What Does End Of Life Look Like For A Dog With Congestive Heart Failure?

Congestive heart failure (CHF) is a common condition in older dogs, especially those with underlying heart disease like mitral valve disease. CHF occurs when the heart is unable to pump adequately to meet the body’s demands. Blood backs up behind the heart, building pressure in the veins and causing congestion in the lungs (pulmonary edema) or abdomen (ascites).

CHF is estimated to affect up to 10% of dogs overall and around 75% of dogs over age 12 [1]. Certain breeds like Cavalier King Charles Spaniels and Doberman Pinschers are more prone to developing heart disease and CHF. While CHF can’t be cured, various treatments are available to manage the symptoms and improve quality of life.

[1] https://www.smalldoorvet.com/learning-center/medical/congestive-heart-failure-in-dogs/


The most common symptoms of congestive heart failure in dogs include coughing, fatigue, labored breathing, and weight loss. Coughing is one of the earliest signs of the disease, as fluid builds up in the lungs and puts pressure on the airways. The cough often worsens at night when the dog is lying down. Fatigue occurs because the heart is unable to pump sufficient blood and oxygen throughout the body. Affected dogs have little energy or stamina for exercise. Labored breathing is another effect of fluid accumulation in the lungs. The dog struggles to get enough air and may breathe rapidly or wheeze. Weight loss stems from a combination of poor circulation and decreased appetite. Despite eating the same amount of food, dogs with congestive heart failure often lose weight as their body is unable to properly utilize nutrients.


A veterinarian will perform a complete physical exam on a dog suspected of having congestive heart failure. They will check for signs such as coughing, difficulty breathing, increased respiratory rate, racing heartbeat, and weak pulses. The vet will listen to the dog’s chest for evidence of fluid buildup in the lungs.

Chest x-rays are usually done to evaluate the size and shape of the heart and to look for an enlarged left atrium. X-rays can also detect fluid buildup in or around the lungs. VCA Animal Hospitals notes that chest films may show an enlarged heart silhouette or pulmonary venous congestion.

An echocardiogram, or ultrasound of the heart, allows the vet to visualize the heart’s size, thickness, valve function, and pumping ability. It can detect decreased pumping ability and abnormal fluid accumulation. Echocardiography provides important information about which side of the heart is involved and the underlying cause of the congestive heart failure.WebMD explains that echocardiograms are considered the gold standard for diagnosing heart disease in dogs.

Blood tests may be run to check organ function and look for signs of an underlying condition causing the heart failure. Bloodwork can also assess the severity of the disease. Small Door Veterinary notes the blood tests look for cardiac biomarkers like NT-proBNP, which is elevated in dogs with heart disease.


There are several treatment options available for dogs with congestive heart failure, aimed at improving quality of life and managing symptoms. Some key treatments include:

Medications: Medications for congestive heart failure in dogs typically include:

ACE inhibitors like enalapril or benazepril help dilate blood vessels and decrease blood pressure, reducing strain on the heart. They are a common first line treatment for dogs with CHF (source).

Diuretics like furosemide help get rid of excess fluid in the lungs and body by increasing urination. They provide rapid improvement in breathing difficulties for dogs with CHF (source).

Dietary Changes: Low-sodium diets help decrease fluid retention. Increased calories help support body condition. Taurine and carnitine supplements may also provide benefits (source).

Oxygen Therapy: Oxygen can help relieve breathing difficulties and may be given on an as-needed basis or more regularly in advanced CHF (source).


The life expectancy for dogs with congestive heart failure depends on several factors. According to the American Kennel Club, with treatment dogs can live anywhere from 6 months to 1.5-2 years after being diagnosed [1]. PetMD states that once a dog reaches stage D congestive heart failure, which is the most advanced stage, the median survival time is about 9 months [2]. However, many things impact prognosis.

Dogs who respond well to treatment and medical management tend to have a better outlook. Catching CHF early also leads to longer survival times. Other factors that affect prognosis include the underlying cause of heart failure, the dog’s age, and the presence of any other health conditions. Providing excellent supportive care and following veterinary instructions closely can potentially prolong a dog’s life.

End of Life Signs

As congestive heart failure progresses to an advanced stage in dogs, there are some common end of life signs to look out for. These typically include:

Increasing respiratory distress – Dogs will begin panting or breathing with an open mouth even when at rest. Their breathing may become very rapid or labored. Fluid can build up in the lungs, causing breathing difficulty (https://www.petmd.com/dog/care/signs-dog-dying-congestive-heart-failure-chf).

No response to medications – Dogs with CHF are often on medications like diuretics or ACE inhibitors. But these drugs may become ineffective at managing symptoms as the disease progresses (https://www.vrcc.com/site/blog/2023/05/15/end-stage-congestive-heart-failure-dog).

