Congestive Heart Failure in Cats: Vet-Reviewed Facts & When to Euthanize


Being a cat parent comes with many ups and a few unfortunate downs. We do our best to take care of our cats so they can live long and healthy lives, but health conditions can creep up when we least expect them.

Congestive heart failure tends to affect senior cats more commonly than younger cats. However, young cats are also susceptible to certain heart problems. The decision to euthanize comes down to your cat’s current quality of life and whether they are in pain.

Here, we provide you with more information about congestive heart failure, including any warning signs to look out for. We also take you through when it might be time to euthanize your pet.

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How a Cat’s Heart Works

A cat’s heart has four chambers: The two upper ones are the atria (plural of atrium), and the lower ones are the ventricles. The heart also has a left side and a right side, each of which has one atrium and one ventricle.

The right side of the cat’s heart pumps blood into the lungs, where oxygen is added to the blood, and the left side pumps the blood to the entire body. This blood carries oxygen and nutrients to body tissues, and waste products, particularly carbon dioxide, are removed.

This exhausted blood is then delivered back to the heart’s right atrium, and the process starts all over again.

a red long-haired tabby cat is being checked up by a vet
Image Credit: Ermolaev Alexander, Shutterstock

What Is Congestive Heart Failure?

Congestive heart failure (CHF) occurs when a cat’s heart is no longer able to pump enough blood to other parts of their body.

To start with, the body may be able to compensate, but as the heart disease progresses, these compensatory mechanisms become overwhelmed. Fluid starts to back up into the lungs causing congestion of the lungs, which is when what we know as CHF begins.

What Causes Congestive Heart Failure?

There are several causes of CHF, but the most common is hypertrophic cardiomyopathy. This is when the heart muscle becomes thickened to the point that it can’t function normally and the heart chambers are unable to fill with blood properly.

Certain breeds of cats have a genetic predisposition to hypertrophic cardiomyopathy, especially Persians, Maine Coons, Ragdolls, and some American Shorthairs. However, it can occur in almost any breed of cat of any age and sex, though it is most commonly found in cats that are middle-aged to senior.

Other conditions that can lead to CHF are:

  • Anemia (low red blood cell count)
  • Blood clots in the heart
  • Defects of the heart walls
  • Fluid in the sac surrounding the heart
  • Heart rhythm abnormalities
  • Heart valve blockages or deficiencies
  • Heartworm disease
  • High blood pressure
  • Hyperthyroidism
  • Tumors


What Are the Signs of Congestive Heart Failure?

Unfortunately, the early signs of CHF are not always easy to detect, particularly since cats are skilled at hiding when they are sick or in pain. CHF can sometimes be in the late stages before you’re aware that anything is wrong.

A common sign is your cat having trouble breathing due to fluid accumulation in or around their lungs. Cats with heart disease are also sadly at increased risk of developing clots. These clots can block the blood supply to the back legs, causing sudden pain and difficulty walking on one or both back legs. This is a very serious condition. Other signs can include include

  • Rapid breathing
  • Difficulty breathing, panting or breathing with an open mouth
  • Blue or gray gums and tongue
  • Lethargy (low energy)
  • Decrease in appetite
  • Restlessness (difficulty lying down and sleeping)
  • Weight loss (sometimes with a swollen belly from fluid)
  • Difficulty or inability to exercise
  • Collapse
  • Coughing, cats can cough with CHF but it is a less common sign

As many cats don’t show signs of heart disease until it is very serious, if you have any concerns, or notice any of these signs,  then you must contact your vet straight away.

vet helping cat breathe
Image Credit: Kzenon, Shutterstock

Diagnosing Congestive Heart Failure

The veterinarian will start with a physical exam, which involves listening to your cat’s heart and chest with a stethoscope. Following this, the vet will run several tests, which might include the following:

  • Chest radiographs (checking the lungs, blood vessels, and heart)
  • Electrocardiogram (checking the electric currents in the heart muscle)
  • Echocardiogram (ultrasound to check the heart)
  • Urinalysis and blood tests
  • Blood pressure test

If your cat is in distress at the time of the appointment (struggling to breathe), your vet will usually try and stabilize them before performing further tests. This is usually by providing them with oxygen and often treatment with a diuretic to attempt to remove any excess fluids.

Treatment for Congestive Heart Failure

If the CHF is caused by a health condition, such as hyperthyroidism, the vet will treat the underlying condition, which might help the heart problem. If the CHF is congenital (the cat is born with a heart defect), it can potentially be repaired through surgery.

Hypertrophic cardiomyopathy and CHF are progressive and not curable. Still, there are treatment options that can make your cat more comfortable and extend their lifespan.

Your vet will prescribe medications to assist with improving heart function and reduce any fluid buildup. You may need to change your cat’s diet and they will need regular monitoring by your vet. The treatment plan may change over time as the condition progresses.

It’s also essential to keep your cat calm, and they should avoid overexertion and stress as much as possible throughout the duration of this disease.

nebelung cat in vet clinic
Image Credit: Juice Flair, Shutterstock

The Future Prognosis of a Cat With Congestive Heart Failure

CHF can’t be cured, though its progress can be slowed to a certain degree with lifelong  medication. Life expectancy varies considerably, but the sad truth is that once a cat is diagnosed with CHF, the average time that the cat has left is six to 18 months.

How long a cat lives depends on the severity of the disease and how well the condition is managed. Working with your vet to curate the right blend of medications is essential to keep your cat feeling more comfortable and to stay with you longer.


When It’s Time to Say Goodbye

Deciding to euthanize your cat is a heartbreaking step that some cat owners need to make. It all comes down to your cat’s current quality of life and whether they are in pain.

There can sometimes be a sudden deterioration in your cat’s condition due to blood clots or rhythm abnormalities.

If your cat is being monitored by you and your vet, and you’re giving them the appropriate medication, but they still seem to be struggling, it might be time to say goodbye.

When CHF has advanced enough, most cats will be living in distress, have difficulty breathing and are not able to enjoy life. That’s the last thing that you want your cat to be experiencing. Once your cat is having more bad days than good, is unable to enjoy the things they used to and is having trouble breathing, talk to your vet about your options.

cat sleeping in owner's arms
Image Credit: Impact Photography, Shutterstock

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While CHF can’t always be prevented, the earlier that heart conditions such as hypertrophic cardiomyopathy are diagnosed, the better the prognosis; it can add extra years to your cat’s life. No one knows your cat better than you, so the importance of talking to your vet the moment that you see your cat acting differently can’t be stressed enough.

Euthanasia is painless, and even though you’ll miss your cat so much, sometimes it’s the kindest and most loving decision that you can make.

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Featured Image Credit; Uryupina Nadezhda, Shutterstock

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