When To Euthanize a Dog with Congestive Heart Failure

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vet examining dog including heart rate check

As a veterinarian, I understand that few topics are as heart-wrenching and emotionally challenging for pet owners as the decision to euthanize a beloved dog. When it comes to congestive heart failure (CHF), this decision becomes even more complex due to the progressive nature of the disease and the impact it has on our dogs’ quality of life.

Over the years, I have walked alongside many dog owners as they navigate the path of managing CHF in their companions (make sure you alreayd read my article about caring for a dog with congestive heart failure). It is a difficult choice that requires careful consideration, empathy, and support. In this article, I will guide you through this journey and provide you with all the information you need to make a compassionate and informed decision for your beloved dog. 

What is Congestive Heart Failure?

Congestive heart failure, or CHF, is a condition in which a dog’s heart struggles to efficiently pump blood around the body. The most common causes of Congestive heart failure (CHF) in dogs is underlying heart disease that leads to an enlargement of a dog’s heart. Other causes could include genetic factors, age-related changes, or other health issues resulting in strain on the heart. 

An enlarged heart is an inefficient heart: since blood can’t be pumped efficiently, fluid builds up in the tissues of the body, including the lungs. This makes it increasingly difficult for a dog to breathe, resulting in many of the symptoms described below.

Signs of congestive heart failure

The main symptoms of congestive heart failure in dogs can vary depending on the severity of the condition. Common symptoms include:

Coughing: Dogs with congestive heart failure may have a persistent cough, especially during physical activity or at night.

Increased breathing effort: Dogs may experience difficulty breathing, characterized by rapid or labored breathing, shortness of breath, or shallow breaths.

Fatigue: Dogs with congestive heart failure may seem lethargic, have decreased energy levels, and appear weak.

Decreased Appetite and Weight Loss: Dogs may show a reduced appetite, leading to weight loss or poor body condition.

Fluid Build-Up: Congestive heart failure can cause fluid to accumulate in the abdomen (ascites) or in the lungs (pulmonary edema), resulting in a distended belly or bloated appearance. 

Pale or Bluish Gums: In severe cases, dogs may have pale or bluish gums due to poor oxygenation.

When to Euthanize a Dog with Heart Failure

Deciding when to euthanize a dog with congestive heart failure can be challenging. As heart failure progresses, it’s essential to closely monitor the dog’s quality of life. Assessing their capacity to partake in everyday activities, ascertaining how relaxed they are, and evaluating their overall healthiness should be done carefully. If the pooch’s quality of life has greatly diminished, it may be an indication that euthanasia should be thought about.

While every situation is unique, there are some signs that may indicate it’s time to consider euthanasia for a dog with heart failure:

  • Lack of response to treatment: If the dog’s condition does not show any signs of improvement despite medical interventions, it may be a sign that their quality of life is diminishing.
  • Severe symptoms: Dogs experiencing severe symptoms such as extreme difficulty breathing, constant coughing, or extreme fatigue may be suffering.
  • Loss of interest in food and activities: If the dog is no longer interested in eating or the activities they once enjoyed, it may be a sign that their quality of life has significantly reduced.

Discussing euthanasia with your veterinarian is essential in the decision-making process, as they can give advice based on their expert knowledge and help you understand the potential advantages and disadvantages of euthanizing your dog under its particular circumstances. 

Key Signs that your Dog is in Late Stages of Congestive Heart Failure

heart rate exam of a senior dog

Heart disease is a progressive condition – depending on when your dog is first diagnosed, their symptoms might not seem too bad at first; occasional coughing and getting out of breath faster are the most common early symptoms.

However, symptoms may get worse over time and while medication can help manage the condition, there often comes a point where heart disease can no longer be controlled effectively. Symptoms that indicate that this might be the case include:

  • Rapid Breathing – Gasping for air is common in dogs with late stage heart disease as they can’t get enough oxygen into their system.
  • Constant coughing – The fluid accumulation in the lungs of dogs with late stage heart failure results in almost constant coughing as your dog attempts to clear their airways. This can result in coughing fits that may seem painful, lasting for up to 5 minutes at a time.
  • Fatigue and Weakness – In the last few days of a dog’s life with CHF, they may be extremely weak, barely able to move and might even faint or collapse. Dogs at this stage of the disease process will likely stay in their bed and be unwilling to take part in the activities that they are used to such as walking or playing. 
  • Lack of Appetite & Weight Loss – Dogs with late stage heart failure often lose their appetite completely, refusing to eat even the tempting foods. This can result in dramatic weight loss to the point where your dog’s ribcage and spine become visible.
  • Blue gums – a lack of oxygen can lead to blue-ish colored gums, this is a sign that heart disease has progressed to a potentially life-threatening point.

Options for Treatment and Management of Heart Failure in Dogs

Congestive heart failure can be a daunting diagnosis for dog owners. Despite the severity, there are numerous treatment strategies available to manage this condition:


Medication is often the initial approach when combating canine heart disease. A mix of ACE inhibitors, diuretics, and beta-blockers could potentially improve your the efficiency of your dog’s heart and reduce fluid buildup in the lungs.

Lifestyle Modifications

In addition to medical intervention, making certain lifestyle changes also plays an important role in maintaining your dog’s health after they’ve developed congestive heart failure. Regular exercise (as tolerated), weight management, and feeding them a low-sodium balanced diet can support overall wellness, slowing down the progression of the disease.

Life Expectancy of a Dog with Congestive Heart Failure

The life expectancy of a dog with congestive heart failure is contingent upon the severity of the disease, any underlying cardiac issues, and how they respond to treatment.

