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What is Heart Failure, Congestive (Right-sided)?

Congestive heart failure (CHF) is a non-specific symptom that can occur with many different types of heart disease. CHF can be either left-sided or right-sided depending on which part of the heart is involved; occasionally, CHF may be biventricular, affecting both sides of the heart at once. Many signs of CHF, such as fainting, shortness of breath, and inability to exercise are common to both left and right-sided origins, however small differences in your dog’s symptoms may suggest which side of the heart is more involved and help the veterinarian make an accurate diagnosis of the problem causing CHF. Oxygen depleted blood from the veins enters the right atrium. It passes through the tricuspid valve into the right ventricle before being pumped into the lungs as the heart contracts. If the right side of the heart is weak, or the tricuspid valve is not functioning properly, the heart is unable to pump as much blood to the lungs for oxygenation. Pressure can build up in the veins that transport blood to the right atrium, sometimes causing a strong pulse and marked protrusion in the jugular vein in the neck. Meanwhile, blood will pool in the lungs since the reduced force of the heart’s contraction will not push it on to the left side of the heart as quickly. Fluid from the stationary blood frequently leaches out of the lungs and accumulates in the abdomen (called ascites). This is the most distinctive symptom of right-sided congestive heart failure. Dogs often have a distended pear-shaped belly, and may be reluctant to lie down or put pressure on their abdomen. Left-sided CHF on the other hand will be more likely to cause fluid accumulation within the lungs (pulmonary edema) with symptoms of coughing. Both types of CHF ultimate lead to oxygen depletion in the tissues and eventual heart failure, so CHF is a very serious condition.

Congestive heart failure is a symptom that often occurs in dogs with severe heart disease. If the problem begins in the right side of the heart, this is called right-sided congestive heart failure. Fluid accumulation in the abdomen is the most distinctive symptom.

Heart Failure, Congestive (Right-sided) Average Cost

From 72 quotes ranging from $800 - $8,000

Average Cost

$2,500

Symptoms of Heart Failure, Congestive (Right-sided) in Dogs

These are some of the symptoms you might notice in a dog with right-sided CHF.

  • Distended abdomen (ascites)
  • Discomfort while lying down
  • Swollen limbs from fluid accumulation
  • Increased breathing rate
  • Exercise intolerance
  • Lethargy
  • Weight loss
  • Weakness
  • Fainting
  • Noticeable protrusion of the jugular vein in the neck
  • Strong pulse in the jugular vein

Types

These are the different types of CHF that might affect your dog’s diagnosis.

  • Right-sided CHF (problem originates on the right side)
  • Left-sided (problem originates on the left side)
  • Biventricular (problem affects both sides)
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Causes of Heart Failure, Congestive (Right-sided) in Dogs

  • Atrioventricular valve degeneration (tricuspid valve)
  • Dilated cardiomyopathy – more common in large dogs
  • Heartworm
  • Congenital heart defects (tricuspid dysplasia, ventricular septal defect, atrial septal defect)
  • Tumor in the heart
  • Infective endocarditis affecting the tricuspid valve (rare)
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Diagnosis of Heart Failure, Congestive (Right-sided) in Dogs

The veterinarian will physically examine your dog. A heart murmur may be audible through a stethoscope and the veterinarian may even be able to tell which valve is affected based on the placement of the murmur. This, along with other symptoms like fluid accumulation in the abdomen or legs can suggest the problem is located on the right side of the heart. Right-sided CHF is a symptom rather than a disease, so the veterinarian will need to diagnose the underlying condition that is causing your dog’s heart to fail. The most common problem is some degree of backflow, or regurgitation in the tricuspid valve that connects the right atrium and ventricle. This could be caused by an inherited condition, age related degeneration, a cancerous tumor, or a heart infection (although this is more likely to cause left-sided CHF). 

More definitive diagnosis is made with x-rays of the chest, as well as electrocardiography, and echocardiography (an ultrasound of the heart). Chamber enlargement may be visible on an x-ray, while an electrocardiogram will record abnormal heart rhythms. The echocardiogram is the most useful tool for diagnosis since this shows the heart in more detail. The veterinarian will also order blood tests and urinalysis to check for infection that could be causing or contributing to your dog’s symptoms. Dogs with severe CHF will usually have signs of liver and kidney dysfunction as well, which may be apparent on these tests. Most dogs with right-sided CHF are also given a heartworm test, which measures for abnormal proteins produced by the worms. The larvae and adult worms live in the arteries that connect the heart and the lungs and often spread into the right ventricle and atrium, so heart failure from heartworm infection usually starts in the right side of the heart.

