DIURETIC THERAPY - Diuretics are given for two main reasons: 1) to diurese dogs with pulmonary edema or substantial body cavity effusions; and 2) to counteract the chronic sodium and water retention that characterizes chronic CHF. Diuretics are used with sodium-restricted diets to control edema.
...DIETS & NUTRICEUTICAL SUPPLEMENTS - A sodium-restricted diet is recommended once overt CHF has developed. Reducing sodium intake decreases the demand for diuretic therapy; however, reduced "salt" intake should not be accomplished at the expense of inadequate food intake. Low sodium diets are NOT indicated in asymptomatic heart disease. Rigid sodium restriction leads to activation of the renin-angiotensin-aldosterone system. Examples of low sodium canine diets in North America include (alphabetically): Alpo senior dry, Cycle senior dry, Hill's h/d diets, and Purina CNM CV. Kidney diets are moderately reduced in sodium, but also have low protein contents that may be undesirable in dogs with cardiac cachexia. Fatty acid supplementation, such as those found in fish oils, may decrease anorexia and counter cardiac cachexia. These fatty acids can reduce plasma levels of various cytokines (e.g., TNF) that are often increased in canine CHF. Freeman and colleagues have advocated combinations of EPA (about 30 to 40 mg/kg PO daily) and DHA (about 20 to 25 mg/kg PO daily). Anorexia in CHF is not uncommon, and can be related to complications of CHF, changes in diet, hospitalization, cytokines, and drug therapy. Occasionally the empirical use of an H-2 blocker is beneficial in reducing anorexia associated with right-sided CHF.[/b]
