THERAPEUTIC MANAGEMENT OF CONGESTIVE HEART FAILURE (CHF) IN DOGS

Abstract

Congestive heart failure (CHF) is a progressive syndrome resulting from myocardial or valvular alterations, with the most common causes in dogs being myxomatous mitral valve disease (MMVD) and dilated cardiomyopathy. This study aims to conduct a narrative literature review on the therapeutic management of congestive heart failure (CHF) in dogs, highlighting the cardiotoxic potential of doxorubicin, possibilities for drug combinations, neurohormonal blockade strategies, proteomic alterations involved in the pathophysiology of the disease, and more efficient methods of clinical evaluation, aiming to enhance the therapeutic response. The methodology included reviewing articles published in the last five years in the PubMed database, with an emphasis on pharmacological protocols and strategies for more effective clinical monitoring. The results indicated that current protocols for CHF secondary to MMVD prioritize dual blockade of the renin-angiotensin-aldosterone system (RAAS). In the acute phase, intravenous furosemide remains the gold standard, along with natriuresis as a prognostic marker. Additionally, monitoring doxorubicin cardiotoxicity and the use of proteomic biomarkers represent crucial advances in individualizing treatment and broaden the management and understanding of the disease. It is concluded that optimizing the therapeutic management of CHF in dogs depends on the integration of multimodal therapies, combined with the use of biomarkers and individualized monitoring. Implementation of dual RAAS blockade demonstrates a greater increase in survival, while natriuresis measurement is used as an indicator of diuretic efficacy. Furthermore, surveillance against drug cardiotoxicity and the diagnostic potential of proteomics are fundamental for early staging, allowing for more targeted interventions.