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Treatment of Heart Failure, Congestive (Right-sided) in Dogs

Dogs with moderate to severe problems may need to be hospitalized until the condition is stabilized. Taps will be inserted to remove fluid from the abdomen and around the heart (called abdominocentesis and pericardiocentesis). Strong diuretics, such as furosemide, may be injected to further encourage fluid elimination, and dogs may need additional oxygen.

Once the immediate attack is stabilized, long-term medications will be prescribed to help to control symptoms. Diuretics and ace inhibitors are the most common medications used to reduce fluid build-up and improve blood flow. Pimobendan can increase the force of the heart’s contractions, and digoxin may be prescribed if your dog’s heart rate is very fast. Beta-blockers and calcium blockers could also be suggested depending on your dog’s condition. Most treatment plans will combine a number of different medications.

Other treatment will focus on eliminating the problem that is causing CHF. If your dog has heartworm, it can be treated with medication once your dog’s symptoms are stabilized. Some conditions, like atrial septal defect, can be treated with surgery. Others cannot. Valve replacement is only done very rarely in dogs, so problems that affect the valves are often only untreatable symptomatically.

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Recovery of Heart Failure, Congestive (Right-sided) in Dogs

Recovery will depend on treating the problem which led to right-sided CHF. Mild heartworm infection, or a heart defect that is treatable surgically can have a reasonably good prognosis, but if severe CHF has developed there may be permanent damage to the heart muscles. With medical management, dogs have an average survival rate of 6-12 months. A low salt diet is recommended and dogs should only be allowed mild exercise. Frequent checkups will be necessary so the veterinarian can monitor your dog’s condition and assess the effectiveness of treatment. Keeping a close watch on your dog’s breathing rate can help you identify the onset of another attack before it becomes serious.

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Heart Failure, Congestive (Right-sided) Average Cost

From 72 quotes ranging from $800 - $8,000

Average Cost

$2,500

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Heart Failure, Congestive (Right-sided) Questions and Advice from Veterinary Professionals

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Ask a Vet

dog-name-icon

Pouffy

dog-breed-icon

mixed Pomeranian and Papillon

dog-age-icon

15 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Only Cough First In The Morning
Cough When Exercising

I'm searching for a second opinion on my dog diagnostic - is it possible to find a cardiologist to read his x-rays online? He is coughing from February 2018, had treatment first with cough syrup, after with antibiotics, and now diuretics telling us he has pulmonary edema, enlarged heart.

Aug. 14, 2018

Pouffy's Owner

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0 Recommendations

You should contact PetRays (link below) to have Pouffy’s medical records reviewed by a board certified Cardiologist. Regards Dr Callum Turner DVM http://petrays.com/specialists/cardiology/

Aug. 14, 2018

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Hazel

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Bull Terrier

dog-age-icon

7 Years

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Serious severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Fluid In Abdomen
Shortness Of Breath
Very High Heart Rate
Standing Long Periods

I have recently adopted Hazel about 6 months ago from a shelter. They told me she was about 3 years old. Later on after these issues started acurring my vet told me she is probably closer to 7. I thought it was strange that she had 2 teeth in the front missing and many chipped teeth for being only 3. She seemed fine and didn’t notice any problems when I got her and was told nothing by the shelter about any possible heart problems. She had been given a heart worm test which was negative. She had what seemed to be kennel cough which my other dogs ended up getting and after it didn’t go away I took her to the vet. The vet only listened with a stethoscope. She was given antibiotics and I was told it could possibly be a heart problem and not kennel cough. The antibiotics took away the cough so I thought that was that being as the vet was very young I thought maybe she just misdiagnosed. After about 4 months of having her or so she started breathing hard after exercising so I took her to the vet again. At this point she was becoming quite skinny and had a swollen abdomen ( which I found out was fluid) and was told it is definitely some type of heart condition. I was recommended to take her to a specialist and since I didn’t have the money to take her right away they put her on the medication listed and drained her abdomen. (4 liters drained) About a week later I had to bring her back to have her abdomen drained again (another 4 liters). She’s walking very slow and her heart rate seems very high. While she had all that fluid it was uncomfortable for her to lay down and her legs seem sore from standing before it was drained the 2nd time. She’s gotten very skinny and is breathing quite hard now. I was reading the above article and it says with treatment she may only live 6 months to a year. I’m very sad because I’ve wanted a bull terrier for about 16 years and finally got one and this is happening. She’s a wonderful dog who was a bit aggressive to the other dogs at first and not good with the cats but in the short period I’ve had her she has become so gentle and will even lay next to the cats. I don’t know whether I should go through all the heartbreak of trying to treat her for 6-12 months or have her put down if what seems to be the case ends up being the prognosis when she sees the specialist. A few months before getting her I had my dogs that I had for over a decade die pretty much one after another. 2 were pretty old one of which had epilepsy and would have seizures and eventually died from one after having other heath issues which he was my baby since before I had real children. Then his puppy ( 8 years old by then) with my female (all beagles) jumped my fence and got hit by a car. And then the mother died of possibly stomach cancer but the vet told me she was so old there was really no point in spending a ton of money due to her age nothing could really be done. I’m extremely sad and am worried I’m going to have to go through all this again. I don’t know what to do. And advice would be greatly appreciated Nikki