Fluid buildup – Fluid can accumulate in the abdomen or chest cavity. This is called ascites or pleural effusion. It puts pressure on the lungs and other organs (https://www.pacificsantacruzvet.com/site/blog/2023/02/28/stage-4-congestive-heart-failure-dog).

Loss of appetite – Dogs may stop eating or drinking as the disease takes away their quality of life. Weight loss and muscle wasting can occur.

Managing Quality of Life

Keeping your dog comfortable is the main focus when managing end-stage congestive heart failure. Palliative care can help control symptoms and improve quality of life without trying to cure the underlying disease. Some options include:

  • Medications like diuretics, ACE inhibitors, and bronchodilators to relieve fluid buildup and make breathing easier
  • Oxygen therapy or cool mist humidifiers to aid breathing
  • Low sodium diet to decrease fluid retention
  • Soft bedding and gentle handling to prevent pain or discomfort
  • Massage, acupuncture or cold laser therapy to increase circulation and relaxation

As your dog’s condition worsens, you may face difficult decisions around euthanasia. Setting quality of life markers ahead of time can help assess when your dog’s bad days start to outnumber the good. Indicators often include:

  • No longer finding enjoyment in favorite activities
  • Having more bad days than good
  • Difficulty breathing or prolonged panting at rest
  • Collapsing or unable to stand
  • Significant weight loss or muscle wasting
  • Little response to medication adjustments

While saying goodbye is painful, euthanasia can be the final act of love to prevent your dog from prolonged suffering. Discuss options with your vet when the time feels right.

Grieving Process

Losing a beloved pet can be extremely difficult. For many pet owners, their animal companions are cherished members of the family. The grief felt after the loss of a pet can be just as intense as the grief after losing a human loved one. It’s important for pet owners to give themselves time and space to fully experience their feelings of sadness and loss.

There are some helpful ways to cope with the grieving process after losing a pet. One recommendation is to allow yourself to feel the pain and express your emotions, whether through crying, talking with friends, or journaling. Holding in emotions can prolong the grieving process. At the same time, it can be comforting to focus on all the happy memories with your pet. Looking at photos and talking about your favorite experiences together brings the pet’s spirit back to life in a positive way. You can also create a memorial, make a donation in your pet’s honor, or plant a tree to provide an outlet for your feelings and have a living legacy.

While the pain of losing your pet may always be present in some way, most people find that the intensity of grief lessens with time. It’s importat to be patient with yourself and recognize that there is no right or wrong way to grieve. With support from loved ones, cherished memories, and outlets for emotional expression, most pet owners can work through their bereavement and eventually adjust to life without their companion.

According to sources like HelpGuide and Outside Magazine, remembering the good times together and integrating your pet’s loss into life with new routines and potentially new animal companions can help cope with the grief in a healthy way. The deep bond between pets and their owners means the pain runs deep, but there are ways to honor that bond while moving forward.


There are some steps dog owners can take to help prevent congestive heart failure in their pets. According to the Small Door Veterinary article (link:https://www.smalldoorvet.com/learning-center/medical/congestive-heart-failure-in-dogs/), early screening for heart disease is critical. Some vets recommend annual screening such as chest x-rays, ECG, and cardiac ultrasound starting at age 7. This allows vets to detect any early signs of heart disease and begin treatment if needed.

Managing risk factors is also important in prevention according to WebMD (link: https://www.webmd.com/pets/dogs/congestive-heart-failure-dogs). Key factors include diet, exercise, and weight. Overweight dogs are more prone to heart disease, so keeping your dog at a healthy weight is essential. Feed a high-quality diet for your dog’s size, age, and activity level. Regular, moderate exercise also helps maintain a healthy cardiovascular system.

Additionally, WebMD notes the importance of proper dental care for dogs, as bacteria from gum disease can enter the bloodstream and damage the heart valves. Regular vet visits for dental cleanings and other preventative care are advised.


As we’ve discussed, congestive heart failure is a serious condition that requires diligent veterinary care and monitoring. While the prognosis depends on the severity and how well the dog responds to treatment, dogs can live for months or even years with proper management. It’s crucial to focus on your dog’s quality of life – keeping them comfortable, managing their symptoms, and providing lots of love and care. Recognizing when their condition is declining and the end is near is so difficult, but ultimately an act of love when the time comes to say goodbye. Your vet can guide you through what to expect and help make that difficult decision.

The takeaway messages are:

  • Congestive heart failure requires lifelong veterinary care and monitoring to manage symptoms and slow progression.
  • Focus on quality of life and keeping your dog comfortable even as their health declines.
  • Work closely with your vet to make informed decisions about your dog’s care and know when it’s time to say goodbye.

While losing a beloved pet is painful, remembering the joy they brought and that you gave them the best life possible can bring comfort. Your dog knows how much they are loved.

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