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Signs of a Dog Dying of Congestive Heart Failure (CHF)

Congestive heart failure (CHF) occurs when the heart cannot pump blood adequately throughout the body, resulting in blood backing up into the lungs and fluid accumulating in the body cavities. This constricts the heart and lungs, preventing sufficient oxygen flow throughout the body. In most cases of CHF, the issue is not reversible. Here are some signs that your dog might be nearing a stage where they need hospice care or you might consider euthanasia.

What Are the Signs of a Dog Dying of Congestive Heart Failure?

There are several stages of congestive heart failure:

  • Stage A: The dog is high-risk for CHF but has no symptoms and no changes to the heart.

  • Stage B1: The dog has a heart murmur but no other signs.

  • Stage B2: The dog has a heart murmur in addition to structural changes to the heart, but no clinical signs.

  • Stage C: The dog has a heart murmur, structural changes to the heart, and clinical signs associated with CHF. These dogs are typically treated.

  • Stage D: The dog has CHF and is not responding to standard therapies. The dog will require special treatment strategies.

The clinical signs for CHF are similar once a dog reaches Stage C and D. These clinical signs that a dog is dying of congestive heart failure are:

  • Coughing

  • Constant panting

  • Issues breathing while indoors

  • Rapid breathing, especially at rest

  • Reluctance or refusal to exercise

  • Easily tired after walking and playing

  • Blue-tinged gums

  • Distended abdomen

  • Coughing up blood

  • Collapse

Monitoring Your Dog’s Quality of Life With Late-Stage CHF

As CHF progresses into the hospice/palliative care stages (starting at Stage C), your veterinarian will focus on maintaining your dog’s quality of life. Some questions that your vet may consider and discuss with you include:

  • Can the dog breathe comfortably on their own?

  • Does the dog enjoy meals?

  • Does the dog enjoy interactions with their family?

  • Can the dog get around to pee and poop with dignity and rest comfortably?

It’s important to check in regularly with the veterinary team to help maintain your dog’s quality of life. Possible complications can come up as a result of disease progression or a side effect of medication. Some of these complications have signs you can see, but others will only show up in lab work at the vet’s office. These may include:

  • Lack of appetite

  • Pulmonary edema (fluid in the lungs)

  • Ascites (swollen belly from fluid in the abdominal cavity)

  • Gastrointestinal ulceration

  • Anxiety

  • Diarrhea

  • Weight loss and muscle mass loss

  • Changes in electrolyte blood work values:

  • Hypochloremia (low blood chloride)

  • Hyponatremia (low sodium in blood)

  • Hypokalemia (low potassium in blood)

  • Hyperkalemia (high potassium in blood)

  • Kidney disease/failure

When Should You Euthanize a Dog with Congestive Heart Failure?

The decision to euthanize a pet that has congestive heart failure is a very difficult and personal choice. While input from your dog’s vet—such as blood work values, physical exam findings, and cost—are all important to consider, your dog’s quality of life and your own concerns are also important factors that can vary greatly.

You know your pet best, and you also know what you are capable of doing for your pet. You also know when your pet seems to be having a really hard time. So when it comes to answering the question, “Is it time?” the answer for your pet may be different from someone else’s pet, even if they are in a similar situation.

Your veterinary team is there to help you and your pet by giving support in any way they can. There is no shame in letting your pet go when a diagnosis is reached, nor is there any shame in supporting your pet until there may be more bad days than good.

Quality of life checklists can be very helpful in giving a more objective outlook, and you can review these with your vet to get a clearer picture. Here are some helpful resources for assessing your pet’s quality of life:

  • Lap of Love Pet Quality-of-Life Scale

  • Lap of Love Daily Assessment

You can also use this Quality of Life Scale by Dr. Alice Villalobos to evaluate your pet:

  • Quality of Life Scorecard for Dogs

Because every experience is different, it may be helpful to create your own quality of life checklist and discuss it with your dog’s vet as well as any family members, friends, and others who are involved in your pet’s care. This will help make sure the list is reasonable and true to the needs of both you and your pet.

Frequently Asked Questions (FAQs)

Q1: What are the signs that my dog is nearing the end stages of CHF?A1: Signs include coughing, constant panting, issues breathing indoors, rapid breathing at rest, reluctance to exercise, blue-tinged gums, distended abdomen, coughing up blood, and collapse.

Q2: Can symptoms of CHF in dogs be managed?A2: Yes, symptoms like cough and trouble breathing can be managed with bronchodilators, antibiotics, corticosteroids, cough suppressants, environmental modification, and weight loss.

Q3: How can I monitor my dog’s quality of life with CHF?A3: Regular check-ins with your vet are crucial. Consider whether your dog can breathe comfortably, enjoy meals, interact with family, and move around to relieve themselves with dignity.

Q4: What complications should I be aware of with late-stage CHF?A4: Complications can include lack of appetite, pulmonary edema, ascites, gastrointestinal ulceration, anxiety, diarrhea, weight loss, and changes in electrolyte levels.

Q5: When should I consider euthanasia for my dog with CHF?A5: The decision is personal and should be based on your dog's quality of life and advice from your vet. Consider factors like your dog’s ability to breathe comfortably, enjoy meals, and interact with family.

Q6: Are there resources to help evaluate my dog’s quality of life?A6: Yes, tools like the Lap of Love Pet Quality-of-Life Scale and Dr. Alice Villalobos' Quality of Life Scorecard can be very helpful.


Congestive heart failure in dogs is a serious condition that requires careful management and monitoring. Understanding the signs and symptoms of CHF, as well as knowing how to monitor and maintain your dog's quality of life, can help you make informed decisions about their care. Regular consultations with your veterinary team and utilizing quality of life scales can provide valuable insights into your dog’s well-being and help guide your decisions about their care and treatment.

Dog Dying of Congestive Heart Failure
Dog Dying of Congestive Heart Failure


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