# Lulu has Congestive Heart Failure--Long Post



## lulu'smom (Jan 4, 2012)

I'm sorry it's been a while since I've been here--life. I knew Lulu had a cough for quite a while like she was coughing up a fur ball. I also knew that a cough was an indication of possible heart issues. I mentioned it to the vet, but he didn't seem too worried about it. He only mentioned hearing a heart murmur on her last annual vet visit, but still wasn't worried about her. I didn't know enough to put 2 and 2 together to link the murmur with the cough. We recently moved, and for a couple of weeks before the move I was packing and "cleaning" out. One week before the actual move I was taking boxes myself daily to our new home. Funny thing, every morning I could hear a crazy fast heartbeat while I was laying on my pillow, but I never thought in a million years it was Lulu's! We moved on a Saturday for 6 hours, and spent our first night at our new place. On Sunday morning I ended up at the ER vet with my mom and Gidget, our Maltese, with bloody diarrhea from nerves. While I was there, Lulu got out at our new place--looking for me I'm sure--that was probably the thing that put her over the edge. Sunday night I noticed she seemed to be breathing funny, but not enough that even I took her to the ER (HUGE GUILT). I took her Monday morning to my vet, and she was diagnosed with CHF. She had fluid on her lungs and heart, both sides of her heart were enlarged. She almost didn't make it. She spent all day at my vet and I took her straight to the ER to spend all night for observation until they felt she was able to go home. She is now on Lasix and Enalapril. She was on Pimobendan for several days, but the diarrhea and no eating was so bad I decided to take her off of it. I have really mixed feelings about that, but she was so bad off on it I didn't see a choice. Her breathing now is great 36-40. Her heart rate stays between 104-120. She still coughs--sometimes she goes long periods of time with no coughing, sometimes she coughs several times in a row.

My most urgent issue (because my overall problem is knowing this is a death sentence for her) is her absolute lack of appetite. She wants to eat, but can't seem to. She sniffs the food and walks away. She stand there and looks at me and shivers. I give her Pepto to settle her stomach-as ordered by the doctor, but it doesn't help with the appetite. When she finally eats, it's not nearly the amount she's used to. I have tried EVERYTHING! She's at the point her backbone is starting to show and you can pinch up her skin and it doesn't go back down. 

I am FREAKING! Any advice is most appreciated!


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## susan davis (Mar 25, 2011)

I am lucky. Zarita has been in heart failure for 3+ years. The meds don't seem to bother her. I have the same three medications for her. I have the first two compounded into a liquid. The lasix is 1/2 a pill. Usually one half, unless she is coughing more then I give a second lasix (1/2). I find that the liquid is easier to give (the vet gives me a few syringes) as she really dislikes pills. Zarita never had diarrhea from the meds. The pharmacy that compounds the meds is: Diamondback pharmacy in Scottsdale Arizona. Phone # is 1-866-646-2223 Your vet will have to give them the dosage or you can read it off the label. They will OK it with your vet.

As for the appetite, I'd feed her anything she wanted. Chicken, other meats, cottage cheese, regular shredded cheese, soft food. People food is not horrid at this stage. You just want her to eat. Are her teeth OK?


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## susan davis (Mar 25, 2011)

As I sat here thinking about the above post, I thought that maybe you could mince the meat up? Sometimes eating actually makes the dog have symptoms. Heart has to work harder to digest food. Several tiny/small meals though out the day? Zarita likes the small soft treats---training ones the size of your pinky fingernail.


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## MelodyoftheForest (Sep 11, 2015)

If her skin stays up when you pull it up over her neck/shoulders/back, she is VERY DEHYDRATED! Get her to the vet for some fluids!


