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Photo of vet checking dog's heart

Heart Disease in Dogs


Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.


Supplements for Dogs with Heart Disease

Supplements recommended for dogs with heart disease include:

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Diet Guidelines for Dogs with Heart Disease

Diets for dogs with heart disease should be high in protein, particularly meat, which supplies amino acids that are good for the heart and helps to preserve lean body mass. Beef heart and other heart meats may be particularly beneficial.  The amount of fat in the diet may need to be increased for dogs with cardiac cachexia (muscle wasting), or decreased for dogs that are overweight, but should remain moderate rather than low. Carbohydrates should also be reduced for dogs that need to lose weight. See the section on Senior and Overweight Dogs for more information on how best to achieve weight loss.

Sodium should be moderately restricted in early stages of heart disease, and more severely restricted in late stages (severe restriction may actually be harmful in early stages). The use of ACE inhibitors such as Enalapril or Benazepril reduce the need for severe sodium restriction. With early stage heart disease, avoid feeding diets that have over 100 mg of sodium per100 kcals. With mild to moderate heart disease, sodium should be restricted to 50-80 mg/100 kcals in the main diet, and with advanced heart disease, sodium should be less than 50 mg/100 kcals. At all stages, avoid treats and table scraps that are high in sodium, such as baby food, pickled foods, bread, pizza, condiments (e.g., ketchup, soy sauce), lunch meats and cold cuts (e.g., ham, corned beef, salami, sausages, bacon, hot dogs), most cheeses, processed foods (e.g., potato mixes, rice mixes, macaroni and cheese), canned vegetables (unless "no salt added"), and snack foods (e.g., potato chips, packaged popcorn, crackers). See Healthy Diet Tips for Pets with Heart Disease for more information.

Pills can be given in pieces of fresh fruit, "no salt added" peanut butter, raw or cooked meat (without salt), or low-sodium canned food. You could also use Pill Pockets -- the smell is very enticing, and you can pinch off just enough to cover the pill, making each one last a long time (I used to think they were too expensive because I thought you had to use a whole pill pocket each time you gave pills). I'm not sure how much sodium they contain, but you can use very small pieces to lessen that concern. Note that Pill Pockets are now available in a Duck and Pea Allergy Formula for dogs with food allergies.

Potassium needs may be increased, if you are giving digoxin or diuretics, or decreased, if you are treating with ACE inhibitors such as Enalapril, or with spironolactone. Monitor blood potassium levels and make adjustments as needed.

Note that many prescription cardiac diets are high in potassium, which may be inappropriate depending on the medications being used.  Some prescription diets are also low in protein, which is always inappropriate for dogs with heart disease. If you are feeding a prescription diet for heart disease, you can improve the quality of the diet by adding high-protein animal-source foods such as meat, eggs and dairy, but be careful not to add foods that are high in sodium, such as cottage cheese and canned fish. Note that prescription diets are not usually necessary unless needed to reduce sodium in later stages of heart disease. This can also be done by feeding a homemade diet. See Balancing a Homemade Diet for more information. You can look up the amount of sodium in various foods on the USDA Nutrient Database.

If your dog does not want to eat, try feeding multiple small meals, and offer different foods. It's more important that your dog eat something than that he eat the best foods for his condition. Foods that are higher in protein and fat are likely to be the most palatable.

See the following for more info on diet and supplements for dogs with heart disease:

Foods that are natural diuretics include celery, parsley, watermelon and dandelion leaf. You can also get dandelion leaf tinctures (using the leaf, rather than the root). Dandelion helps replace the potassium that is lost with diuretics. You can feed bananas and apples to help with potassium loss if you are giving diuretics, such as lasix, or you can get potassium pills if your dog develops hypokalemia (low potassium). Side effects of lack of potassium are nausea, vomiting, muscle weakness, listlessness and rapid heart beat.

