Abdominal swelling due to congestive heart failure ... what would you do???

28866 Views 9 Replies 10 Participants Last post by cmoorewv, Jun 7, 2012

Barton Hills

Discussion Starter · Jun 6, 2012

I'll try to keep this short as possible ... looking for opinions.

Boston Terrier ... 8.5 years old
She is like a child to me and my wife
Diagnosed with a huge heart murmur as a puppy
Most active dog I've known
No real medical issues until 2 months ago
Fluid build-up started in the abdomen, due to heart issues, had her put on medication
Was "fine" for 2 months, although fluid build-up never went away ... it was only managed
I'm told the fluid, when lots is present, impedes ability to breathe ... can be painful and cause lots of pressure
During this process dog was completely normal, never lost appetite, still demands to play, no signs of pain, etc.

Fast forward to this Sunday ...

Build up got worse
Fluid moved to hind legs
Breathing was really labored ... I could tell she was in pain
Trouble walking
Took her to vet, tests were ran
Everything "normal", other than confirmation of congestive heart failure
Abdomen was drained (TWO liters), meds were increased

Doc stated that this amount of fluid is VERY uncomfortable for a dog. With how bad her heart is, doc stated we may want to start conversations of putting her down in the near future. Also told me she is really only comfortable draining fluid like this about two times.

But I wanted to see how my pup responded to the drain ...

She was like new. Running, jumping, eating like a horse ... overall very happy. I can tell that even on the new regimen of pills the fluid is slowly starting to come back, but nothing major as of today. I've read that these "drains" can be performed as often as every two weeks, even though the vet we are seeing says otherwise.

My question for you:
If you have a dog, who is very happy and not experiencing much pain (unless belly is completely full of fluid), would you continue to do the fluid drains if it resulted in 1-2 weeks of happiness at a time?

Or does the temporary discomfort when her belly is full warrant the consideration of putting her down??

If this was a constant pain, no question I'd put her down. But her normal behavior when the fluid is not there makes me think the procedure is worth doing.

As of today, my thought is that if my dog can go 1-2 weeks without needing a drain, then this is semi-managable. Of course if the fluid starts returning more rapidly then we have a problem.

Thoughts? I'm torn up on this. I'll stop rambling.

How can I talk about putting a dog down when they are running around the house normal as can be the majority of the time?

And for clarification, I realize that if the full fluid accumulation returns in less than a week, that these drains are not sustainable. This is only on option if the meds can fight off the need for a drain for at least 1-2 weeks at a time.

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oldhounddog

· #2 · Jun 6, 2012

Barton Hills ,
I can not give any advice to you , but my heart goes out to you and your dog.
You are making a great effort and I hope it works for your dog. Anything beyond this you know more than anyone else. I wish you and your dog the best.

oldhounddog

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Bordermom

· #3 · Jun 6, 2012

That's a tough one! I feel bad for you and your family.

I do think that dogs don't tend to show pain till it's really, really bad, so it's likely that she's uncomfortable for a bit before she's really in a lot of pain. What you have to find out is if it is managable long term, or if it's going to get worse anyway, and if so, how long that will be - are you delaying something that is only going to give you a few more months, or years? Is there another vet you can get advice from to see what the options are?

Thinking of you guys and hope you find the right answers.

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Amaryllis

· #4 · Jun 6, 2012

My MIL has congestive heart failure. She's on 13 different medications to control it, and I saw her before they made the diagnosis, did the quadruple bypass and put her on all those meds. She managed to go to work and pretend everything was okay, but she was suffering. CHF isn't all about the fluid buildup. The heart just isn't working right. There's fatigue, joint pain, headaches, shortness of breath, urinary symptoms, it's a mess. (She was misdiagnosed with Fibromyalgia because doctors just don't think heart disease in women. It's a huge problem.)

That being said, my general rule is twofold. 1. Do the good days outnumber the bad? If the good days are less than or equal to the bad, I consider euthanasia a kindness. 2. How much is the dog hiding? Say discomfort/pain is a scale from 0 -10. 0 is no pain, 10 is supreme agony. If my dog is only showing 8 or above, but I know he's at a 5 or above every day, again, there are fates worse than death.

It's up to you. I am so sorry this is a decision you have to make. Make it with love and you are blameless.

