbye and that i love him...my adopted mom told me he had a ttear going down his cheek when they put him to sleep.. :""""(
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Avatar_m_tn
I have a Bischon Freze that I've had sense I was around 16, she is now about 10-12 years old. (We aren't exactly sure.) She takes Furosmeid 2 full tablets twice a day, enalapril half a tablet twice a day and quarter of a tablet of vetmedin twice a day.

About a month back was when she started having problems. At the time we took her to the vet and got her on half a tablet of Enalapril x2, half a tablet of Furosmeid twice a day. She was doing fine for about month then she had a very bad episode two days ago. She pasted out several times and everything.

So we took her back and got her doses upped and the new vetmedin. She drinks tons of water, pees fine, has no accidents and eats rather well.

All I can hope is that she'll make it for atleast another year or two. I'm not ready to lose my baby so early.
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1823395_tn?1317389769
I too have a pug name Wrinkles and he is showing the same symptoms, though he is not coughing much.  I thought it was his arthritis and being an old dog.  He has been drinking water constantly and not eating much.  He also has had some accidents that started last week.  He is 12 yrs old.  Yesterday my daughter said he would not eat his treat, I knew then something was wrong.  He loves his treats.  He get these big eyes and his tongue hangs out when I bring out the bag or even walk to the closet to get them.  I love my Wrinkles so much, he has such a big personality.  I recently (1 yr ago) had my pickganese put to sleep due to CHF.  So sad!  I'm looking at him now and his little stomach is so round from drinking so much water.  I don't think I want him on all those meds and suffer through all those side affects, I hope that does not make me a bad owner.  I pray that he goes peacfully at home.
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1842659_tn?1318767560
Excellent info on kidney failure. Deal with it a lot in my rescue as I have mainly older and special needs dogs.
Too much Lasix will dehydrate the dog and lead to kidney failure. Arghhh!
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Avatar_f_tn
Hi, I just took in a foster dog.  She is a pit bull and was surrendered by her owner.  She is such a sweetheart that my daughter has fallen in love her already and vise versa.  Her abdomen is so swollen she looks pregnant.  That's what they thought at the 'so called shelter' and why I agreed to take her because that is a death warrant for her and the puppies.  At the check up with the vet's office we found out it was heart worms to the point it has caused CHF and she was given two months max to live.  The vet gave her some pills to take (Lasix and Enalapril) but she looks so bad.  If the swelling isn't down in two weeks, I am supposed to take her in and they will drain it.  I didn't have the heart to put her down.  I felt she deserved a couple of months of love (very abused.)  I think I may start rambling now.  Thank all of you for the posts, it has helped me understand what she is going through and if she doesn't get better in a few weeks she may have to be put to sleep.  I just want her to have a good life.

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Wow these post are all so encouraging. My miniature poodle was diagnosed with CHF last Tuesday (vet stated her heart is enlarged due to prolapsed valve). She was started on a regimen of benazepril, spironolactone daily and vetmedin, lasix twice daily. On Friday (3 days later) they did the follow up blood work and found her creatinine level has increased to 1.8 and today to 4. They vet said today that she only had 2-3 weeks to live. What should I do? I know the feeling everyone else has described here as "scared and not sure what to do". Today she told me to cut the lasix dosage in half. I've notice that others have had luck alternating the lasix. What about the spironolactone? Not sure what to do. I noted a homepathic mixture on line call tripsy for kidney failure. Not sure if that could help the kidney failure or not. I'm just not ready to let go yet? Any suggestions?
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Avatar_m_tn
I thought I would post just in case people are still reading. My Pomeranian was placed on lasix to treat an enlarged heart (along with something else I can't remember.) and it sent him into kidney failure. I will never allow one of my pets to be placed on it again! My baby lost part of the tip of his tongue because of it!

