Cardiology NAVLE Guide
Canine and Feline Congestive Heart Failure: Clinical Approach
CHF management requires integrating staging, medication strategy, and monitoring priorities. This guide covers species differences, decompensation recognition, and practical treatment sequencing for exam success and clinical application.
Use this guide to move from first-pass pattern recognition to structured diagnostic and treatment logic. The flow is designed for NAVLE-style decision sequencing and practical ward preparation.
Rapid Algorithm
- Recognize respiratory distress patterns consistent with pulmonary edema or pleural effusion from cardiac origin.
- Assess oxygen needs and provide supportive care while gathering diagnostic context.
- Determine ACVIM stage to guide acute and chronic management decisions.
- Initiate decongestive therapy appropriate to species and presentation severity.
- Establish monitoring plan with clear escalation and follow-up intervals.
Diagnostic Flow
- Thoracic imaging confirms congestion pattern and helps differentiate cardiac from non-cardiac causes.
- Echocardiography characterizes underlying structural disease and guides prognosis.
- ECG identifies rhythm disturbances that may complicate management.
- Blood pressure and renal markers inform medication safety and tolerance.
- NT-proBNP can support diagnostic uncertainty in select cases.
Treatment Flow
- Oxygen and stress reduction are first priorities in acute decompensation.
- Diuretic strategy varies by species: cats often need pleural drainage; dogs typically respond to furosemide.
- Pimobendan benefits select stages and should be considered early in appropriate candidates.
- Monitor electrolytes, renal values, and blood pressure during active treatment phases.
- Plan transition to chronic therapy with owner education on monitoring and recheck timing.
Exam Traps
- Treating cats identically to dogs misses important species-specific physiology.
- Focusing on murmur grade rather than congestion signs can delay CHF recognition.
- Ignoring azotemia risk when using diuretics and ACE inhibitors together.
- Failing to adjust treatment when electrolyte abnormalities emerge.
- Omitting client education on resting respiratory rate monitoring at home.
Practice Prompts
- What differentiates feline from canine CHF presentation and management?
- When should pleural effusion be drained versus managed with diuretics alone?
- Which medications are indicated in ACVIM Stage B2 versus Stage C?
- How do renal trends alter CHF medication dosing?
- What owner monitoring catches decompensation early?
Related Content
- Return to NAVLE Topics (Cardiology and CHF are under Topics)
- CHF Staging Overview for Dogs and Cats
- Dog and Cat Murmur Approach: Triage and Workup Logic
- Pimobendan and Diuretics in CHF: Educational Overview
- Dilated Cardiomyopathy Basics in Dogs and Cats
- ECG Rhythm Identification: AF, SVT, and VT in Veterinary Cases
- Use the CHF Staging Planner
- Try 5 free practice questions on this topic
- Unlock unlimited practice (Premium)
Sources and Review Notes
- Drug label search (DailyMed)
- IRIS stages
- Normal lab values
- Heartworm treatment protocol
- Lab test protocols
- Microchip lookup
- Vertebral Heart Score
- BCS charts
- ACVIM cardiology consensus guideline references
- Dental charts
- AAHA vaccination guidelines
- Flea/tick product info
- Dog/cat breed search
- RECOVER CPR guidelines
Last reviewed: February 13, 2026
Educational only. This page is designed for study and does not replace case-specific diagnosis, local protocols, or direct supervision.