Understanding Congestive Heart Failure
Holistic veterinarians say congestive heart failure is sometimes reversible.
Dogs don’t experience heart attacks the way humans do, but this doesn’t mean they don’t die of heart disease. Heart failure is increasingly common in America’s dogs, with many showing symptoms by age seven or eight. Even some young dogs develop congestive heart failure, inheriting the propensity for the disease from their parents.
Conventional medical practitioners consider congestive heart failure and other circulatory problems to be progressive and irreversible, but holistic veterinarians know that in many cases, heart disease can be slowed, reversed, and even cured. Understanding heart disease will help you prevent it in healthy dogs and treat it in dogs who are already ill.
The symptoms of congestive heart failure (CHF) are easy to overlook, and the illness is often mistaken for other conditions, such a respiratory infection or the normal aging process. In short, the condition is an inability of the heart to pump enough blood to meet the body’s needs, because of a failure to adequately empty the venous reservoirs.
In congestive heart failure, the heart doesn’t actually fail or stop beating; instead, its valves become thick with scar tissue, which prevents them from closing properly. Leaking valves cause fluid to accumulate on either side of the heart, and the heart grows larger as it works harder. Fluid accumulating on the right side of the heart produces lung congestion and coughing; fluid on the left side leads to edema (fluid retention) in the abdomen. Arrhythmia, or an uneven heartbeat, can occur as well.
In dogs as in humans, there are four functional classifications of CHF. Class 1 has no obvious signs. This early phase, during which the heart begins to malfunction, can last for years.
In Class 2 CHF, fatigue and shortness of breath begin to accompany active exercise or heavy physical activity. There are no symptoms when the dog is sitting still or lying down. A lack of circulation in the extremities in this and later stages may interfere with wound healing, and mental confusion can occasionally result from a lack of oxygen in the brain.
In Class 3 CHF, even slow walking on a level surface can produce shortness of breath and fatigue. Other possible signs include a persistent dry or hacking cough, wheezing, sudden collapse, and a bluish discoloration of the tongue and gums during exercise. Because the accumulation of fluid in the chest interferes with deep breathing, the dog may seek fresh air more than usual.
In Class 4 CHF, the patient is uncomfortable at all times, even while resting. Edema can affect the legs and feet as well as abdomen and chest area. In advanced cases, fluid collecting in the chest cavity can push on the heart and collapse the lungs. In contrast to the long time lag between Class 1 and Class 2, the illness progresses quickly from Class 3 to Class 4, so that a dog that seemed healthy and active may suddenly enter a critical condition.
Conventional versus complementary approaches
Conventional medicine treats CHF with diuretics, which remove accumulated fluids; digitalis or other heart drugs, which stimulate and temporarily strengthen the heart muscle; oxygen, which improves the animal’s breathing; and a low-salt diet, which helps prevent further edema. These treatments effectively treat the symptoms of the disease, vastly improving the quality of the animal’s remaining life, but do nothing to prevent the progression of the illness.
Generally, holistic practitioners also employ the effective conventional drugs to suppress the symptoms of CHF and seek to augment conventional treatments with nutritional support and herbs. Their goal is to improve whatever underlying imbalances or deficiencies the dog may be experiencing, which may help to slow or stop the progression of disease.
Since all drugs used to treat symptoms of CHF have some adverse effects, another goal of holistic practitioners is to facilitate the safe reduction or even elimination of the dog’s conventional prescriptions. Of course, success depends on the type, severity, and duration of the dog’s illness, but many veterinarians and dog guardians have seen great improvements in their patients with this approach.
Vitamins, minerals, enzymes, and other nutrients play a crucial role in maintaining circulatory health.
• Vitamins: In the 1940s, Drs. Wilfrid and Evan Shute, who were brothers, began a 40-year study of the effects of vitamin E on the heart. Wilfrid Shute’s research involved dogs as well as humans, for he was a show judge and Doberman Pinscher breeder. Soon, thanks to his efforts, vitamin E improved the health of dogs around the world.
As Wendell O. Belfield, DVM, reports in his classic book How to Have a Healthier Dog, many of these cases were dramatic. In 1945, Dr. N. H. Lambert in Dublin, Ireland, learned of the Shute brothers’ work and began giving vitamin E to dogs, the first of which, a nine-year-old Griffon, was dying of heart disease complicated by an inflammatory uterine condition. Conventional treatment had been unsuccessful. “Placed on vitamin E, she made a spectacular recovery,” Dr. Belfield reports. “Lambert said she became quite rejuvenated and lived for another six years.
