Congestive heart failure (CHF) is a common end-stage condition in older dogs, particularly small breeds, requiring compassionate medical management focused on comfort and quality of life.
Congestive heart failure causes significant respiratory distress — the sensation of breathlessness is acutely distressing for dogs, as it is for any air-breathing animal. Poorly controlled CHF means dogs experience episodes of gasping, inability to sleep lying down, and profound fatigue. Optimal medical management dramatically improves comfort — dogs on pimobendan and furosemide often resume normal activities and regain quality of life. Monitoring for acute decompensation (sudden worsening breathlessness) and having a plan for emergency furosemide dosing is essential. The welfare question of when to euthanise must be addressed proactively — breathlessness that cannot be controlled with medication represents an endpoint beyond which continued treatment prolongs suffering rather than life.