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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16471
Experience:  Over 20 years of experience as a veterinarian.
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My yorkie has been diagnosed with congestive heart failure.

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My yorkie has been diagnosed with congestive heart failure. She is on three medications including a lasic to help with her fluid. Last night was a really tough night. She couldn't get comfortable and roamed around most of the night. She coughed quite a bit and scratched like crazy. I don't understand the scratching - is it related at all. She had Revolution applied after she was groomed earlier this week. Would that have any effect on the heart? My vet didn't give me any indication that it would. Also, how will I know when it's so advanced that I should take action? She was just diagnosed about three weeks ago and was doing pretty good with the medication until last night. It was an awful night and I don't want her to have to go through that just because I still want her around. She's still eating well and walks at least four to six blocks a day. She does like to be cuddled but often goes off on her own to find another place to lay down. Just looking for some guidance. Thanks so much.

Hello, I am sorry to hear that Holly had such a difficult night.
While Revoution should not affect her heart at all if she is stressed, itchy and uncomfortable that will. Has she ever had Revolution applied before? Some dogs do have a sensitivity to it and that will cause reddened, itchy skin or sometimes a "skin crawling" type effect as the medication distributes in the fat layers/oil glands of the skin.Sometimes this effect only lasts for a short period of time until the medication is distributed. If it persists I would pick another medication for heartworm prevention and flea control for her.
Dogs with uncontrolled congestive heart failure do seem to have more trouble at night than during the day, when they lay down they have more difficulty breathing and pressure on the trachea increases.
How is she this morning?
Does her skin seem pinker than normal?
What is her gum/tongue color? Bubblegum pink, gray, blueish?

If her cough persists today, especially if her appetite seems off, I do recommend you have her rechecked by her veterinarian.
In the meantime you might try bathing her with an oatmeal shampoo and cool water to soothe her skin. I suspect that she is sensitive to Revolution and her difficult night was a stress response to that more than her heart disease,. But if you are unsure and her gum/tongue color isn't normal then it never hurts to have her rechecked.
Let me know if you have any further questions.

Customer: replied 5 years ago.
I am at work right now so I can't check her gums/tongue. She ate heartily this morning and my husband said she didn't lag when he walked them so maybe it was the sensitivity to Revolution. She has had it before but not for several months as we have not had a flea problem this year. I only started it now because summer is almost here and I don't want her getting any fleas. We used to use Advantage but the fleas seemed to attack in spite of it. Then we tried Comfortis but that didn't work either. The vet recommended Revolution because it's stronger and more effective and it worked wonders last year. I have asked my husband to check her tongue color and will let you know once that answer is received. I will be back to you soon.
Thanks for the further information.
I am glad to hear about her good appetite and normal activity on her walk. Very encouraging.
I understand about flea prevention. Perhaps try Frontline Plus as a flea prevention rather than Revolution. Advantage Multi is another option but it has moxidectin in it which is in the same family of drugs as selamectin (Revolution's active ingredient) so she may have a similar reaction. Although she may be reacting to the vehicle (part that the active ingredient is dissolves in and moves the product over the body) rather than the actual active ingredient.
Customer: replied 5 years ago.
Thanks again. My other question in the original text was what should I be looking for to know that the end is near? I feel like I felt when I was first pregnant and getting close to the delivery -- every little twinge was like "is that it?" but there was no doubt when the time really came. I just want to be prepared and not rush her out to the emergency veterinarian in the middle of the night and spend thousands of dollars just to end up putting her to sleep anyway. I'd like to know how to tell if the disease is progressing rapidly or if she's still raring to go for a few more years. Also, if it is progressing, how will I know when it's time so she doesn't suffer. I try to imagine what it would be like not to be able to breathe and can't even go there. Sorry to keep asking but I just want to do the right thing.
I understand your concern. In most cases dogs with heart failure can be controlled and do well for a long period of time.
Signs to watch for are a consistent decrease in appetite, poor mucous membrane color (white, blue or gray in color), difficulty sleeping, coughing that cannot be controlled, inability to play or go or walks as she has enjoyed in the past.
She will have a cough her and there, and she may be a little less active but the key is consistent difficulties and poor perfusion (gray or blue mucous membrane color). Those are the key signs things aren't going well.
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