“Among the virtues of vitamin E is the prevention of excessive scar tissue production,” he adds.
Vitamin C is another crucial nutrient for heart health, as it stabilizes blood vessel walls by supporting the production of collagen, elastin, and other connective tissue. Some physicians consider congestive heart failure a form of scurvy, caused by a deficiency of vitamin C. A powerful antioxidant, vitamin C protects the cardiovascular system as well as speeds wound healing throughout the body, including tiny lesions and wounds within blood vessel walls. In addition, vitamin C is a cofactor for enzymes (biological catalysts) that improve the metabolism of cholesterol and triglycerides.
But of all the vitamins associated with heart health, the most important may be those of the vitamin B complex, including one that has never been recognized as important to human health (vitamin B4, or adenine), even though animal research has shown that withholding it produces congestive heart failure. Vitamin B4 is found in yeast, liver, and wheat germ.
In the last 20 years, Bruce West, DC, has treated thousands of congestive heart failure patients with nutrition rather than drugs. Although he works with humans rather than dogs, his explanation of how congestive heart failure develops applies to both. The cause in most cases, he says, is what he calls American beriberi, or beriberi of the heart. Beriberi is a B-vitamin deficiency that causes nerve conductivity problems, weakness, and muscle paralysis. “Congestive heart failure,” he says, “is a problem of poor nerve conductivity to the heart, an almost paralyzing weakness of the heart muscle, and the resultant failure of the heart muscle to be able to pump out blood.”
Dr. West recommends nutrient-rich foods that contain the entire B-vitamin complex as well as all of the nutrients important to circulatory system health. Unlike prescription drugs, these supplements help the body repair itself by providing the nutrients whose deficiency caused the damage in the first place.
According to Dr. West, most human patients who follow his protocol reduce their prescription drugs and diuretics within a few months and stop them altogether within a year, and this is quite possible for canine patients, too. “Heart drugs are powerful and can prolong life,” he notes, “but when they are no longer needed, they can do serious damage to the heart and kidneys and should be discontinued.”
Recommended dosages vary widely, depending on the prescriber’s philosophy. Practitioners of orthomolecular medicine use very high doses of synthetic vitamins to treat heart disease and other conditions. In Keep Your Pet Healthy the Natural Way, Pat Lazarus lists the supplements used by Richard J. Kearns, DVM, to treat canine heart disease, which include 400,000 International Units (IU) of water-soluble vitamin A, 20 to 25 grams of vitamin C, and up to 4,000 to 6,000 IU of water-soluble vitamin E. Megadoses of synthetic vitamins have a drug-like effect and require professional supervision.
At the opposite end of the spectrum are those who use whole-food supplements rather than synthetic vitamins or isolated nutrients. Even though they supply individual nutrients in minute quantities, whole-food supplements such as those made by Standard Process and Wysong contain all of the C-complex, B-complex, and other families of vitamins, plus hundreds of other nutrients. Food-source supplements are readily absorbed and utilized, have no adverse side effects, and work synergistically to repair damaged tissue.
• Coenzymes: Coenzyme Q10 is used by holistic practitioners for many heart ailments, including CHF. Coenzyme Q10 (generally written as CoQ10 and pronounced “Coe-cue-ten”) is a vitamin-like substance that resembles vitamin E in its action, and strengthens the heart muscle and enhances immunity.
For his canine CHF patients, San Diego-based veterinarian Stephen Blake (see “Holistic Veterinarians Propose Other CHF Causes and Treatments” sidebar at end of story) prescribes one milligram of oil-based CoQ10 per pound of body weight per day, or two milligrams of powdered CoQ10 per pound of body weight.
• Amino acids: The amino acids taurine and L-carnitine are popular supplements because they have been shown to help strengthen the heart muscle, increase its output, and help relieve edema. These amino acids work best when given with high-quality protein and are usually recommended for CHF in doses up to 10 mg per pound of body weight.
