Herbal support for the Heart
Common canine and feline conditions
Heart disease in dogs and cats is common, and may be congenital or acquired. In all cases, both dietary evaluation and herbal support may slow progression of the condition or at a minimum, offer improved quality of life. In all cases, too, veterinary care is essential. Congenital conditions tend to present early in life and may carry a less optimistic prognosis than the acquired types – notably, dilated cardiomyopathy in dogs and hypertrophic cardiomyopathy in cats. These are the conditions I have worked most extensively with, but the ideas in this article can apply to any of the conditions dogs and cats may present with. Many older animals present with CHF – congestive heart failure, which may be related to any number of conditions. “Heart failure is not a specific heart disease, but rather is the final common manifestation of many types of heart disease. Heart failure can manifest as inadequate blood flow to the body (low-output heart failure), accumulation of fluid behind the heart (congestive heart failure), or both. Many different types of heart disease can result in heart failure.”1
Diet, supplements and herbs work in tandem with conventional veterinary care to offer the greatest support for dogs and cats with heart disease. The type of illness, age of the animal and other considerations will influence prognosis, of course, but in all cases, we can make an important difference with herbs.
Signs and Symptoms: These can include lethargy, depression, weakness, weight loss, breathing difficulties, panting excessively with minimal or no exercise, and a progressive cough. Sometimes, there are no symptoms, so my sense of this is, older animals and/or breeds with known predisposition should be screened annually. With some canine cardiomyopathies, the owner is not aware of any problem until a sudden collapse, often during exercise, and sadly, often fatal, too.
Screening and classic veterinary measures: If your dog or cat presents with any of the symptoms above, which can all indicate other health problems, your vet will listen to the heart, check pulse strength and gums, order bloodwork and possibly chest Xrays. Treatment depends on the type and stage of the condition but usually involves medications, which may be contraindicated with some herbs. Always let your vet know which herbs you plan to use and discuss strategies for medication with him or her.
Preventive measures: as with so many conditions, early detection/preventive measures are best. I’m speaking here of acquired disease, such as the very common cardiomyopathies and degenerative valve disease; congenital issues can still benefit from natural measures, too. Nutrition, a few select supplements and some herbs(kudzu, linden and hawthorn, notably) are all useful preventions in keeping the heart healthy in an animal without disease but perhaps susceptible( in dogs, this means (dilated cardiomyopathy) American Cockers, Labrador Retrievers, English Bulldogs, Boxers, Doberman Pinschers and Great Danes, German Shepherds, Irish Wolfhounds, Scottish Deerhounds, Newfoundlands, Saint Bernards, or any mix that contains one of these breeds. Smaller dogs such as Dachshunds are more prone to valvular disease, and cats tend to hypertrophic cardiomyopathy, which is also heritable, with Maine Coons, ragdolls, many types of Persians and American shorthairs among susceptible breeds.
Nutrition: It is well known that cats fed a diet deficient in the amino acid taurine will develop dilated cardiomyopathy; this is now rare as pet food manufacturers include the amount needed to prevent this condition, but needs to be considered in any home made protocol. Some purebred dogs may be prone to taurine-related DCM as well, so I include a taurine supplement daily in any home made diet – essential for cats and a good strategy with dogs. Bvitamins, selenium, Vitamin E and Omega 3 fatty acids are all important for heart health, and may be supplemented over and above the Recommended Allowance for pets with heart disease. Sodium should be restricted, potassium and magnesium adequately provided for but not in excess of the RA . I don’t have a preference for raw or cooked here, but I assess each case individually and use either one. I do prefer home made fresh food here as with any therapeutic situation, but it’s essential the nutrients be present in optimal amounts, and this is definitely not always the case with home made diet developed by the owner(or taken from Internet sources) so use a nutritionist, holistic vet or a very reliable resource. I’ve seen diets for heart disease online that featured Parmesan cheese – loaded with sodium!
The Omega 3 fatty acids DHA and EPA, most bioavailable to carnivores in the form of fish or fish oil, are always important. So, too are supplemental antioxidants, from whole food (fruits and vegetables) where possible, but I don’t hesitate to add supplements as indicated. I use pycnogenol from pine bark in most heart disease protocols, or grapeseed extract is a very good alternative.
Hawthorn (Crataegus spp) The classic cardiotonic works for dogs and cats, too. I like to use a decoction of the berry for dogs; I’ve been using very small amounts of the solid extract with cats, which has been great as they are more ready to accept it in this form. (about 1/8 of a tsp daily). Hawthorn may potentiate the action of some veterinary heart medications; discuss with vet if using ACE inhibitors or beta-blockers. For longterm use, I make berry decoction (for dogs) and add generously to food, anywhere from ¼ to ½ cup per 20 pounds body weight. . With small or picky dogs, solid extract may be the way to go.
