Heart Health guides
Practical, veterinary-led guidance on Heart Health, written by vets, free to read. View all guides
Understanding the ACVIM Stages of Mitral Valve Disease (A to D)
"She's a stage B2." "He's in stage C now." A vet says it, hands you a leaflet, and the letter and number do most of the talking while you are left to work out what they actually mean. So let's translate. The staging is...
Alastair Greenway, BVM&S MRCVS · 10 min read
Mitral Valve Disease Explained: The Leaky Valve Behind Most Canine Heart Murmurs
If your vet has mentioned mitral valve disease, or told you the murmur they heard points to a "leaky valve", start here. By a wide margin it is the most common heart condition we see in dogs, and it gets misunderstood...
Alastair Greenway, BVM&S MRCVS · 11 min read
Mitral Valve Repair Surgery: Is It an Option for My Dog?
Tablets for mitral valve disease are genuinely good, and pimobendan in particular can buy a great deal of good time (Boswood et al., 2016). But they manage a leaking valve. They do not mend it. Sooner or later most...
Alastair Greenway, BVM&S MRCVS · 9 min read
Mitral Valve Disease: Prognosis, and What the Numbers Really Mean
Almost every owner asks the same question after a diagnosis, even when they cannot quite say it out loud: how long has my dog got? It is the most human question there is, and you deserve a straight answer rather than a...
Alastair Greenway, BVM&S MRCVS · 9 min read
Living With a Dog in the Pre-clinical Stage: Monitoring and Rechecks
A murmur has been heard, and the plan is to "keep an eye on things". No tablets, no procedure, just an appointment for some point down the line. After coming in worried about your dog's heart, that can feel oddly like...
Alastair Greenway, BVM&S MRCVS · 10 min read
When Mitral Valve Disease Becomes Heart Failure (Stage C)
A murmur you have lived alongside for months or years has a way of fading into the background. Your dog has one, you keep half an eye on things, and life carries on much as before. Then the rules change. Your vet says...
Alastair Greenway, BVM&S MRCVS · 9 min read
Screening and Genetics: Maine Coons, Ragdolls and the proBNP Test
Three different tests get talked about for feline hypertrophic cardiomyopathy, and online they are often thrown together as if you could pick any one of them. A gene swab, a blood test, a heart scan. They are not...
Alastair Greenway, BVM&S MRCVS · 11 min read
Feline HCM Explained: The Thickened Heart, and Why Cats Hide It
Hypertrophic cardiomyopathy is a mouthful of a diagnosis, and most owners leave the consulting room holding the letters HCM and not much else. Meanwhile the cat it refers to is asleep on the sofa, looking entirely fine....
Alastair Greenway, BVM&S MRCVS · 10 min read
Saddle Thrombus: The Sudden Clot Every HCM Owner Should Know
A cat who seemed entirely well an hour ago is abruptly screaming in pain, dragging its back legs, and unable to stand. There is one feline emergency that frightens vets as much as it frightens owners, and this is it. To...
Alastair Greenway, BVM&S MRCVS · 11 min read
Living With a Cat With HCM: Monitoring, Stress and Rechecks
A diagnosis of hypertrophic cardiomyopathy comes with a steep learning curve, but here is the part to hold onto first: it does not have to mean a fearful life, for you or for your cat. Many cats with HCM live for years...
Alastair Greenway, BVM&S MRCVS · 10 min read
Feline HCM: Prognosis, From Incidental Murmur to Managed Disease
The question behind every other question, the one that rarely gets asked aloud in the consult room, is how long you have and how bad it will get. You deserve a real answer to that, not a single grim figure...
Alastair Greenway, BVM&S MRCVS · 10 min read
When a Cat With HCM Goes Into Heart Failure
Heart failure in a cat usually skips the warnings owners brace for. No cough builds over weeks, no visible slow decline. A cat who seemed perfectly fine in the morning is, by the evening, sitting hunched and breathing...
