Q: My 10-year-old Chihuahua has been on medication for over a year for mitral valve disease. His condition recently deteriorated and my vet said that he’s at high risk for heart failure. What are the warning signs and what should I do if that happens?

Approximately 10 percent of dogs will develop some form of heart disease during their lifetime and the most common is mitral valve insufficiency.  

More common in small breeds, patients with mitral valve disease may suffer from congestive heart failure, whereby the heart cannot pump blood efficiently to the rest of the body. Clinical signs of congestive heart failure include coughing, exercise intolerance, breathing difficulty, fainting and collapse. 

When a pet collapses, it is important to ascertain if cardiopulmonary resuscitation (CPR) is necessary and to learn how to perform CPR:

  1. Stay calm.
  2. Assess the ABCs:
  • Airway—Open his mouth to ensure his airway is unobstructed.
  • Breathing—Look at his chest to see if it is going up and down.
  • Circulation (pulse)—Feel for the femoral pulse by gently pressing your four fingers over the inside of his thigh at the level just above the knee. 
  1. If CPR is required, lay the dog on his side
  2. Begin chest compressions. For small breeds, I recommend using circumferential compression (directly over the heart) as opposed to the widest point of the chest for larger dogs.
  • Position—Cup your hand over the point of the chest with the thumb on one side of the chest and the rest of fingers on the other side (just behind the dog’s elbows) and squeeze firmly.
  • Frequency/strength—Perform chest compressions of 1/3-to-1/2 of the chest width at a rate of 100 to 120 compressions per minute.
  1. Assisted breathing.
  • Position—Cover the patient’s mouth, place your mouth over his snout, and blow into his nose.
  • Frequency—Mouth-to-snout assisted breathing should be given once every 15 compressions.
  • Continue with CPR safely en route to the veterinary clinic. 

As a precaution, you should record your dog’s resting respiratory rate (RRR) regularly. Done when the animal is at rest, it measures the up-and-down movements of the chest per minute. A normal dog should have a RRR of less than 35 breaths per minute.