Congestive Heart Failure – In People and the Dogs We Love ©.
Copyright 2010 by Jane D. Ogilvie
Everyone who has had congestive heart failure (CHF), or known anyone who has, knows that it can come on suddenly and be completely unexpected. Usually a diuretic is given in the ER to help the body get rid of excess fluid that’s accumulated because the heart muscle has been taxed and isn’t working as it should. There are many other complicated factors to think about as the circulatory system functions in conjunction with all of our other bodily systems. I’m used to dealing with patients and clients who have histories of cardiac problems, and what happens to them when they have an episode of CHF. Sometimes we can bail people out, and other times, it just doesn’t work. What I’m not used to is dealing with the same problem when it happens to a dog- not just any dog, but MY dog.
Recently our 14-year-old dog had an unexpected episode of CHF. He has seen the vet regularly and never had anything been said about any heart problems. An unusual cough developed overnight, he became lethargic, and like people, “He just wasn’t himself”. In a nutshell, he was in bad shape.
I have only dealt with people and my people assessment skills are honed after doing it for nearly 30 years. However, when it came to assessing my poor old dog, I was nearly at a loss. I didn’t know for sure it was circulatory and thought it could be an upper respiratory infection. After all, he’d been to the vets to have two growths removed 3 weeks before. That was scary enough for me, knowing the affects anesthesia can have upon us people at any age. Maybe he had “kennel cough”. Maybe he caught something else there. All I knew for sure was that Rex needed to see the vet! I felt completely helpless, much like others I imagine who have no medical background to help them understand even a little bit when they or a human loved one gets sick.
We have watched Rex slow down and show signs of aging. He still loved his daily walk but they’re well abbreviated these days. His running and chasing days are gone with exception to an occasional short sprint to inspire a stray cat to leave his territory. We’d watched his appetite back off a bit too, but since he was in no way undernourished, we thought that wasn’t such a bad thing.
As I do with my people clients, I racked my brain to figure out what was going on, what was causing this, how can I make it better? What had I missed?
On two occasions we had seen him sprint after a cat and suddenly stop as if frozen in place. Both times we thought, “This is it. He’s having a heart attack”. We expected him to fall to the ground but within a couple minutes he began walking again, albeit as if he’d had “one too many”.
The second time this happened and I went over to him, besides panting heavily I noticed his gums and lower tissue around his mouth wasn’t dark pink anymore but rather gray/whitish. Again he recovered but “circulatory” went through my head. Again knowing he was 98 in people years, I just figured maybe he was getting close to having to leave us. Considering I think he’d rather die at home than anyplace else, we were preparing in our heads for this to happen sometime “soon”.
I looked this symptom up on the Internet and confirmed it was a circulatory problem that caused this type of freezing behavior. It wasn’t what I wanted to read, but it wasn’t a big surprise.
I called the vet and later that day we got in to see her. We were thinking the visit might have to end in euthanasia. As sick as Rex was though, he remembered there were doggie treats in the exam room. In his usual manner, he charmed the vet tech into giving him one. I’m sure he was pleased to get it but by then, he had to deal with the aftermath, the coughing which quickly accompanied any pleasure he had from the treat.
The vet couldn’t be sure if it was cardiac or respiratory either without x-rays of the chest. We had to return the next morning as soon as the office opened. We brought poor old Rex home and waited to see if he’d still be with us the next morning. He was. We went, dropped him off, and had to wait for a phone call.
A couple of hours later the vet called. We were prepared for the worst. Instead she said, “You can come get him now”. I couldn’t believe it. They had given Rex 100mg injection of Lasix (a common people diuretic), and we’d have to give him Lasix twice a day for two weeks along with another common people pill called Vasotec to dilate his blood vessels and make it easier for the heart to pump. We saw the enlarged heart, and realized it was pushing up on the trachea, which was one of the things that were causing the coughing. We also saw his lungs were full of fluid. Neither of these things was good news but…
We made it home and for the whole first week afterwards it was touch and go everyday and night. He had no desire to eat but finally took some food out of my hand. He did drink. He was able to urinate and get outside before that happened. I would have gone and gotten doggie diapers if he’d needed them. Poor old Rex got a lot of special loving. We had talks, and we were all comfortable with whatever was in the wind for him. After all, His cough became less frequent and before two weeks time it was gone completely. Slowly, he got back to being able to be more of himself, follow us as he always had, and began to eat again. His appetite’s still not what it used to be but that’s ok too.
His breathing has returned to a more normal rate but is still faster than it should be (I think). In a couple of days we’ll return to the vet so she can listen to his heart and lungs. What will she say?
We don’t know, but we do know that Rex’s heart can’t go on enlarged as it is forever. We know we don’t want him to suffer any more than he already has. We know he can’t talk to us in words to tell us exactly what he wants or how he feels. We know we’ll have to do the best we can do to help him be as “normal” and comfortable as we can. We know we want to be helpful to him and not harmful. We know he can’t tell us when he’s ready to go like people can. We know he won’t ever fully recover, and luckily we know, that we can put him out of his misery if he’s not able to really be the Rex he used to love being. It’s a choice we can make for our beloved pets, but it’s never an easy one to make-even if it is the most loving and kind thing to do.
Like people we love, we have to let our 4 legged, non-judgmental, loyal companions go when their bodies prevent them from having a quality life ever again.
UPDATE: May 3, 2010
On April 28th, we took Rex for a 2 week follow up chest xray. The fluid was gone from his lungs. Unfortunately, it allowed a much clearer picture of what else was going on. There were multiple lesions in his lungs and there was one in his heart. The handwriting was on the wall. We helped him to leave us peacefully as we talked him through his last minutes as our loyal companion.
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