Aug. 4, 2018

Hazel's Owner

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Without examining Hazel and possibly doing an echocardiogram I cannot say whether there is heart failure or how severe it is; prognosis varies widely depending on the type of heart failure, underlying conditions and response to treatment. Treatment with Vetmedin (pimobendan), diuretics and ACE inhibitors are the treatments for dilated cardiomyopathy and atrioventricular valvular insufficiency (Vetmedin shouldn’t be prescribed for any other cause of heart failure). You should visit a Cardiologist to confirm the diagnosis and to determine a treatment plan. Regards Dr Callum Turner DVM

Aug. 4, 2018

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Waskle

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Pomeranian

dog-age-icon

15 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Right Side Of Heart Enlarged
Clear Spetum
Restlessness At Night

Hi, my name is Cade and was wondering if i could get your opinion on Waskle's possible diagnosis? My family and I moved to a more humid climate in Jan 2016, after about 12 months we noticed that each time Waskle drank water he would bring some of it back up with a bit of a hack (as it is hot and humid where we live he would skull heaps of water and assumed he was drinking too fast), and he also started snoring of a night time and becoming very restless unless the aircon was on, after this went on for a little while we assumed it was old age and the heat until one night he let out 4 quick short sharp barks and stopped breathing and went totally limp, after a chest massage and a breath through his nose he came to and was very groggy. In the morning we took him to the Vet and he was diagnosed with a heart murmur and fluid on his chest, he was prescribed foretekor plus 1 twice a day and fluid tablets 1/2 twice a day, when he went back for a follow up appointment his potassium was low due to the fluid tablets and was prescribed 600mg slow release-k 1 twice a day, with his next follow up he was taken off the potassium tablets as his potassium was still too low and his fluid tablets were halved. Over this whole time his snoring nor his hacking up after drinking had got any better. He went in for chest x-rays yesterday and I have been told the right side of his heart is enlarged twice its original size and it was a ticking time bomb although his trachea seemed intact and normal. I am just trying to understand how this is possible as at 15 he is one of the most active dogs i know, frequently goes to the beach swimming and running walks up and down stairs all day, swims in the pool all the time & never seems to be breathless? I have asked them to do an ultrasound to check it is his heart enlarged or a tumor or possibly he has just got a large heart from birth. The weird thing is I was diagnosed with a abnormal heart (genetic condition) about 6 months before Waskle.

April 13, 2018

Waskle's Owner

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0 Recommendations

Without examining Waskle I cannot second guess the diagnosis made by a Veterinarian which has performed an in person examination; however, if you are having concerns or doubts about Waskle’s diagnosis you should think about getting a Cardiologist’s opinion. I would recommend retaking the x-rays and sending them along with the original x-rays (and blood tests and case notes) to PetRays for a second opinion. Regards Dr Callum Turner DVM http://petrays.com/services/cardiology/

April 13, 2018

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Luna

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Papillon

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9 Years

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Moderate severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Fluid In Abdomen
Lethargy
Sob

Hi. My pappillon was just diagnosed with right sided CHF in the last two days. My boyfriend gave her some hamburger we cooked last night and now im worried it might be too salty for her. Should i be worried?? She was tapped two days ago onset of diagnosis

March 20, 2018

Luna's Owner


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Dr. Michele K. DVM

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0 Recommendations

Thank you for your email. One small bit of hamburger should not be enough to increase her salt content significantly, but it is definitely a good idea to keep her salt content to a minimum. I hope that she is okay.