To treat the kidney failure (it happened twice) we had to give him fluids: 200 ccs a day. (100cc in the morning and at night). After a lot of vet visits and money we figured the signs out. He wouldn't urinate much, would stop eating, couldn't walk straight. So I watch for that. I also give him 50cc to 100 cc every few days (I do this at home. ASK your vet for the liquids and they will let you have it. My vet charges $15 for it.) It helps to keep his kidney functioning right. I can tell if my dog feels good or not b/c he will yelp when the needle goes in and when he feels fine.

It does produce more phlegm which is caused by the heart issue but there doesn't seem to be any medicine that I can find or that the vet knows of to treat it without then needing meds like lasix.

So my pom is on reglan to help with the phlegm. Sometimes it seems like it helps and other times I am not so sure. I'll have to try the injectable type.
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Avatar_m_tn
I forgot to mention, my Pomeranian refused to eat. So thankfully my vet had bil-jac and he likes that. (Sometimes I have to give him an appetite stimulate or I mix some spaghetti sauce in it.) He will eat it. He also likes bread with mayo or butter on it. He's lost 4 lbs so it came to a point where we had tried the kidney foods and he wouldn't eat anything. So bil-jac was the answer. (Albertson's carries it in the dog aisle in the frozen section.) It's much to high in the protein department but we are giving fluids so it seems to be working pretty well.
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462827_tn?1333172552
Your Vet recommends Bil-Jac?  Oh Dear!!!!!!


http://www.dogfoodadvisor.com/dog-food-reviews/bil-jac-raw-frozen/
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Avatar_m_tn
So my little guy (Frankie ) 14 year old Shih tzu was diagnosed with chf about a month ago. Started to have a lot of fainting seizures, coughing and seemed bloated. Thought we were going to lose him at one point he was so bad and boy was I devastated . So he was on lasix 12.5 2x and encard 2.5 1x per day. Did great ,not one seizure fainting spell, bloating seems gone, just coughs once in a while(boy I hate that sound). We cook all his food 93% lean beef, rice,lentils , peas, and he is eating very well. Peeing a lot and drinking from the meds. The vet is not a cardiologist but seems the meds are the the correct choice. I've read a lot about vetmedin but he doesn't seem to want him on it at this point. Not sure I like that. He did suggest to cut back the lasix and we did but he still has that cough once in awhile. Is that normal or should the cough be gone completely ? That's why I'm thinking vetmedin in the mix. Is the lasix at 1 or 2 a day to high, he weighs about 12-13lbs.  His disposition has changed a little seems more tiered or out of it at times? Meds? Other times like a puppy eating and loves his walk .Thanks for any input ,Mario.  
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Avatar_m_tn
We had two Yorkshire terriers from the same litter.  Millie and Buffett were 12 1/2 years old.   Sadly, On Saturday, Dec. 14th, 2013 Millie passed on due to complications from Congestive Heart Failure and Kidney Failure.  They both were diagnosed with Enlarged Hearts at the age of 5 years.   Both did great for years taking Enalapril daily.  Buffett, the male, continues to do fine with just this medication.
Unfortunately, our beautiful, loving Millie started having complications starting in October 2013. She had a persistent cough for years before.  She started struggling to breathe during the night. Here breath rate was extremely high.   Took her to the vet, and she was diagnosed as progressing to Congestive Heart Failure and prescribed Lasix.  A couple of weeks later, she was sleeping in bed with us and started crying, moaning in pain.  Took her back to the vet, and they thought it was gas build-up in the colon.  However, the enema they gave her did not solve the problem.  She continued crying at night.   Back to the vet 3 days later, and we were told she was in Chronic Kidney Failure.  Her BUN was 290 (I believe 25 - 35 is normal range).  She was hospitalized for several days to clean our the toxins.   She was taking the following meds:
Norvasic - CHF
Azodyl - Kidneys
Enalapril - CHF
Lasix- CHF
Vetmedin - CHF
She came home for another 3 days.  She was doing well, then on Sunday afternoon she suddenly started scratching at her head and falling over.
Took her back to the vet again, where she was placed in an Oxygen tank for a Stroke.   Amazingly, she survived and came home the next day and she did well for about one week.  Then you could see the symptoms again:   Not Eating;  more lethargic;  throw up.   Back to the vet for overnight treatment to bring down the BUN count from (190).    
This time the vet suggested we begin hospice care at home.  So we started give the Sub-Q treatment 2x daily at home.  
Friday, Dec. 13, 2013 We decided to take our male yorkie, Buffett, to the vet for his annual shots.  While there we decided to have Millie's BUN number tested because she wasn't eating as normal.   Her BUN jumped again over 140, so we decided to let them keep her overnight and give her the treatment to bring the BUN down to normal range.
Shockingly, we received a phone call from the vet's office saying our Millie passed away on Saturday morning as they were preparing to take blood to check her BUN count.  Vet told us her BIG, BEAUTIFUL HEART finally gave out on her.   Needless to say, we like all animals lovers, were completely devastated.   We are still trying to recover, but as we know, you never do.  You merely adjust.   Besides, we still have our male, BUFFET to squeeze and love as much as possible.

