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THERAPEUTIC NUTRITION

Useful information about the needs of cats and dogs with nutritionally sensitive health conditions.

Cardiovascular Disorders

Congestive Heart Failure (CHF) in Dogs

Heart failure refers to the clinical signs–such as fluid accumulation in the lungs or abdomen–that occur when the heart can no longer adequately compensate for changes associated with the heart disease. 

Once a dog develops congestive heart failure, nutrition recommendations based on guidelines from the American College of Veterinary Internal Medicine (ACVIM), cardiology research, and dietary history, can help manage heart health.

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Key Messages

Nutritional recommendations for dogs with CHF include:

  • Moderate sodium restriction, considering clinical signs and patient response, can help control edema and congestion.1-3 
    • Excessive sodium restriction can cause adverse effects including excessive activation of the renin-angiotensin-aldosterone system.
    • Diets with less salt are often less palatable, and maintaining appetite and lean body mass is important.
  • Supplementing with omega-3 fatty acids (e.g., DHA and EPA) may help reduce inflammatory mediators and oxidative stress, stabilize cardiac arrhythmias, reduce blood pressure, and reduce cardiac remodelling. Omega-3s may also help prevent cachexia, the muscle wasting that often occurs in dogs with CHF.4-6 
  • Monitor potassium and magnesium levels.
    • Cardiac medications may cause excesses or deficiencies of potassium.
    • Magnesium has many roles in healthy heart function, including antiarrhythmic and antioxidant actions, and hypomagnesemia has been linked with increased risk of heart failure in human patients.7 
  • Maintain protein and calorie intake to avoid weight loss.1
  • Antioxidants, such as vitamins C and E, can help prevent damage from reactive oxygen species, shown to be increased in dogs with CHF.8,9 

A detailed dietary history is important in dogs with CHF.

  • High-sodium foods and treats, or small amounts of human food, can unintentionally add excessive sodium to a dog’s diet.10 

Supplementing taurine and/or carnitine may help improve left ventricle size and function in some dog breeds that are predisposed to heart failure caused by dilated cardiomyopathy (DCM).11-13 

  • L-carnitine myocardial deficiency has been linked with DCM in Boxers and Doberman Pinschers.11, 12
  • American Cocker Spaniels and Golden Retrievers may be predisposed to taurine deficiencies.14,15  
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Sodium from dog treats or table food used to give pet medications can add up: 1 slice of cheddar cheese has ~180 mg sodium; 1 slice of white bread has ~100 mg sodium; 1 tablespoon of regular smooth peanut butter has ~70 mg sodium.

Related Tools and Content:

Taking a Good Diet History

The only way to know what each patient really eats is to ask ꟷ and document the information in the medical record.

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How to Perform a Body Condition Assessment - Dog

Assess a dog's Body Condition Score in just 3 simple steps.​

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Cardiac Conditions/Heart Failure

Heart disease invariably progresses, but it does not always lead to heart failure. The prognosis depends on the pet’s overall health, the type of heart disease and its rate of progression.

View Research 6 min to 10 min

To Share With Pet Owner:

Nutrition and Heart Health

The heart is a vital organ that relies on specific nutrients and a continuous supply of energy to support and maintain a regular rate and rhythm, yet the role of nutrition in pets’ cardiac health is often overlooked.

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Evaluating Your Dog’s Body Condition