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Curbside Prophet

· #5 · Jun 6, 2012

Barton Hills said:
My question for you:
If you have a dog, who is very happy and not experiencing much pain (unless belly is completely full of fluid), would you continue to do the fluid drains if it resulted in 1-2 weeks of happiness at a time?

Or does the temporary discomfort when her belly is full warrant the consideration of putting her down??

If this was a constant pain, no question I'd put her down. But her normal behavior when the fluid is not there makes me think the procedure is worth doing.

As of today, my thought is that if my dog can go 1-2 weeks without needing a drain, then this is semi-managable. Of course if the fluid starts returning more rapidly then we have a problem.

Thoughts? I'm torn up on this. I'll stop rambling.

How can I talk about putting a dog down when they are running around the house normal as can be the majority of the time?

And for clarification, I realize that if the full fluid accumulation returns in less than a week, that these drains are not sustainable. This is only on option if the meds can fight off the need for a drain for at least 1-2 weeks at a time.

For me, all of this doesn't describe the kind of life I want for my dog. I've been at this point before, and I felt I did right by my dog by putting him down. 8.5 years is a decent life, my opinion only.

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Abbylynn

· #6 · Jun 6, 2012

I am so sorry you are going through this. I whole heartedly agree with what Amaryllis posted. I had to make that fateful decision 2 months ago. Different disease ... but the quality of life and pain and ability to not be able to save my guy ... outweighed my tremendous desire to keep him with me.

I am keeping all of you in my thoughts and prayers.

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Hambonez

· #7 · Jun 6, 2012

Is there a veterinary cardiologist within a reasonable distance that you could go see? If not, what about another vet in the area for a second opinion? I'd get a second opinion, preferably from a specialist, before I made any decisions. Good luck to you and your pup.

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spotted nikes

· #8 · Jun 6, 2012

I had a Cocker that went thru that. Her CHF was misdiagnosed, so by the time she got meds for it, her abdomen was like a water balloon. Vet drained about 2 lbs of fluid off her, and she went from lethargic and not eating, to playing with her toys and eating and being normal. Kept her on Lasix, and 2 heart meds, and 2 weeks later she ballooned up again/stopped eating, so drained again. Ended up needing to drain her weekly, and each time, she sprang back. After about 3 months, she no longer got the swelling in her abdomen, but instead her lungs got fluid in them, and she stopped eating. I put her down then.

After going through that, I always swore, I would never do that to a dog again. I think I kept her going for me, not because of what was best for her. So, yes, the draining and meds can buy you time. If she is ok with going to the vet often, then, it can buy time, when combined with meds. But it won't buy much time, and you need to realize that the time will come, when the fluid will not build in the abdomen, but instead start filling the lungs. You do not want to see a dog suffocate. And it seems to come on that way pretty quickly. So you need to be aware, and have access to a vet 24/7. They don't generally just die peacefully in their sleep when they have CHF.

Sending you hugs, because putting a pet down, and making the decision of when is awful.

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hanksimon

· #9 · Jun 7, 2012

What Nikes said - Lasix is a diuretic used on people for CHF and for high blood pressure. Just from the mechanics of the fluid, the heart weakens, builds up fluid, weakens more, causes fluid build up in the lungs, increasing the fatigue, resulting in more fluid, putting a strain on the kidneys. In people, the lungs and heart tend to be the weak point, in dogs, the kidneys can get overloaded very quickly. The problem with the fluid fill is that heart, lung, and kidneys are degrading rapidly.

Let me echo Nikes very bluntly - you do not ever want to participate in an emergency euthanasia when the dog is suffering. It's much, much easier on the dog and on you to follow the advice of the Vet and relieve the dog of suffering, when he first starts to go downhill.

It is much easier to recover from the guilt of euthanizing a friend who will eventually die painfully ... than it is to release a friend who is suffering through the process of dying painfully... especially in the middle of the night. I don't mean to be so rude, but I've been through the second scenario (not CHF), and it took me a long time to get over it, even after getting a new puppy...

Unless a Vet cardiologist or a Vet college has some other treatment, I agree with the others that this is the time to have good times and make memories.

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cmoorewv

· #10 · Jun 7, 2012

I, too, am very sorry to hear what you and your dog are going through. I lost my beloved chow when he was 9 to congestive heart failure. He swelled up with lots of extra fluid and was gone within a week. Lasix didn't do anything for him. But he was a large dog. Little dogs may respond better to diuretics. I knew it was time to let him go when it was an effort for him to even sit up. My thoughts are with you.

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