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## lulu'smom (Jan 4, 2012)

Took her back to the vet yesterday because of her lack of appetite. Thank you, Reta, for your response. I know that normally that does indicate dehydration--which is a concern for me with her on Lasix, but I was more concerned with it's meaning in connection with her extreme weight loss. She's lost 7 oz in 3 weeks. She weighs 5 lbs 4 oz now which is the lowest she's ever weighed. The vet didn't like her weight loss, but said it was far from dangerous at this point. Just wanted to check and make sure there wasn't an underlying cause other than the meds. Thus the bloodwork--which I very much wanted any way. We never did blood work when all this happened because it was all we could do to keep her alive, then get meds sorted now fighting weight loss. Susan, thank you so much for responding!! So glad to hear Zarita is doing OK!!! Lulu has no problem taking the pills--as far as me giving and her taking. The problem came with the Pimobendan giving her HORRIBLE diarrhea and absolutely no eating. She just couldn't take it. My doctor prescribed 1/2 Lasix pill (12.5 mg) and 1/2 enaparil (2.5 mg) every 12 hours. I probably should have left well enough alone, because within a few days her breaths have come down to consistently be 36-40. Never over 40. Her resting heartrate is consistently 104-120. Never over 120. My vet says that's very acceptable, but every time she did that cough like she was hacking up a furball more that 3 times I would give her a 1/2 Lasix. I could just picture her full of fluid and drowning! When it would get within 2 hours of time for her meds she would cough more on the 1/2 Lasix and actually come get me for her meds (it could be because she liked the bit of peanut butter I hid them in). For the past week I started giving her 1 Lasix every 12 hours. My vet knows I increased her Lasix, and said it was OK if she needed it, but now I'm wondering if I'm over-reacting. He has continually told me if her breaths are good and her heartrate is good she's OK, but the coughs scare me. My husband said she's been coughing like that months--I shouldn't over-react. What do you think?

As far as food--I do mince her chicken because I found she would chew on it and not swallow if I tore it even in tiny bites. I have been putting down boiled chicken, brown rice in chicken broth, cooked hamburger meat, her Primal she usually loves, I bought Ziwi Peak again because it can be left down longer without going bad--she ate it 2 times really good, then sniffs and walks away, I even gave her some roast beef I cooked in the crock pot--the center where I was hoping salt didn't work it's way to. She ate a couple of bites and left. She did eat every bit on canteloupe I gave her but that's no nutritional value. She loves cheese and begs for it but won't eat it.


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## susan davis (Mar 25, 2011)

I think (and I'm not a vet) that giving Lulu 2 full lasix is too much, in 24 hours. If she coughs really often; like 3-4 times in a period of a hour then I would give 1/4 of a lasix. I use a 20 mg lasix, so Zarita USUALLY gets 10mg in the am. About once a week or so I'll give her another 10mg at night if she has been coughing. She always coughs after a nap, or in the am when she wakes up. She also has a really big abdomen, which the vet says is ascites. That means her heart is not able to clear the fluid and it collects in the abdominal area. Lasix also helps that.If you have a scale that does ounces, then you might weigh her in the am. If her breathing and heart rate are OK, then I'd say RELAX! As your hubby says--! Have you tried some cream cheese, or whipped cream cheese? Zarita loves it! Good luck, and keep up the good attitude! Dogs know!


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## lulu'smom (Jan 4, 2012)

The vet called this evening with Lulu's bloodwork. Thankfully nothing that can't be overcome. Her potassium is low. He said not dangerously low, but low at all is dangerous. I have had that worry/fear in the back of my mind as well. The vet said that comes from her not eating and can make her not want to eat only making things worse. He gave several options to get her potassium up and said overdoing wasn't possible at this point. I went straight to his office and picked up some Tumil-K to give her 1/2 tablet twice a day. He said of course feed her bananas if she will eat them. Unfortunately that's one of the only things she doesn't like when she's doing well.  He also said I could sprinkle a little of something called No Salt on her food. She should not have sodium chloride, but she needs potassium chloride (or maybe it's something else I can't think of at the moment). I'm just so grateful this seems to be medication issues, and at this point I feel like we can get it worked out. 

