Congestive heart failure (CHF) is common in older small-breed dogs and represents a significant welfare challenge requiring careful management of symptoms, quality of life, and end-of-life decision-making.
CHF creates a chronic welfare burden through multiple mechanisms. Pulmonary edema - fluid in the lungs - causes the sensation of air hunger or drowning, one of the most distressing forms of suffering. Exercise intolerance means dogs can no longer engage in activities they previously enjoyed. The medication burden is significant: multiple daily pills, regular vet visits, and the emotional strain of monitoring for decompensation episodes. Episodic acute decompensation - sudden worsening of symptoms - causes acute suffering and emergency veterinary interventions. End-of-life decisions in CHF are among the most difficult: the disease can have good periods interspersed with acute crises, making the timing of euthanasia genuinely difficult.