Pinning down an exact average life expectancy is tricky because each case relies so much on individual circumstances. Generally speaking, most veterinarians estimate anywhere between 6 to 24 months post-diagnosis, depending upon the various aforementioned factors. A study published in the Journal of Veterinary Internal Medicine found that the median survival time after the diagnosis of advanced heart failure in dogs was 281 days (a little over 9 months). However, remember that this is a “median” time and many dogs will live more than 9 months.

What is the longest a dog can live with congestive heart failure?

It’s difficult to predict how long a dog might live with congestive heart failure; it depends on so many factors as we have mentioned before. Dog that are diagnosed early, are regularly monitored and are treated with medication live significantly longer – according to the same study, the longest time a dog lived after diagnosis was 885 days, or about 2 years and 5 months.  You can learn more with our veterinarian article about life expectancy of dogs with congestive heart failure.

Monitoring your dog’s quality of life with late-stage congestive heart failure

In late-stage heart failure, monitoring a dog’s quality of life is crucial to ensure their comfort and well-being. Here are some steps that owners can take to monitor their dog’s quality of life:

  1. Regular veterinary check-ups: Schedule regular appointments with a veterinarian to assess the dog’s condition, adjust medications if needed, and discuss any changes in symptoms or behaviors.
  2. Observe breathing patterns: Pay attention to any changes in your dog’s breathing, such as increased effort, rapid breathing, or coughing. These can be signs of worsening heart failure.
  3. Monitor activity level: Keep track of your dog’s energy levels and exercise tolerance. If you notice a significant decrease in activity or difficulty performing everyday tasks, it may indicate a decline in their quality of life.
  4. Assess appetite and weight: Changes in appetite, weight loss, or fluid retention (seen as a bloated abdomen) should be monitored. These can be indicators of heart failure progression.
  5. Evaluate comfort and restlessness: Watch for signs of discomfort, restlessness, or signs of pain. This can include pacing, difficulty finding a comfortable position, or vocalization. Consult with a vet if these symptoms persist.

Learn more with my article about caring for a dog with congestive heart failure.

Cost of euthanizing a dog

The cost to euthanize a dog can vary depending on several factors, including location, the size of the dog, and the specific services chosen. 

The cost typically starts around $50 at a veterinarian’s office or pet hospital, but it can be higher in certain regions. At-home pet euthanasia services usually range from $250 to $400, with additional fees for larger dogs, after-hours, or holiday services. Nonprofit organizations may offer lower-cost options, typically between $50 and $100. Prices for communal cremation or private cremation can also vary.

For more information of the options and cost available to you when euthanizing a pet, see our break-down here. It is recommended to contact local veterinarians or clinics for accurate pricing information based on individual circumstances.

What can we do to make this process easier for our pets?

Owners can take certain steps to make the process of euthanizing their pet easier for both themselves and their beloved animal. Here are some suggestions:

  • Seek professional guidance: Consult with a veterinarian who can provide support, advice, and information about the euthanasia process. They can explain the options available and answer any questions or concerns.
  • Consider at-home euthanasia: Instead of taking the pet to a veterinary clinic, owners may opt for in-home euthanasia services. This can provide a more familiar and comfortable environment for the pet and allow the family to say goodbye in the privacy of their own home.
  • Prioritize comfort: Ensure that the pet is as comfortable as possible leading up to the euthanasia appointment. This may involve providing soft bedding, offering favorite toys or treats, and creating a peaceful and calm atmosphere.
  • Be present and provide emotional support: It can be comforting for both the pet and the owner to be present during the procedure. Offering gentle words, gentle touches, or simply being there can provide reassurance and a sense of closure.
  • Consider sedation: Talk to the veterinarian about the possibility of administering sedatives to the pet before the euthanasia process. This can help relax the animal and minimize any anxiety or discomfort they may experience.
  • Create a peaceful environment: Dim the lights, play soft music, or use aromatherapy to create a serene and peaceful environment. This can help reduce stress and create a more calming atmosphere for the pet and the family.
  • Seek support: Reach out to friends, family, or support groups who have experienced similar situations. Sharing feelings, memories, and concerns can provide comfort during this difficult time.


What food strengthens dog heart? Does it help with CHF?

Certain foods can contribute to overall heart health in dogs. Including these foods in their diet may provide some benefits. Good options include fatty fish (rich in omega-3 fatty acids), berries (packed with antioxidants), leafy green vegetables and lean proteins. While a healthy diet can support cardiovascular health, it is important to note that food alone cannot cure or treat CHF. CHF is a serious condition that requires proper medical management, including medication and veterinary supervision.

What medication is used for heart failure in dogs?

Several medications are commonly prescribed for the management of heart failure in dogs. These include diuretics like fursemide to help remove excess fluid from the body, ACE-inhibitors to help dilate blood vessels, aiding circulation and beta-blockers to help improve heart function. Pimobendan is another commonly used drug that helps improve the pumping capacity of the heart.

Is there anything else I can do at home to help my dog with CHF?

There are several things that owners can do at home to help support the well-being of a dog with CHF, these include maintaining a calm and stress-free environment, monitoring your dog’s weight, avoiding strenuous activities but still making sure your dog is active and ensuring they eat a quality balanced diet.


  • Dr Alex Crow, Veterinary Surgeon

    Alex Crow, VetMed MRCVS, is an RCVS accredited Veterinary surgeon with special interests in neurology and soft tissue surgery. Dr Crow is currently practicing at Buttercross Veterinary Center in England. He earned his degree in veterinary medicine in 2019 from the Royal Veterinary College (one of the top 3 vet schools in the world) and has more than three years of experience practicing as a small animal veterinarian (dogs and cats).

Disclaimer: This website's content is not a substitute for veterinary care. Always consult with your veterinarian for healthcare decisions. Read More.

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