Motherwort (Leonurus cardiaca) – especially useful where there are palpitations and anxiety; a go-to for hyperthyroid cats, or any cat with heart disease and associated nervousness and fear. Not for use with hypothyroidism, which mainly affects dogs and is seriously underdiagnosed, Motherwort is nonetheless useful in formula with or without hawthorn, stoneroot, dandelion etc. for dogs as well as cats, provided the thyroid is healthy. When in doubt, use linden.
Dose for tincture is one drop per pound bodyweight, in divided doses – may be a challenge to get cats to accept infusion but dogs will usually take it. For infusion I stick with 25 grams of herb in 8 ounces water – try ¼ to ½ cup per 20 lbs bodyweight. I use alcohol tincture or glycerite depending on how long I plan to use it, masked with strong foods like green tripe or cooked lamb. Cats may accept the fresh plant chopped into food, too. Mine roll around in the herb as if it were catnip.
Dandelion (Taraxacum officinale) – important for cases where fluid is built up in the lungs or general edema. Many vets will prescribe Lasix; in these scenarios I often am able to wean the animal off the medication with dandelion – or see if you can try the herb first in mild cases. We have very good studies on the diuretic action of taraxacum, I recommend bringing some of them to your vet if he or she is skeptical. In cases of advanced disease, you will want to work with the medications.
Use the leaf in tincture for edema – 1 – 2 ½ mls per 20 lbs bodyweight, divided three times daily is ideal. Dogs will often accept infusion. I use 25 grams per 8 ounces of water, and start with ¼ cup per 20 pounds – increasing if accepted and if more is needed(or we are weaning off Lasix). Don’t use with gallbladder disease.
Linden (Tilia platyphyllos, cordata etc) I consider linden an essential herb for dogs and cats with various forms of heart disease – mild and safe but effective, linden helps calm the anxious individual while offering cardiotonic support, in a palatable form (or at least I’ve found so). Dose as with dandelion, if using infusion; linden works beautifully with all of the other herbs here.
Bugleweed (Lycopus virginianus) A specific for feline hyperthyroidism, Lycopus is included here specifically for cats with heart issues secondary to that condition. I much prefer infusion and again, this is not easy to get cats to take, if it proves impossible and there is known hyperthyroidism, use tincture. Infusion dose is 5 – 30 grams per 8 ounces of water, administered at ¼ to ½ cup per 20 pounds body weight, so you can average about 1/8 to ¼ cup for an average (10 lb) cat. Tincture dose is about a half drop per lb (so I drop per 2 lbs). Use with linden, hawthorn, motherwort .
Stoneroot ( Collinsonia canadensis) I use Stoneroot for stones! But also with heart disease, for it’s diuretic, antispasmodic and tonifying actions. I first learned about Collinsonia’s potential action on the heart rom Paul Bergner and have used it consistently with clinical cases since then, with remarkable effect. Indispensable for it’s broad range of actions.
I dose in tincture, ½ to 1 ½ mls per 20 lbs body weight.
“As a venous tonic,C. Canadensis was one of the preferred herbal choices for stagnation and for irritated mucous membranes (Felter, 1922). Being mildly astringent, it was used in early stages of hemorrhoids (Mundy, 1904). It was considered to have a profound fortifying effect on the heart, strengthening the capillary flow and improving circulation throughout the body.”2
Kudzu (Pueraria spp) Another very underutilized herb in veterinary herbalism, I include kudzu in almost every formula I develop for mild to moderate cases. Cardiotonic, vasodilator and antispasmodic, kudzu with hawthorn has been clinically demonstrated to reduce angina in humans – kudzu is nontoxic even at high doses, has no interaction concerns and is generally well accepted in powder form, mixed into food. I use about ½ – 1 tsp of the powder for small dogs (daily) 1-2 for mid sized and up to a Tbsps daily for large breeds. You can start smaller of course, and build up.(I use kudzu with IBD as well in both acts and dogs). Try just ¼ tsp daily for cats.
Astragalus: (Astragalus membranaceus) For me, astragalus is another indispensable for cardiovascular disease – where appropriate. I use decoction; 25 mgs of herb to 8 ounces water, and then ¼ cup per 20 lbs body weight to start. Astragalus is cardiotonic, diuretic, hypotensiveand immune stimulating – which means it may not be a herb of choice for animals with auto-immune disease. These diseases are common in both cats and dogs and include both discoid and systemic lupus, pemphigus, IMHA (immune-mediated hemolytic anemia) masticatory myositis, and thyroid disease (there are others). If your animal is clear of all these conditions, consider astragalus as part of your formula.