Susan, part of me really thinks I should go back to 1/2 Lasix pill every 12 hours, but the coughing has all but stopped even with the 1/2 Lasix every 8 hours. My vet said I could do whichever I felt comfortable with because he says that cough can also be collapsed trachea etc., but he also said if she's doing well on 3x a day consider leaving that for a bit. I don't want her on any more Lasix than she absolutely needs, but I'm convinced the cough is fluid or why else would it get so much better with the increased Lasix. If her breaths and heart rate are great would you back up to 2 times a day and see if the cough comes back? Thanks so much for helping me!!


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## susan davis (Mar 25, 2011)

Tina, yes I would go back to giving Lulu 1/2 a tablet every 12 hours. She probably will never stop coughing completely. Just so you know not to judge too much from the coughing. Of course if the coughing becomes more pronounced, then you can increase the lasix to every 8 hours. Zarita does well with 1/2 of a 20mg lasix a day. Yes lasix can cause some electrolyte problems, so that is why I think maybe a lesser dose might help. It can be a real 'trick' to see how much medication to give sometimes! Lula will probably cough after a nights sleep, after a nap, and sometimes just to get attention! Yes, Zarita has learned that too. When I tell her, 'its time to take your medicine', she will sometimes cough! Doesn't work! If you have any other questions just ask away, and I will try to give you an answer.


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## susan davis (Mar 25, 2011)

Tina, another issue is her not eating. Could you get some canned dog food (good quality please) and put it into a blender. Then you could put some of the blended food into a syringe and get a 1/8th of a cup down her? Maybe she would take it from a spoon?


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## susan davis (Mar 25, 2011)

Tina, maybe you could get some canned dog food (good quality please) and put it into a blender. Take the blended food and feed her 1/8th of a cup 3-4 times a day. If she won't take it from a spoon, ask the vet for a syringe and get it down her that way.


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## lulu'smom (Jan 4, 2012)

Susan, you have been so helpful!! My vet has really been great-texting with me and even calling/talking to me on weekends, but I don't want to overdo with him. She is eating a bit better, and probably "milking" it a bit too! lol I have literally finger-fed her crumbs while she was in her bed, but if it gets food down her I'll do whatever! Anyway, thank you again for caring and helping!


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## susan davis (Mar 25, 2011)

Tina, Zarita has been a picky eater since she was a wee pup. She weighed just over a pound at 12 weeks. She didn't want to eat! Never had a puppy not want to eat. We started feeding her on top of the dining room table (just too hard to keep bending over) and she ate there until early this year, when I put the food down on the floor. She will watch me to see if I'm looking, and if I am, she waves her head all over the place, before finally eating. If I am not watching, she'll eat sooner, or walk away. She always does eat, but has never been one of those 'live to eat' dogs. It is real easy to 'train' a dog to be finicky! Good luck on the feeding issue.


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## Huly (Mar 5, 2012)

You are in my thoughts and prayers


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## jan896 (Dec 9, 2009)

...Chico was the same way....once he started 'fainting'.... I knew it wouldnt be long....he is waiting for me at the Bridge now

You are in my thoughts and prayers....**HUGS**


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## susan davis (Mar 25, 2011)

Tina, I just thought of something to feed Lulu. Baby food!!! There are meats that are already pureed, and my vet recommended them to me, when one of the dogs had a severe digestive problem. Mine licked them up pretty well. Here's hoping that you can Lulu to eat.


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## lulu'smom (Jan 4, 2012)

Thanks so much for your concern Christie and Jan! It means the world to me!! Yesterday and today Lulu has been eating very good thank the Lord!!! Since I've been giving her Tumil-K twice a day and adding No Salt to her food, I believe it has helped with her low potassium and her appetite has come back. I was really trying to work her back on the Lasix to maybe 1/2 tablet every 10 hours instead of every 8 hours, but her coughing tonight has been so bad I had to give her 1/4 tablet 4 hours after her last dose. I think I'm just going to keep her on the 1/2 tablet every 8 hours. It seems to be the "magic" dosage at the moment. I really hope I'm making the right decision.