Assess your dog's Body Condition in just 3 simple steps.​

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References

  1. Keene, B. W., Atkins, C. E., Bonagura, J. D., Fox, P. R., Häggström, J., Fuentes, V. L., Oyama, M. A., Rush, J. E., Stepien, R., & Uechi, M. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of Veterinary Internal Medicine, 33(3), 1127–1140.
  2. Rush, J. E., Freeman, L. M., Brown, D. J., Brewer, B. P., Ross, J. N., Jr., & Markwell, P. J. (2000). Clinical, echocardiographic, and neurohormonal effects of a sodium-restricted diet in dogs with heart failure. Journal of Veterinary Internal Medicine, 14(5), 513–520. doi: 10.1111/j.1939-1676.2000.tb02269.x​
  3. Strickland, K. N. (2016). Pathophysiology and therapy of heart failure. In F. W. K. Smith, Jr., L. P. Tilley, M. A. Oyama, & M. M. Sleeper (Eds.), Manual of canine and feline cardiology (5th ed., pp. 287–312). Elsevier.​
  4. Freeman, L. M., Rush, J. E., Kehayias, J. J., Ross, J. N., Jr., Meydani, S. N., Brown, D. J., Dolnikowski, G. G., Marmor, B. N., White, M. E., Dinarello, C. A., & Roubenoff, R. (1998). Nutritional alterations and the effect of fish oil supplementation in dogs with heart failure. Journal of Veterinary Internal Medicine, 12(6), 440–448. doi: 10.1111/j.1939-1676.1998.tb02148.x
  5. Freeman, L. M. (2010). Beneficial effects of omega-3 fatty acids in cardiovascular disease. Journal of Small Animal Practice, 51(9), 462–470.
  6. Laurent, G., Moe, G., Hu, X., Holub, B., Leong-Poi, H., Trogadis, J., Connelly, K., Courtman, D., Strauss, B. H., & Dorian, P. (2008). Long chain n-3 polyunsaturated fatty acids reduce atrial vulnerability in a novel canine pacing model. Cardiovascular Research, 77(1), 89–97.
  7. Del Gobbo, L. C., Imamura, F., Wu, J. H., de Oliveira Otto, M. C., Chiuve, S. E., & Mozaffarian, D. (2013). Circulating and dietary magnesium and risk of cardiovascular disease: A systematic review and meta-analysis of prospective studies. American Journal of Clinical Nutrition, 98(1), 160–173.
  8. Michałek, M., Tabiś, A., Cepiel, A., & Noszczyk-Nowak, A. (2020). Antioxidative enzyme activity and total antioxidant capacity in serum of dogs with degenerative mitral valve disease. Canadian Journal of Veterinary Research, 84(1), 67–73.
  9. Sozen, E., Demirel, T., & Ozer, N. K. (2019). Vitamin E: Regulatory role in the cardiovascular system. International Union of Biochemistry and Molecular Biology Life, 71(4), 507–515.
  10. Freeman, L. (2016). Nutrition and cardiovascular disease. In F. W. K. Smith, Jr., L. P. Tilley, M. A. Oyama, & M. M. Sleeper (Eds.), Manual of canine and feline cardiology (5th ed., pp. 394–404). Elsevier.
  11. Keene, B. W. (1991). L-carnitine supplementation in the therapy of canine dilated cardiomyopathy. The Veterinary Clinics of North America: Small Animal Practice, 21(5), 1005–1009. doi: 10.1016/s0195-5616(91)50108-x
  12. Oyama, M. A. (2016). Canine cardiomyopathy. In F. W. K. Smith, Jr., L. P. Tilley, M. A. Oyama, & M. M. Sleeper (Eds.), Manual of canine and feline cardiology (5th ed., pp. 141–152). Elsevier.
  13. Sanderson, S. L. (2006). Taurine and carnitine in canine cardiomyopathy. The Veterinary Clinics of North America: Small Animal Practice, 36(6), 1325–1343. doi: 10.1016/j.cvsm.2006.08.010
  14. Bélanger, M. C., Ouellet, M., Queney, G., & Moreau, M. (2005). Taurine-deficient dilated cardiomyopathy in a family of golden retrievers. Journal of the American Animal Hospital Association, 41(5), 284–291. doi: 10.5326/0410284
  15. Kittleson, M. D., Keene, B., Pion, P. D., & Loyer, C. G. (1997). Results of the multicenter spaniel trial (MUST): Taurine- and carnitine-responsive dilated cardiomyopathy in American cocker spaniels with decreased plasma taurine concentration. Journal of Veterinary Internal Medicine, 11(4), 204–211. doi: 10.1111/j.1939-1676.1997.tb00092.x