Moral of my story:
Have the blood test done at an early age for Kidney and Liver.
Have the test done yearly.
Watch and listen for the persistent coughing.
Watch for a change in eating habits; loss of appetite.  (Our Millie started losing weight the last two months.  She went from 7.1 lbs down to 4.7 lbs.
Watch for peeing accidents with larger than normal amounts of Urine.
If you notice a foul smell coming from the mouth, like ammonia, have your pet checked.  It could be toxin build-up in the system.
Lastly, hold your pet, hug them and love them as much as you can.  They are not children, but they are definitely your "Best Friend."
Best Wishes to all of you going through Congestive Heart Failure and/or Kidney Failure.
Our Millie was one heck of a Fighter, but she couldn't beat both diseases.
Bob and Carol  and Buffett
  

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Avatar_f_tn
I feel so terrible for you. I did get a second opinion and let me just say...he really has not helped. I am now overwhelmed with trying to decide between the two treatment plans and hope that I make a wise decision...
Emma is 15 in August. Young in the mind, healthy, energy...overall in excellent shape. she was dx with an enlarged heart two years ago, placed on enalapril 2.5 mg twice daily and Lasix 12.5 mg twice daily. I reduced her lasix on my own to 12.5 mg total daily...thank God. No labs were ever drawn in the five visits she was seen since being placed on medication and nothing about kidney failure was mentioned.
I requested labs to see if she could handle anesthesia for a dental and discovered my precious is in kidney failure, right CHF and collapsing trachea. So...confused....
treatment plan
Vetmedin
1/4-1/12 the dose of lasix
Epikitin- supplement -supposed to bind phosphorus
fluids SQ when necessary
I still do not know what is the best for her.
new diet--rice and turkey
Just hoping anyone out there can give a treatment plan that worked for their dog in a similar situation.
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Avatar_m_tn
Do you know what her levels were?  Specifically BUN and creatinine?  

For a 15 year old dog, I would not go through with the anethesia for the surgery.  I tend to worry too much and would be scared to put my baby under for a dental procedure at age 15.  Too risky if you ask me.  

Moving forward, I would treat the heart and kidney problems.  Although CRF can elevate the blood pressure so upping her dosage of enalapril might be an option.  

I'd ask the vet about giving SQ fluids daily, depending on her levels.  They can really help flush out her kidneys.  Rather than epikitin for phosphorus, substitute Tums.  It's cheaper that way.  

Diet - can you give her KD canned?  It has more water and will help keep her hydrated.  Otherwise, if she is losing weight, pasta might be a good alternative.  

I'm sorry, I know how frustrating it is and scary not knowing what to do.  It may be time to find a vet who will treat your pet not just her number.  What worked for Daisy might not work for every dog.  
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