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## Huly (Mar 5, 2012)

I am happy she is doing better! Y'all are in my thoughts and prayers. Seaweed and bananas are high potassium too.


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## susan davis (Mar 25, 2011)

Sounds as if she is improving. Good. You are becoming used to what is important as a owner of a dog in heart failure! Good for you! You did the right thing in giving her a small dose of lasix when she was coughing a lot. My vet also gave me some codeine for coughing, but it upsets Zarita's tummy, so I just do what you do and watch for increased coughing.


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## lulu'smom (Jan 4, 2012)

Unfortunately bananas are the only fruit I think she DOESN'T like. I can try seaweed though--that's new to me. Of course, the additional Lasix for the cough made her queasy and she hasn't eaten well this morning at all. It's such a roller coaster--drives me crazy!!


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## susan davis (Mar 25, 2011)

Tina, Google potassium high foods. There are lots of them. I only know the banana. My roommate had to take potassium pills and they were 'horse size'!! She had to cut them in half. Good luck!


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## lulu'smom (Jan 4, 2012)

I have learned a ton this weekend! I posted how great she was doing Friday only for her to go backward on Saturday. Well, I spent much time studying Saturday. Although her dr told me this and I sorta knew it, it didn't register until I read it on a website with xray photos that (description EXACTLY as I describe Lulu's cough) a cough that sounds like they are trying to hack up a furball is very often not indicative of fluid but instead often times associated with among other things an enlarged heart pressing on the bronchial tube. If cough is persistent it is treated with cough suppressant--as Susan said. Lulu didn't have any fluid in her lungs Tuesday when she went to the vet, but Friday evening when she had a coughing spell I gave her 1/4 Lasix between doses. Then Continued on with 1/2 tab Lasix every 9 hours. I believe that's why she went backward on Saturday. 
I couldn't stand it any more and took her to the ER during the night Saturday night. I knew they would do blood work and have immediate results and could do xrays. They did so, and her blood work showed her potassium level is actually now 1 point WITHIN normal. Coming up!! Her BUN, which was 77 with Tuesday's blood work, had come down to 55, and her Creatinine, which was too low Tuesday was beautiful! The dr showed me her xray which showed no fluid in her lungs, and was textbook case of an enlarged heart pressing on her bronchial tube. They gave her a medication to stimulate appetite that I can give her when neccesary, but I have changed her meds to 1/4 Lasix and 1/2 enaparil every 12 hours. 
He also made me understand she is not now in active CHF, and that looking at her xray, with proper medication there was no reason to think she wouldn't continue a relatively normal chihuahua life expectancy (although I understand no one knows the future). It's the first time I've felt like I really grasped what I've been told and had hope although I have to point out my dr has told me every bit of that. I think it was seeing the xray and the 2 blood work results to close together and the research I had been doing.
I wanted to say too that I requested all her results in writing, and when they emailed it to me and I was looking it over I noticed that I had taken Lulu to the ER in September of last year they made a note that her heart was normal with no murmur. My vet had told me on her check-up berfore last she didn't have any murmur. He heard a murmur on her last check-up. They called it a grade 5 murmur in the ER last night, so from all that I'm guessing she has developed this murmur in the past year.

Thanks everyone, especially Susan, for your care and suggestions to me! It's just really nice to have someone to talk with about this.


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## Huly (Mar 5, 2012)

Hugs! We are all here for you and Lulu. Let me know if you need anything or just a ear to listen!


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## susan davis (Mar 25, 2011)

This is exactly what Zarita has. Enlarged heart pressing against the trachea, which is already collapsted! I'm glad you got someone that was willing to show you on x-rays what was happening. Seeing is believing!


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