March 20, 2018

Doctors, My dog Max is my best friend and he’s suffering from a grade 4 or 5 heart murmur. I was given Vetmedin, Enalapril, and Lasix as a form of treatment. Max is a 14 year old Shi Tzu. His appetite seems great. He is sleeping. However, his stomach seems to be contracting when he is still or normal. He seems to sleep with it. Is he near the end? Is there anything we can do at his age?

July 20, 2018

Cristian S.

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Cosmo

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Bichon Frise

dog-age-icon

11 Years

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Moderate severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Panting
Lays Down

Hello, I have a 11 year old Bichon Frise who was diagnosed in November of 2017 with an enlarged heart. He’s been doing great and I’ve been monatoring his breathing and when it’s to high his vet told me to give him 1/2 of his furosemide. Well he likes to run and bark at the other dogs next door at our house I try to stop him but sometimes he won’t listen. And I’ve been noticing that he’s out of breath and will walk a little and lay down after his conversation with the next door dogs. He doesn’t pass out but I feel like he catches himself before he completely passes out. He doesn’t cough much maybe 4 times or less a day. I’ve also have been giving him the vetriscience cardio support. I guess my question is, is what is causing him to do this? He’s been running to the next door dogs when he’s had an enlarged heart before with no issue. I really try to discourage it though.

March 7, 2018

Cosmo's Owner


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0 Recommendations

Without examining Cosmo it is difficult to say what stage he is at with his heart condition and whether or not an increase in severity is causing exercise intolerance which is leading to this behaviour. You should return to your Veterinarian for another examination and a review of medication to see if any adjustments need to be made or not. Regards Dr Callum Turner DVM

March 7, 2018

Doctors, My dog Max is my best friend and he’s suffering from a grade 4 or 5 heart murmur. I was given Vetmedin, Enalapril, and Lasix as a form of treatment. Max is a 14 year old Shi Tzu. His appetite seems great. He is sleeping. However, his stomach seems to be contracting when he is still or normal. He seems to sleep with it. Is he near the end? Is there anything we can do at his age?

July 20, 2018

Cristian S.

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Bracken

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Dachshund

dog-age-icon

11 Years

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Critical severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Critical severity

Has Symptoms

None

I had my dearly loved 11 year old dog put down 6 years ago after she (apparently quite suddenly) went from near perfect health - she had a Grade 2 heart murmur - into right-side heart failure. She saw the vet (a car ride away) only 30 minutes after I spotted "something" significant was wrong after coming downstairs in the morning. My well respected, very thorough vet told me the chords(?) in her valve had either broken or had become stuck open and she was actually likely to die within 24 hours if left. She routinely exercised for 2 hours a day but 3/4 of the way through her last walk of the day wasn't quite as enthusiastic as normal ... though not flagging on the hills. She was as nosy and engaged with visitors as usual, eating well and behaving absolutely normally. The only "symptoms" I noticed was that over the last 48 hours of her life she had been drinking more than usual and her tummy was a little more rounded. She'd clearly developed ascites and sicked it up that morning. If she had time to develop ascites why weren't there other symptoms of the heart failure when maybe I could have done something to help her? I have another dog now - 9 year old, same breed - who's just gone from no heart murmur to a Grade 3 heart murmur within months. She is also a lively dog with no symptoms. How common is sudden heart failure among dogs please?

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Rasky

dog-breed-icon

teckel

dog-age-icon

12 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Fluid In Abdomen
Coughing
Ascites
Distended Belly

We started Rasky's treatment for heart failure about 4-6 months ago. Lately he has started suffering ascites (fluid in abdomen). We have to take him regurlarly to our vet to drain his belly. We increased furosemide daily dosis up to 80mg (60mg furosoral + 20mg injected seguril). Our dog weight is about 10kg, so it means 8mg/day/kg. I have been reading about Beta-blockers, calcium blockers, pimobendan, beta andregenic blockers, ace inhibitors and espironolactone (prilactone). It seems that somettimes furosemide is not effective if not combined with espironolactone. Is it true? Is there anything I could do to cure his ascitis?

