Heart Problems

[Chippendale]

I have a 12 ½ year old female cocker spaniel that was diagnosed with congestive heart failure around November of 2017 and she has been on Vetmedin 5mg, 1 and ½ tablets every day since then. I was told that she would eventually start coughing because of fluid buildup in her lungs and was given Lasix to use "if needed". The coughing started as best I can remember about 8 or 10 months ago and has gotten progressively worse. She is now daily taking Lasix 25mg 2 X day, a Rx cough tablet that I don’t know the name of 3 to 4 times a day and then Enalapril 5mg 2 X day for blood pressure. I honestly cannot tell that any of this medication is helping.

One thing I found very strange is that she would at first only cough in the house, but if I put her on a leash and took her for a walk, no coughing, and until recently no one would know she was even sick. She still doesn’t cough much when out walking, but the coughing has gotten worse in the house plus I am starting to find clear fluid on the hard wood and title floors which does not have an odor, so I am pretty sure it is not urine. Sometimes it is just drops but every now and then it is a puddle like urine would be.

When she first wakes up, the coughing is a very loud hacking noise and then later it turns into a puffing cough about every second or two and then sometimes will subside to nothing for a while. Sometimes when she lies down, her whole body will jerk or react to the coughing spasms. Sometimes, not too often she will make a whimpering noise while coughing. She seems to be getting enough oxygen, her Vet said that a sign of low oxygen would be a dark tongue and mouth which I haven’t noticed.

I know at some point I am going to have to make the decision I don’t want to make. I guess what I need to know is: 1. Are these coughing spasms causing her pain because that is the last thing I want to do. I am sure it has to be stressful. 2. Is there some other medication that I might suggest to her Dr. to try that might give her some relief? 3. Or should I just go on and get it over with?

She also has been plagued with dry eye for her entire life, I put Optimmune and GenTeal Severe gel in her eyes for this. Plus she has cherry eye that I use to be able to massage back in place, and it would be ok for several months at a time, but now even the Vet can’t get it to stay in place. The Vet says she can’t operate on the cherry eye because the anesthesia would, because of her heart, kill her. The cherry eye doesn’t seem to bother her.

I am guessing that there is someone who has gone through this with their pup and if so, I will greatly value your suggestions.

Thank you,
George Speir

[DownTheAvenue]

I am so sorry you are dealing with this. Hopefully, your life with your dog has been close enough that you both know how to communicate with each other. Listen with your head and your heart. You both will know when it is time to say good bye.

[LadyRVer]

I went through CHF with my last cocker. He was on a lot of the same meds yours in on. Every once in a while, I would take him in and his doctor would give him a shot for the extra fluid in his lungs. Be prepared to stop for potty break on way home. Bailey starting to pull away from us, went off by himself. To me, he was preparing us for his departure. He finally starting getting seizures and his doctor said it was from lack of oxygen reaching his brain. He could no longer walk and I would carry him outside for potty and to see his friends. My husband was totally against making the decision but one day we had no choice. My guilt comes from waiting too long. But, I had hubby to contend with. I just hope my Bailey Boy knew I was there at the end holding him. God Bless you and your baby. It is hard.

[Edd505]

Ask your vet. Don't like the answer find another vet and get a second opinion. I know my vet takes care of my service dog since I got him will do all she can for him. 8 cancer surgerys prescription food, allergy meds, 2 body scans, he gets what she says he needs.

[dturm]

The pattern of cough, increased while inactive or laying down and then disappearing while walking is normal with CHF. The heart rate increases with exercise and blood flow increases. When heart rate slows, gravity takes effect and fluid tends to accumulate in the lungs causing the cough.

The medical treatment you are doing is really the best available. The medicine undoubtedly is working, it's just that her heart is damaged to the point that it's not able to always provide adequate circulation. Unless there has been a change in her heart and another condition has added to the CHF, there really isn't much more that can be done.

The coughing spasms or spells are not really painful. Distress comes when they can't breath fast enough or deep enough to provide the minimum oxygen needed. Most dogs in this situation will sit (provides the greatest ability to fill the lungs), extend their head and just pant.

Knowing the exact time is hard for any of us not with her on a daily basis to offer an opinion. It has been my experience that the dogs will tell us when they have had enough, usually a drastic change in behavior. Sometimes they tend to go off by themselves. Sometimes get clingy. Many stop eating. I guess if the coughing spells become frequent enough that they bother her or she get to the point where she can't go for walks or do any routine activities, it's time.

Doug, DVM