Kopi The Cavalier King Charles Spaniel: Congestive Heart Failure

There are many causes of congestive heart failure in dogs. Mitral valve disease (MVD) is a degenerative disease of the heart valves affecting the mitral valve on the left side of the heart. MVD is a common cause of heart murmur and congestive heart failure in dog breeds like Cavalier King Charles Spaniels.

Prognosis is guarded once signs of congestive heart failure develop. Left-sided congestive heart failure leads to fluid build-up in the lungs which can cause coughing and breathing difficulties in your dog.


As the condition progresses to right-sided congestive heart failure, fluid accumulates in the abdomen (ascites) which gives 7-year-old Kopi a heavy pot-bellied appearance. Owners may mistake fluid accumulation as weight gain. Very often, body mass is actually decreasing.



  • The heart is divided into 4 chambers: right atrium (RA), right ventricle (RV), left atrium (LA), left ventricle (LV).
  • Blood enters the RA from the head, neck and abdomen, and flows into the RV where it is pumped through the pulmonary artery into the lungs.
  • Blood is then oxygenated before it flows back to the heart into the LA and then the LV. The oxygenated blood is then pumped forcefully from the LV into the aorta and back into the rest of the body.
  • A valve is present between the upper and lower chambers of the heart (tricuspid valve and mitral valve) and between each ventricle and major blood vessel (pulmonary valve and aortic valve). The function of these valves is to prevent the blood from flowing backwards as the heart pumps.

Radiography is an important diagnostic tool to identify cardiomegaly & presence of fluid in the lungs. X-rays showed Kopi’s heart was severely enlarged & pressing onto the trachea.


An enlarged heart pressing onto the trachea can lead to coughing & breathing difficulties. Dr Jade Lim, AMK Veterinary Surgery, also detected heart murmur of grade 5/6.

Common signs of congestive heart failure
  • coughing
  • tachypnea (rapid breathing)
  • dyspnea (laboured breathing)
  • lethargy
  • poor appetite
  • weight loss & muscle wasting
  • sudden collapse

Abdomenocentesis was done to remove excess fluid from Kopi’s abdomen. A needle is inserted into the abdominal wall to drain excess fluid so that Kopi feels more comfortable & can breathe more easily. A total of 2.4L of fluid was drawn out. After the procedure, Kopi weighs 6.06kg.


Kopi continues with the necessary medications to manage her heart condition. Diuretics like furosemide help to flush excess fluid out of the body. Pets on diuretics will drink & urinate more, so they should always have excess to fresh water.


Another patient, a 16-year-old Jack Russell Terrier, is also living with congestive heart failure & ascites.


230ml of fluid was removed from her abdomen today.

Congestive heart failure is a progressive disease. Pets living with congestive heart failure have to monitored very closely, especially for signs of breathing difficulties. Limit your dog’s activities to avoid straining the heart and provide a low-salt diet to decrease fluid build-up in the body.

When medical therapy fails to manage your dog’s condition and provide a good quality of life, euthanasia is the kindest option.

While it is tough to see Kopi living with congestive heart failure, we are glad her family is positive and optimistic. No doom and gloom for this sweet girl who was wagging cheerfully after the procedure. Dogs always find a reason to be happy, don’t they?