Alastair Greenway, BVM&S MRCVS · 10 min read
Preventing Clots: Clopidogrel and the FATCAT Evidence
Clopidogrel is a small daily tablet your vet may have started, or suggested, for a cat with heart disease. You have probably been told it is "to thin the blood" or "to prevent a clot". That is the gist of it, but it is...
Alastair Greenway, BVM&S MRCVS · 11 min read
HCM and Anaesthesia: Why Screening Before a Routine Op Matters
Most cats sail through a neuter, a dental or a lump removal without a hitch, and modern feline anaesthesia is genuinely safe. There is one quiet exception worth understanding, though, because it is both real and largely...
Alastair Greenway, BVM&S MRCVS · 12 min read
The Grain-Free Question: Diet-Associated DCM, Explained Fairly
Few topics in canine heart health have stirred up as much worry, and as much heated argument, as the link between grain-free food and dilated cardiomyopathy. Maybe a frightening headline sent you here, or your vet...
Alastair Greenway, BVM&S MRCVS · 10 min read
Dilated cardiomyopathy explained: what DCM is, which dogs get it, and why it stays silent for so long
Dilated cardiomyopathy is one of the most serious heart diseases of dogs, and there is no point pretending otherwise. It is also one of the most misunderstood, partly because it behaves so differently from the...
Alastair Greenway, BVM&S MRCVS · 13 min read
Living With a DCM Dog: Diet Correction, Exercise and Monitoring
The name dilated cardiomyopathy sounds final, and a "weak heart muscle" is harder to picture than a leaky valve, so a diagnosis can feel as though it has taken matters out of your hands. In practice, day-to-day life...
Alastair Greenway, BVM&S MRCVS · 9 min read
Dobermans and Sudden Death: Arrhythmias, Monitoring, and What Can Be Done
Of all the heart problems a dog can have, the one that frightens Doberman owners most is the one that arrives with no warning. You have probably heard about it already, from a breeder, a forum, or a vet picking their...
Alastair Greenway, BVM&S MRCVS · 10 min read
Screening at-risk breeds for DCM: Holters, echo and why catching it early matters
Dilated cardiomyopathy can sit in a dog's heart for years before anything shows on the outside. Owners of Dobermans, Great Danes, Irish Wolfhounds and the other prone breeds are usually told this, often quite bluntly,...
Alastair Greenway, BVM&S MRCVS · 10 min read
DCM Prognosis, and Why Catching It Early Changes the Story
How long has my dog got? That is the question almost every owner asks within a minute or two of hearing the words "dilated cardiomyopathy", even when they can barely bring themselves to say it aloud. It is the right...
Alastair Greenway, BVM&S MRCVS · 9 min read
When DCM Becomes Heart Failure
Dilated cardiomyopathy can run quietly for a long time. The heart muscle is weakening and the chambers are stretching, yet on the outside your dog looks well: eating, walking, greeting you at the door. Then the balance...
Alastair Greenway, BVM&S MRCVS · 11 min read
Recognising a Heart Failure Crisis: The Emergency Signs and Your Action Plan
A heart failure crisis is fluid flooding into or around the lungs faster than the body or the medicines can cope, and it can come on over hours. If your pet has heart disease, the time to read this is before you need...
Alastair Greenway, BVM&S MRCVS · 11 min read
Congestive Heart Failure Explained: What It Is, What "Congestive" Means, and What You Can Do
If your vet has used the words "congestive heart failure", or you have seen them written on a discharge note, they can land like a verdict. They sound final, and they sound frightening. So the first thing worth saying...
Alastair Greenway, BVM&S MRCVS · 12 min read
When Heart Failure Stops Responding: Advanced Options and Comfort
There is a point in some heart journeys when the medicines that worked so well start to lose their grip. The cough creeps back, the breathing rate climbs more often, the dose goes up and then up again, and the good...