Hawthorne berry is also sometimes recommended, but it may potentiate (increase the effects of) digitalis and other positive inotropic drugs and cardiotonic glycosides, so be sure to ask your vet before using it. When supplementing with herbs, I prefer to use tinctures that are made specifically for dogs, so that the dosage will be correct. Brands that I trust include Animal Apawthecary (see Hawthorn Plus and Senior Blend), Azmira Holistic Animal Care, and Tasha's Herbs for Dogs and Cats.

Another supplement I've seen recommended for heart problems in humans, including cardiac failure, hypertension, angina, endocarditis, pericarditis and edema, is the Ayurvedic herb Terminalia Arjuna. Arjuna seems to work by improving cardiac muscle function and the pumping activity of the heart. Arjuna also benefits cardiomyopathy, or weakening of the lower muscles of the heart. The commonly recommended human dosage is 500mg three times a day, adjust accordingly for the size of your dog (large dog would get adult human dosage, medium dog half the adult dosage, small dog 1/4 the dosage). This herb is one of the ingredients in Bio-Cardio from Thorne Research, which contains all of the above recommended herbal supplements along with a few others. Thorne Research products are often recommended by veterinarians.

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Dilated Cardiomyopathy (DCM)

Dilated Cardiomyopathy (DCM) can occur in both dogs and cats if the diet is deficient in taurine . This problem has been discovered in a number of dogs being fed commercial dog foods. See Nutrition and Congestive Heart Failure for more information. Adding fresh, raw meat to the diet would help counteract the potential for deficiency. See Commercial Dog Foods and Adding Fresh Foods to a Commercial Diet for more information on a good diet for your dog. Also see Taurine for a chart of the taurine content in different foods (note how much it decreases when the foods are cooked). Cocker Spaniels, Golden Retrievers and Newfoundlands are some of the breeds that are prone to Dilated Cardiomyopathy that may be related to taurine deficiency.

See the following sites for more specific information:

A study published in 2012 found that a relatively new medication for heart disease, Pimobendan (see below), prolonged the time to onset of clinical symptoms and extended survival significantly when given to Doberman Pinschers with pre-clinical DCM (dogs with enlarged hearts but no clinical signs of heart disease). More info:

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Medications and Tests for Heart Disease

There is a new medication approved in 2007 called Vetmedin (pimobendan), which can increase quality of life for dogs suffering from congestive heart failure related to either dilated cardiomyopathy (DCM) or mitral valve disease, and can lead to significant improvement in clinical signs and improved survival times. A study published in 2012 found that pimobendan delayed progression and significantly improved survival rates in Dobermans with DCM when given even before clinical signs were seen. More info:

CEVA Animal Health claims that "dogs suffering from heart failure are 3 times less likely to see their health deteriorate or die due to heart failure (the risk of death alone being 9 times reduced) when spironolactone is combined with benazepril [an ACE inhibitor], compared to benazepril alone." CEVA has created a combined medication called Cardalis, but it has not yet been released in the U.S. You can still ask your vet about giving both supplements separately. More info: Spironolactone: A promising adjunctive therapy for myxomatous mitral valve disease

There is a new blood test available for detecting heart disease in dogs. The Cardiopet proBNP Test from IDEXX Labs detects the results of early heart disease from various causes, so it can be used as a screening test, or to help differentiate whether symptoms such as coughing might be caused by heart problems, and to help determine the severity of existing heart disease. The same methodology has been used for humans as well. See the followingfor more info:

There is a new DNA test available for detecting a mutation that causes cardiomyopathy in Boxers. It's done with a cheek swab and costs around $70. See the following for more info:

For more information on heart disease in dogs, see the following:

Two email lists that may be helpful are CanineHeartHealth and CanineCongestiveHeartFailure

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If you have any questions or comments, you can contact me, but I have less time to answer questions than I used to, and it may be several days to a week before I can respond. My name is Mary Straus and you can email me at either or

   


Rocky is a Yorkie-Poodle mix who had suffered from digestive problems his whole life. Click on his image to read about the diet his owner finally found to help him.
Pashoshe Fisher, a Chihuahua, was a wonderful, joyful companion to his owner for 19 & a half years. He was on a high quality raw diet for over half his life.
This is Ella, my Norwich Terrier.