Valvular replacement surgery is not usually an option for dogs, as it is for humans with mitral valve disease. Consequently, veterinarians usually prescribe medications to reduce the symptoms of heart disease and improve the function of the dog's ailing heart. But even with long-term treatment, most dogs will require frequent reassessment of their illness and periodic adjustments to their medication regimen. Acute destabilization can cause severe symptoms, but often these may be treated successfully with aggressive techniques.
Common treatment regimens include a lower sodium diet, which may become increasingly restrictive as the disease progresses. Exercise is restricted until symptoms of heart failure are controlled, and then only mild to moderately intense activity is recommended.
There are numerous medications available to treat heart abnormalities. Typically, dogs with congestive heart failure secondary to mitral valve disease are treated with multiple drug types simultaneously in order to improve the forward movement of blood flow, decrease the backflow of blood into the atrium, and moderate the compensatory mechanisms. These medications include diuretics, such as Lasix, which promote urine formation and excretion and thereby decrease the amount of excess fluid in the body. The veterinarian may also prescribe drugs that dilate the blood vessels in order to prevent high blood pressure. These include enalapril, an angiotensin-converting enzyme inhibitor, as well as other specific arteriolar and venous dilating drugs. Medications called positive inotropic agents, such as digoxin, may also be prescribed to promote the heart muscle's ability to contract.
The examining veterinarian or veterinary cardiologist will determine the appropriate time to start medical therapy, as well as what drugs are necessary for the individual patient. Because this heart condition is progressive, patients will require frequent reassessment in order to appropriately adjust the treatment as the disease worsens. A dog with heart failure will require long-term medication.
Animals that have an acute episode of congestive heart failure and pulmonary edema will require more aggressive types of therapy in order to be stabilized. In such cases, a veterinarian will prescribe cage rest and the avoidance of stress and anxiety, and diagnostic procedures should be kept at a minimum until the animal is stabilized. The dog may be given oxygen in order to reduce the load on its heart and lungs. In some cases, free fluid will accumulate around the lungs of a dog with congestive heart failure, limiting the space in which the lungs can expand. This fluid can be removed by means of a procedure called a thoracocentesis. High doses of fast-acting drugs may be administered in order to promote the improved functioning of the heart.
