Heart disease is a significant concern for the health and well-being of our animal companions. While we are often aware of heart disease in humans and take steps to maintain our own cardiovascular health, it’s crucial to recognize that dogs and cats are also susceptible to various heart conditions. Unlike the common coronary artery disease seen in people, which is often linked to atherosclerotic plaques, canine and feline heart diseases typically manifest in different forms.
In dogs, the most prevalent conditions include cardiomyopathy, a disease where the heart muscle weakens, and mitral valve disease, characterized by leaky heart valves. Cardiomyopathy often affects larger breeds such as Doberman Pinschers and Boxers. Mitral valve disease, conversely, is more common in middle-aged to older small breeds, with Cavalier King Charles Spaniels being particularly prone, often developing it even at a young age. In fact, most Cavaliers will experience some form of heart disease during their lifetime.
For cats, cardiomyopathy is the predominant heart condition. A specific form, dilated cardiomyopathy, was once widespread due to taurine deficiency but is now rarely seen thanks to the inclusion of taurine in modern cat foods. Currently, hypertrophic cardiomyopathy is the most common type of heart disease diagnosed in felines.
Diagnosing Heart Disease in Pets
Diagnosing heart disease in pets is generally straightforward. Your veterinarian will use a stethoscope to listen to your pet’s heart. The detection of a heart murmur or an irregular heartbeat is a primary indicator of heart disease. However, at this stage, two common missteps can occur.
Mistake #1: The “Wait and Watch” Approach
With very few exceptions, a heart murmur almost invariably signifies heart disease. Adopting a “wait and watch” strategy is ill-advised, as it could mean waiting for the animal to enter heart failure. When a heart murmur is detected, it necessitates further diagnostic testing to ascertain the severity of the condition.
Mistake #2: Premature Medication
Prescribing medication solely based on the detection of a heart murmur is often unnecessary. Without further diagnostic evaluation, it’s impossible to determine if medication is actually needed at this early stage. Fortunately, for the majority of asymptomatic animals with heart murmurs, a natural approach can be effective, and medication may not be required.
Further Diagnostic Testing
Following the detection of a heart murmur, additional tests such as radiographs (X-rays), an electrocardiogram (EKG), and an echocardiogram of the heart are essential. These diagnostics help determine the stage of the heart disease and guide appropriate treatment strategies. Based on extensive experience, most asymptomatic animals exhibit very early-stage heart disease and do not require medication. Regular follow-up testing, typically including echocardiograms and EKGs every six months, is recommended. Medication is generally reserved for cases where the disease has progressed or when heart failure is present.
Conventional Treatment Options
For animals diagnosed with more advanced heart disease or heart failure, three main categories of medication may be employed. These treatments are typically not necessary for pets with mild heart conditions.
- Diuretics: Furosemide (Lasix) is a commonly prescribed diuretic used to help the body eliminate excess fluid. This medication is only indicated when fluid accumulation, often in the lungs (pulmonary edema), is present. Since edema usually signifies advanced heart failure, diuretics are not recommended for most pets with early-stage heart disease.
- ACE Inhibitors: This class of drugs, including enalapril (Enacard) and benazepril, aids the heart in pumping more efficiently by dilating blood vessels, which reduces resistance to blood flow. ACE inhibitors can help alleviate coughing in animals with an enlarged left atrium. While generally safe, they are potent medications that can lead to side effects like kidney damage. Pets on ACE inhibitors require frequent veterinary check-ups and blood and urine tests. Again, these are usually not needed for early heart disease but may be considered for advancing conditions or heart failure.
- Pimobendan (Vetmedin): This newer medication offers significant benefits for dogs experiencing heart failure. It works by dilating blood vessels, thereby decreasing the workload on the heart, and also enhances the heart’s pumping efficiency. Although sometimes prescribed for heart disease rather than heart failure, its primary benefit is realized when heart failure is present.
Natural Alternatives for Heart Health
A variety of natural remedies can be beneficial for dogs and cats with heart disease. In clinical practice, animals diagnosed with early heart disease, based on a heart murmur and normal cardiac test results, are often placed on one or more of the following natural therapies.
- Coenzyme Q10 (CoQ10): This antioxidant is synthesized in most body tissues and is present in all cells, with the highest concentrations found in the heart, kidneys, liver, and pancreas. CoQ10 is vital for energy conversion from carbohydrates and fats during ATP synthesis and also protects cell membranes and DNA from oxidative damage. Studies in humans with hypertension have shown a reduction in systolic blood pressure with CoQ10 supplementation. In humans with heart failure, CoQ10 therapy has been observed to increase cardiac output, improve heart contraction, and dilate blood vessels, facilitating normal blood flow. A general guideline for animals with heart disease is 1 mg of CoQ10 per pound of body weight, administered once or twice daily. Since CoQ10 is fat-soluble, it’s recommended to take it with a meal or a small amount of oil.
- Hawthorn: This herb is renowned for its heart-healthy properties, attributed to its content of flavonoids and oligomeric proanthocyanidins (OPCs). Hawthorn offers several clinically beneficial effects, including anti-arrhythmic properties, enhanced coronary blood flow, reduced energy utilization by a compromised heart, and decreased cardiac excitability.
- Omega-3 Fatty Acids: Derived from cold-water fish rich in EPA and DHA—such as wild salmon, mackerel, sardines, and herring—omega-3 fatty acids are frequently recommended supplements for both humans and animals dealing with various health issues, including heart disease. Fish oil has demonstrated superiority over statin therapy in reducing mortality in human patients with cardiovascular disease. While it may lower lipids (particularly triglycerides), it can also cause slight increases in LDL concentrations. Additionally, it may reduce blood clotting, atherosclerosis, coronary heart disease, arrhythmias, heart failure, sudden cardiac death, and stroke. To prevent oxidation, most fish oil products should be refrigerated after opening.
- Homeopathic Remedies: Homeopathic options can also be utilized for animals with heart disease. Homotoxicology remedies, such as those produced by Heel Corporation, are combination remedies containing multiple homeopathic ingredients. Cralonin is a commonly used homotoxicology remedy for heart disease patients, particularly those with heart damage or older animals. It comprises several homeopathics, including crataegus, spigelia, and kali carbonicum. Cactus compositum is another beneficial remedy for animals suffering from circulatory disorders and heart weakness, containing homeopathics like kali carbonicum, spigelia, prunus, and glonoinum. In clinical practice, combining homotoxicology remedies with nutritional supplements and/or herbs often yields the best results.
While heart disease cannot be entirely prevented, natural treatments hold the potential to significantly delay or prevent mild heart disease from progressing to heart failure, offering a hopeful outlook for many pets.