Alastair Greenway, BVM&S MRCVS · 10 min read
Managing Furosemide at Home: Dosing, Dehydration and the Rescue Protocol
When a pet goes into heart failure, furosemide is almost certainly the tablet doing the most visible work. It is the one that clears the fluid off the lungs and lets your pet breathe again, and it is also the one that...
Alastair Greenway, BVM&S MRCVS · 11 min read
A Low-Sodium Diet for Heart Failure: What to Feed and What to Avoid
Once a pet is in heart failure, with fluid backing up on or around the lungs and a water tablet on the prescription, the bowl stops being a side issue. Salt makes the body hold on to water, and a heart that is already...
Alastair Greenway, BVM&S MRCVS · 11 min read
Quality of Life with Heart Failure: Knowing When, and Saying Goodbye with Support
How will I know when it is time? It is the question that sits behind every other worry once a pet is living with heart failure, and most owners are too frightened to say it out loud. You are not being morbid for...
Alastair Greenway, BVM&S MRCVS · 10 min read
The Heart Failure Medication Toolkit: Diuretics, Pimobendan and the Rest
When a pet tips into congestive heart failure, the prescription often jumps from one or two tablets to what looks like a small pharmacy. That escalation can land hard, and plenty of owners quietly assume more drugs must...
Alastair Greenway, BVM&S MRCVS · 10 min read
How Your Pet's Heart Works, and What Can Go Wrong
The heart is one of the simplest organs to explain and one of the easiest to be frightened by. Before any diagnosis makes sense, and before you can tell which articles in this space are actually about your pet, it helps...
Alastair Greenway, BVM&S MRCVS · 11 min read
"The Vet Heard a Murmur": What It Means and What It Doesn't
"There's a heart murmur." Your pet went in for a routine vaccination or a check-up, the vet listened with the stethoscope a beat longer than usual, and out came those words. It is one of those sentences that can hijack...
Alastair Greenway, BVM&S MRCVS · 11 min read
Heart Medications Explained: What Each Drug Actually Does
A heart diagnosis often comes home in a paper bag of tablets with names that sound far more alarming than they are. Pimobendan, furosemide, benazepril, spironolactone, clopidogrel: it looks like a lot, and the leaflets...
Alastair Greenway, BVM&S MRCVS · 9 min read
The Resting Respiratory Rate: The Most Useful Heart-Monitoring Skill You Can Learn at Home
Count how fast your pet breathes while they are fast asleep. It takes about thirty seconds, it costs nothing, and it tells you more about their heart between vet visits than almost anything else you can do at home. No...
Alastair Greenway, BVM&S MRCVS · 10 min read
Working With a Veterinary Cardiologist: Referral, Costs and What to Expect
A referral to a veterinary cardiologist is a normal step, and for some hearts it genuinely changes the outcome rather than just the bill. It can sound expensive and serious, and it can feel as though your familiar vet...
Alastair Greenway, BVM&S MRCVS · 10 min read
Heart Tests Explained: X-ray, Echo, ECG, Blood Pressure and proBNP
A murmur, an odd rhythm, or just an older pet whose heart your vet wants to check: any of these tends to lead to the same next step, a test or two. What comes back is a list. A chest x-ray, an echo, an ECG, a blood...
Alastair Greenway, BVM&S MRCVS · 12 min read
Is It a Heart Cough or an Airway Cough?
A dog has a heart murmur, then starts to cough, and the two facts seem to lock together into one frightening conclusion. The words "heart" and "cough" sit so close in most owners' minds that a single dry cough can ruin...
Alastair Greenway, BVM&S MRCVS · 10 min read
Diet and the Heart: Sodium, Taurine and the Supplements Worth It
"Is there something I should be feeding, or not feeding?" That question turns up almost every time a pet is diagnosed with a heart problem, and it is a good instinct. What goes in the bowl genuinely does matter for a...
Alastair Greenway, BVM&S MRCVS · 10 min read
Find real-world care
When you're ready to take the next step in person, the PetCare Atlas lists cardiology specialists across the UK. Search by your postcode to find someone near you.
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