dog-name-icon

Wrangler

dog-breed-icon

Yorkie Fox terrier mix

dog-age-icon

14 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Weightloss
Breathing Difficulty
Swollen Abdomen
Coughing
Discomfort
Weakness
Exercise Intolerence
Lack Of Appetite
Lethargy
Heart Murmur

Wrangler began with just a hacking like cough, then the symptoms of Congestive Heart Failure progressed rapidly. I have hit a rough patch & lack the financial means to afford much of the testing & treatment, thank God my vet has been very helpful & accommodating with me, however, tests (such as blood work, more x-rays, ultrasounds, etc.) cannot be done due to my lack of finances. From all of his symptoms they believe it is Congestive Heart Failure, as well as him having a heart murmur. They put Wrangler on Benzaepril 5mg 1/4 a tablet a day & Furosemide 12mg 1/4 tablet twice daily. It was near Christmas & after being on the meds for a week, he seemed to not be getting any better, and he actually declined a little, but after Christmas (a day or 2 later from his week of taking the meds) he seemed to be doing much better. His appetite increased, he was more active, walking more, had solid stools, he went to the water bowl to drink for himself instead of me syringe feeding him water. However, this seems to have been short lived, the following week he has declined tremendously! He has lost appetite for most anything, he won't drink water on his own again. Along with all this his abdomen is extremely swollen, & his urine output is very low. I took him to my vet, & I was told to increase his meds (Benazepril 5mg 1/2 tablet daily, & Furosemide 12mg 1 tablet twice a day). I know its a bit early, seeing as how this is the first day trying the upped doses, but I'm really worried about his swollen abdomen. I am administering a substantial amount of water since I was told he seemed slightly dehydrated, & also to help flush him out, yet he has only urinated twice. Along with this, he is refusing to lay down, due to how swollen he is, & is almost wobbling, or falling/collapsing, like he has no stability & is too tired/weak to hold himself up. Every time I lay him down, he gets right back up! I had talked to my vet about other options since I feel like the diuretic isn't very effective for reducing his distended abdomen, but she has told me this really the only option. I'm extremely worried that the this is not enough to help, & his abdominal swelling will get worse & that his urination will halt. I'm at a loss & so discouraged. Could something else help or work with this diuretic or can anything help with reducing the fluid build up in his abdomen? If this persists with such little urine output, how long will he survive? I know hes older, but I want to do everything I can to help him live! Euthanizing him is not an option for me, but my finances hinder much of my ability for further testing. My vet has prescribed Pimobendan, but there is a back order of this med across the nation. What do I do? Would heat or cold compresses help at all? Please help, I need to all that I possibly can to help him!

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Bailey

dog-breed-icon

Dachshund

dog-age-icon

14 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

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1 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Lethargic
Syncope
Exercise Intolerence
Exercise Intolerenc

Bailey is a 14 year old male dachshund with increasing syncope that first started 4 weeks ago. Experienced severe gastroenteritis 1 month ago and experienced a syncope episode after a trip outside. Took to emergency vet who initially diagnosed seizure, but after I pressured them referred us to a cardiac specialist after hearing a grade V murmur. Cardiac diagnosed as pulmonary hypertension after ultrasound and prescribed Vetmedin and Sildenafil. Gastroenteritis resolved naturally 3 days later. Dog felt better over the next few days but experienced a syncope episode every 4 days or so for the next three weeks. Typically associated with minor exercise. Consulted a second cardio for a second opinion at end of week 3 since no improvement in Syncope. Second cardio added Plavix and doxycycline. Throughout week 4, another quick bout of poor stools associated with two quick syncopes in one day. Exercise tolerance has plummeted during week 4 and syncopes have increased to 1x per day. Dog getting very lethargic. No coughing and no elevated respiratory rate throughout this entire month. Murmur has improved to I-II during this time as well. Dog lays on stomach with no issue. Barks at housemate from time to time. Are we dealing with valvular flow issues or do I need to pursue chasing down arrhythmia issues? Or is this just his version of presenting with heart failure? Will try to contact our cardio on Mon, but considering euthanasia if we don’t see improvement soon. We’ve had Bailey since he was 1/2 lb and 4 weeks old so we are heartbroken. FYI we had a 17 yo Dachshund we euthanized 3 months back with very similar symptoms (increasing syncope we later connected to a bout of stomach issues. Thanks.

Heart Failure, Congestive (Right-sided) Average Cost

From 72 quotes ranging from $800 - $8,000

Average Cost

$2,500

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