You’re aware of the prevalence of heart disease in humans and are probably doing what you can to keep your own cardiovascular system healthy. But did you know it’s also a common affliction in dogs and cats? Unlike people, who often develop coronary artery disease because of atherosclerotic plaques, dogs and cats typically develop other types of heart disease.
In dogs, cardiomyopathy and mitral valve disease are common. Cardiomyopathy is a condition in which the heart muscle fails. It typically occurs in larger breeds such as Doberman pinschers and boxers. Mitral valve disease, in which leaky heart valves develop, most often occurs in middle-aged to older small breeds. Cavalier King Charles spaniels are especially prone to this disease, even at an early age; in fact, most Cavaliers will develop heart disease at some point in their lives.
In cats, cardiomyopathy is the typical heart condition. One form of the disease, dilated cardiomyopathy, is caused by taurine deficiency and was once very common. Now, thanks to added taurine in cat foods, the condition is rarely seen. Now, hypertrophic cardiomyopathy is the most common form of heart disease found in cats.
Making a Diagnosis
Diagnosing heart disease is relatively simple. Your veterinarian will listen to your dog or cat’s heart with a stethoscope, and if he hears a heart murmur or irregular heartbeat, then the animal has heart disease. At this point, however, one of two mistakes are often made.
Mistake #1: The veterinarian takes a “wait and watch” approach. With very few exceptions, a heart murmur always indicates heart disease. To simply “wait and watch” makes no sense. What are we waiting for and watching for — the animal to go into heart failure? Whenever a heart murmur is detected, it indicates the need for more testing to determine the severity of the disease.
Mistake #2: The vet puts the animal on medication. There is no need to prescribe medication to a dog or cat simply because a heart murmur is detected. Without further diagnostic testing, there’s no way to know if the animal has a need for medication at this stage. The good news is that for most asymptomatic animals with heart murmurs, a natural approach can be taken and no medications are needed.
Once a heart murmur is detected, radiographs (x-rays), an EKG, and an echocardiogram of the heart will be necessary. These tests allow us to determine the stage of heart disease and will guide the treatment. In my experience, most asymptomatic animals have very early heart disease and do not require medication. Follow-up testing, usually with further echocardiograms and EKGs, are done every six months. Medication is prescribed only when the disease has progressed or when heart failure occurs.
Three different types of medication can be used for the animal with heart disease. With rare exceptions, these are only necessary with severe heart disease or failure. They have no place in the treatment of dogs or cats with mild heart disease.
- Diuretics – Furosemide (Lasix) is most commonly prescribed whenever a diuretic is needed. Diuretics work by removing excess water from the animal. This class of medication is only needed when fluid accumulation, most often in the lungs (pulmonary edema), is present. Because edema is not present until advanced heart failure occurs, diuretics should not be used for most animals with heart disease.
- ACE Inhibitors – This class of drugs, which includes enalapril (Enacard) and benazepril, is used to help the heart pump more efficiently and reduce resistance to blood flow by dilating blood vessels. ACE inhibitors may reduce coughing in animals with an enlargement of the left atrium. While generally safe, these are potent medications that can cause side effects such as kidney damage. Animals taking ACE inhibitors should have frequent examinations and blood and urine testing. Once again, these medications are not needed for most animals with early heart disease but may be considered for those with advancing heart disease or failure.
- Pimobendan (Vetmedin) – This new medication offers several positive benefits for dogs with heart failure. It opens the blood vessels, reducing the amount of work the heart has to do to circulate blood through the dog’s body. It also helps the heart pump more efficiently. Pimobendan is often prescribed for animals with heart disease rather than heart failure, but there is no reason to do so as the drug is not beneficial unless heart failure is present.
A number of natural remedies can be used for the dog or cat with heart disease. In my practice, animals with early heart disease (based on a heart murmur and normal cardiac testing) are placed on one or more of the following natural therapies.
- Coenzyme Q10 is an antioxidant synthesized in most tissues of the body and found in all cells. The highest concentration is found in the heart, kidneys, liver, and pancreas. It is one of several coenzymes and is required for the conversion of energy from carbohydrates and fats in the synthesis of ATP. CoQ10 also protects cell membranes and DNA from oxidative damage.
Studies in people with high blood pressure showed a reduction in systolic blood pressure when they were treated with CoQ10. In humans with heart failure, CoQ10 therapy also increases cardiac output, improves contraction of the heart, and dilates the blood vessels necessary to allow normal blood flow through the body.
In general, 1 mg of CoQ10 per pound of body weight one to two times daily is used for most animals with heart disease. It’s recommended that it be taken with a meal or a small amount of oil since it is a fat-soluble supplement.
- Hawthorn is an herb well known for its use in the treatment of heart disease thanks to its flavonoids and oligomeric proanthocyanidins (OPCs). Hawthorn exhibits several clinically beneficial effects, including anti-arrhythmic properties, increased coronary blood flow, decreased energy utilization by the damaged heart, and decreased cardiac excitability.
- Omega-3 fatty acids derived from cold-water fish rich in EPA and DHA—especially wild salmon, mackerel, sardines, and herring—are among the most commonly prescribed supplements for people and animals with a variety of problems, including heart disease.
- Fish oil has been shown to be superior to statin therapy for lowering mortality in human patients with cardiovascular disease. Fish oil may lower lipids (especially triglycerides) but may cause minor elevations in LDL concentrations. It may decrease blood clotting and can also reduce atherosclerosis, coronary heart disease, arrhythmias, heart failure, sudden cardiac death, and stroke. To minimize oxidation, most fish oil products should be kept refrigerated after opening.
- Homeopathic remedies can be used for animals with heart disease. I typically use homotoxicology remedies (made by the Heel Corporation) which are combination remedies that contain several different homeopathics.
- Cralonin is a commonly used toxicology remedy for patients with heart disease, especially those with heart damage and older animals with heart disease. It contains several homeopathics including crataegus, spigelia, and kali carbonicum.
- Cactus compositum is another remedy useful for animals with circulatory disorders as well as heart weakness. It also contains several homeopathics including kali carbonicum, spigelia, prunus, and glonoinum.
In clinical practice, I will typically combine homotoxicology remedies with nutritional supplements and/or herbs to get the best response.
Unfortunately, heart disease cannot be prevented. The good news is that natural treatments may be able to delay or prevent mild heart disease from progressing to heart failure.