Prickly ash (Zanthoxylum americanum) My peripheral vasodilator of choice for dogs – I find cayenne too heating and animals are repelled by the taste. Always use as part of a total strategy, I decoct at about 5 grams, per 8 ounces of water and give no more than ¼ cup per 20 lbs body weight to start. I’ve seen nausea with Prickly ash at higher doses and so always start low. Have not used with cats.
Ginkgo biloba: Another classic cardiovascular herb, especially helpful with cognitive decline. One drop alcohol tincture per pound is a good starting place, less if in formula (and I rarely use it alone). Ginkgo’s positive effects on cognition are well known, making it a herb of choice for older animals with cognitive decline. Susan Wynn reports incidences of nausea and skin irritation, which I have not personally seen( I follow a protocol of starting with the low end of a dose and increasing gradually as needed). Ginkgo is most commonly use in veterinary herbalism as a standardized extract; I have used it many times this way with excellent results. The dose is anywhere from 10 to 50 mgs per 10 kgs bodyweight, as always in 2-3 doses per day. The only concern I have seen with ginkgo involves excessive blood thinning – use with awareness if the dog is also on a number of other anticoagulant herbs and supplements.
When I formulate for a dog or cat with heart disease, as with any other type of formulation I evaluate the diet, type of disease, symptom history, any other health conditions, medications and always, temperament/personality type. This last aspect ties in to the constitutional type and as with humans, we might want to offset any energetic imbalances in our formulas with herbs that cool or moisten, for example. Not to go into the art of formulation, but just to touch on the fact that dogs and cats have individual tendencies ,and this needs to be worked into the formulations as needed. I find energetics so often left out of the equation in veterinary herbalism.
A note on garlic: Conspicuously missing from this list is the very popular garlic. I have treated countless cases of heart disease I dogs and cats over the years, and lived with a dog myself who was diagnosed with DCM at just 5 years old. I have never used garlic, primarily because it is too heating for most dogs and cats loathe it. I am able to obtain the same therapeutic benefits with diet and herbs as I could from garlic,without the risk – so I don’t use it. My exception to this is with some bacterial infections, short term high dose use may be justified. But doses high enough to offer significant therapeutic benefit may also induce Heinz body anemia in vulnerable animals. It’s not a go-to for me, for dogs and cats, at all – despite it’s great popularity and the myth that it repels fleas.
Extras – supplements
Supplements play a key role in both management and prevention. In addition to an optimized diet – which varies from animal to animal, but will meet the criteria for nutrient balance using the freshest foods possible, with moderate/appropriate carbohydrates for dogs and minimal for cats – and an appropriate herbal protocol, supplements below add another layer of support. Consider CoEnzyme Q10 ( 60 mgs for small dogs, 1-150 for medium and up to 300 for giant breeds, and I prefer ubiquinol form ) cats can generally have 30 – 60 mgs daily) marine lipids ( fish body oil or krill, not cod liver oil which may contain too much Vitamin A for animals eating commercial diet or high content of liver in a home made recipe) Vitamin E (essential when giving fish oils, I use a full spectrum tocopherol product with tocotrienols if possible at a minimum, make sure the E is natural source, not synthetic.
A word on nervines with heart disease
Many pets with any type of heart disease experience anxiety as the disease progresses, and it may be true (in my experience certainly) that dogs who are prone to taking on a lot of stress from their humans, will develop heart issues in much the same way we consider the classic Type A hard-driving human to be more at risk than a mellower, more relaxed individual. Nervines to address anxiety may be factored into the formula of a dog with active disease, and adaptogens can be considered for a dog who seems at risk (competitive, anxious). I particularly like Rhodiola for this type, but as with humans, the history must be taken before an ideal adaptogen or nervine formula can be developed. Just a quick word, as I feel that milky oats, passionflower, and others can help enormously, if not directly, with heart disease. Flower essences, massage, TTouch and acupuncture are all extremely helpful too, as they are with so many animal health challenges. As with any condition, keeping an animal comfortable and relaxed is key to both management and possible recovery.
Heart disease is all too common in our beloved animal companions. It’s a great comfort to know that natural support can make such a difference in the prognosis and quality of life both.
1) Colorado State Veterinary Teaching Hospital
1) Dietary Patterns of Dogs with Cardiac Disease -Waltham International Symposium http://jn.nutrition.org/content/132/6/1632S.full.pdf
2) Manual of Natural Veterinary Medicine: Science and Tradition Steve Marsden,DVM and Susan Wynn DVM
3) Veterinary Herbal Medicine: Susan Wynn DVM and Barbara Fougeres DVM
4) Diuretic effect in human subjects of an extract of Taraxacum officinale http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155102/
5) Merck Veterinary Manual (online: http://www.merckmanuals.com/vet/)
6) Medical Herbalism, David Hoffman
Personal notes and case studies, 1999 – present