Congestive Heart Failure in Dogs: Stages & Treatment

xray view of dog
X-ray of a dog’s chest used to assess heart size. An x-ray is one of the most useful tools to diagnose congestive heart failure in dogs.

Today we will discuss the stages and treatment of congestive heart failure in dogs. In our last blog we discussed the connection between dog coughing and congestive heart failure.It is one of the signs of congestive heart failure in dogs, among other symptoms. Once your dog has been diagnosed with congestive heart failure, your veterinarian will stage the disease and discuss treatment options.

Stages of Congestive Heart Failure in Dogs

While there are four stages to classify dogs with heart disease, the last two refer specifically to stages of dogs in congestive heart failure. According to the American College of Veterinary Internal Medicine classification, these are stages C and D.

  • Stage A is a dog that is of a breed or has another disease that predisposes the dog to heart disease, but may not have any change to the heart.
  • Stage B is a dog that has a heart murmur on physical exam, but there are no structural changes to the heart and no signs and symptoms of congestive heart failure in these dogs.
  • Stage C is a dog with signs of congestive heart failure or is currently in congestive heart failure.
  • Stage D is a dog that has congestive heart failure that is not responding to treatment.

Treating Congestive Heart Failure in Dogs

  • Stage A dogs do not need any treatment, but should be regularly screened for heart disease by their veterinarian. This could include regular physicalveterinary exams, x-rays and ultrasoundsof the heart.
  • Stage B dogs have structural change to the heart onx-ray and ultrasound.These dogs are not showing signs of congestive heart failure and therefore do not need treatment. They should be re-evaluated routinely to monitor any changes with x-rays or ultrasound. Dogs that start to show signs of congestive heart failure including coughing or a decrease in activity should be seen immediately as they may now be in Stage C. 
  • Stage C dogs have clinical signs or symptoms of congestive heart failure. These are dogs that are coughing and/or have a decrease in their ability to exercise. These dogs will be started on medications to help their failing heart deal with the demands placed on it. These medications will be needed for the rest of the dog’s life. These dogs may also benefit from adiet designed for dogs with congestive heart disease.
  • Stage D dogs are currently receiving medications as treatment for congestive heart failure, but are not responding to the standard treatment protocols. These dogs will need advanced medical therapy and are best helped by a specialist in cardiology.

If your dog is showing signs or symptoms of congestive heart failure, you need tocontact your veterinarianimmediately. Your dog’s quality of life will benefit from early diagnosis and treatment.


Drs. Kent and Lia Morley


J Vet Intern Med 2009;23:1142–1150 ‘ACVIM Consensus Statement, Guidelines for the Diagnosis and Treatment of Canine Chronic Valvular Heart Disease’ C. Atkins, J. Bonagura, S. Ettinger, P. Fox, S. Gordon, J. Haggstrom, R. Hamlin, B. Keene (Chair), V. Luis-Fuentes, and R. Stepien

Veterinary Information Network – Left Sided Heart Failure, Associated Database

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