• Minerals: Of the many minerals that help maintain heart health, the most important are found in raw bones. Dogs on a raw bone-based diet ingest these minerals daily. Calcium supports the contraction of muscle cells in the heart as well as the conduction of nerve impulses that trigger heartbeats. Magnesium helps normalize an irregular heartbeat, and works synergistically with calcium to strengthen the heart. Trace elements such as zinc, manganese, copper, selenium, chromium, molybdenum, and boron are also important, but are needed in only small quantities.
Supplements such as Calcifood, Min-Tran, and Organic Minerals from Standard Process or Wysong’s Orgamin and Chelamin contain all of these important nutrients. Powdered kelp (½ teaspoon per 15 pounds of body weight) and liquid colloidal minerals (½ teaspoon per 30 pounds of body weight) can be added to food for additional support.
• Essential fatty acids: Essential fatty acids (EFAs) can be important supplements, especially for dogs fed a grain-based commercial diet. EFA supplements that contain fish oils (marine lipids) provide omega-3 fatty acids that improve heart function by correcting EFA deficiencies and balances.
• Enzymes: Systemic oral enzyme products such as Wobenzym and Nutrizyme (see “Banking on Enzymes,” WDJ January 2001) help repair damage to the heart and other organs, especially where inflammation is involved. Systemic oral enzymes are enteric-coated digestive enzymes taken between meals on an empty stomach.
“Instead of staying in the stomach and digesting food,” explains enzyme researcher Charles Green, “these enzymes circulate through the body, removing inflammation, breaking down scar tissue, and restoring healthy tissue.” According to Green, this therapy reduces inflammation quickly, within a matter of days or even hours, while the removal of scar tissue takes place more slowly. These products have been proven safe even in large doses for long-term use.
Herbs for the heart
Of the many herbs that support heart health, several are suitable for use with dogs.
The hawthorn berry (Crataegus oxyacantha), is gentle, effective, and nontoxic. Hawthorn’s flavonoids increase coronary blood flow while slightly enhancing the force of the heartbeat; it stabilizes the pulse, increases the heart’s tolerance of oxygen deficiency, and increases cerebral blood flow. Because it has a gradual effect, hawthorn should be taken over a long period, such as several months or years, for maximum effectiveness. Prolonged use is safe, as hawthorn has shown extremely low toxicity in every animal species tested. Any hawthorn preparation sold for human use can be given to dogs, adapting label directions to the patient’s weight.
Another herb with impressive cardiovascular benefits is garlic (profiled in “Great Buds of Garlic,” WDJ November 2001). Garlic improves cholesterol balance, inhibits harmful platelet congregation, and acts as an antioxidant. There is much debate about which type of garlic is best, and every preparation (fresh, dried, cooked, raw, aged, or extract) has its proponents. Although side effects are rare, garlic does thin the blood and should not be used by dogs with bleeding disorders. Otherwise, it is usually safe to take in “courses” of five days on and two days off for four weeks, then discontinued for one week before resuming, with occasional breaks of a month or more.
Cayenne pepper (Capsicum annuum), another culinary herb with cardiotonic properties, helps stop internal bleeding, relieves pain, strengthens tissue, and improves circulation. Cayenne capsules are widely sold and easy to administer in food.
Other tonic herbs with circulatory system benefits include ginkgo (Ginkgo biloba), gotu kola (Centella asiatica), rosemary (Rosmarinus officinalis), and bilberry (Vaccinium myrtillus).
Liver support, which is important in most cases of congestive heart failure, is well provided by dandelion leaf or root (Taraxacum officinale) and milk thistle seed (Silybum marianum).
For best results, work with a veterinary herbalist to determine which herbs would benefit your dog, adjust the dosages, and monitor their effects. As mentioned earlier, success with nutritional support or herbal medicines may enable you to reduce your dog’s conventional medications. However, this must be done under a veterinarian’s supervision. Contact the American Holistic Veterinary Medical Association (see "Resources") to find a holistic veterinarian in your area.
Congestive heart failure has many possible causes and many possible treatments. By focusing on diet and nutrition, by avoiding conditions and products that add stress to the body, and by providing appropriate support therapies, many patients with CHF can experience a total restoration of health.
-by CJ Puotinen
CJ Puotinen is the author of "The Encyclopedia of Natural Pet Care," "Natural Remedies for Dogs and Cats," and several books about human health including "Natural Relief from Aches and Pains," published last summer. She and her husband live in New York with Samantha, a nine-year-old black Labrador Retriever, and two cats.