Multiorgan dysfunction in a geriatric dog with congestive heart failure complicated by chronic kidney disease and uremic enteritis
DOI:
https://doi.org/10.29244/avl.10.1.9-10Keywords:
Congestive heart failure, chronic kidney disease, uremic enteritis, Golden Retriever, cardiorenal syndromeAbstract
Congestive heart failure (CHF) in geriatric dogs may progress to multi-organ dysfunction, particularly affecting the renal and gastrointestinal systems. A 12-year-old male Golden Retriever presented with progressive dyspnea, nocturnal cough, vomiting, diarrhea, and weakness. Clinical examination revealed severe dyspnea with mild cyanosis. Hematology revealed mild anemia, leukocytosis, and thrombocytosis, whereas biochemistry revealed severe azotemia (urea 238.9 mg/dL; creatinine 14.85 mg/dL), indicating advanced chronic kidney disease. Thoracic radiography showed cardiomegaly with pulmonary edema, and abdominal radiography revealed intestinal gas distension, suggesting uremic enteritis. The patient received supportive care, including IV fluids, oxygen, antibiotics, and gastroprotective agents. Despite respiratory improvement, gastrointestinal bleeding persisted. The diagnosis was left-sided congestive heart failure with advanced chronic kidney disease and uremic enteritis. The prognosis was infausta. The patient was treated with four days of supportive therapy consisting of low-rate intravenous Ringer’s lactate, antibiotics, gastroprotectants, vitamin B-complex supplementation, and oxygen therapy.
References
Bedel F, Betting A, Girod M, Chavalle T, Prata D, Lecoindre P, Lecoindre A. 2025. Clinicopathological and endoscopic features of diffuse alimentary lymphoma in 18 dogs. Veterinary Sciences. 12(8):751. https://doi.org/10.3390/vetsci12080751 | PMid:40872702 PMCid:PMC12390282
Bozkurt B, Coats AJ, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, Anker SD, Atherton J, Böhm M, Butler J, Drazner MH. 2021. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and writing committee of the universal definition of heart failure. Journal of Cardiac Failure. 27(4):387-413. https://doi.org/10.1016/j.cardfail.2021.01.022 | PMid:33663906 PMCid:PMC12587276
Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL, Oyama MA, Rush JE, Stepien R, Uechi M. 2019. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of Veterinary Internal Medicine. 33(3):1127-1140. https://doi.org/10.1111/jvim.15488 | PMid:30974015 PMCid:PMC6524084
Lombardo SF, Ferasin H, Ferasin L. 2025. Subcutaneous furosemide therapy for chronic management of refractory congestive heart failure in dogs and cats. Animals. 15(3):358. https://doi.org/10.3390/ani15030358 | PMid:39943128 PMCid:PMC11815753
Martinelli E, Locatelli C, Bassis S, Crosara S, Paltrinieri S, Scarpa P, Spalla I, Zanaboni AM, Quintavalla C, Brambilla P. 2016. Preliminary investigation of cardiovascular-renal disorders in dogs with chronic mitral valve disease. Journal of Veterinary Internal Medicine. 30(5):1612-1618. https://doi.org/10.1111/jvim.14524 | PMid:27717188 PMCid:PMC5032878
McCauley SR, Clark SD, Quest BW, Streeter RM, Oxford EM. 2020. Review of canine dilated cardiomyopathy in the wake of diet-associated concerns. Journal of Animal Science. 98:1-10. https://doi.org/10.1093/jas/skaa155 | PMid:32542359 PMCid:PMC7447921
Pouchelon JL, Atkins CE, Bussadori C, Oyama MA, Vaden SL, Bonagura JD, Chetboul V, Cowgill LD, Elliot J, Francey T, Grauer GF. 2015. Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement. Journal of Small Animal Practice. 56(9):537-552. https://doi.org/10.1111/jsap.12387 | PMid:26331869 PMCid:PMC4584495
Pradnyani GAPI, Widiastuti SK, Erawan IGMK. 2021. Laporan kasus: menangani penyakit ginjal kronis pada anjing peranakan pomeranian. Indonesian Medicus Veterinus. 10(3):517-531. https://doi.org/10.19087/imv.2021.10.3.517
Puccinelli C, Pelligra T, Bracco A, Lippi I, Perondi F, Mannucci T, Citi S. 2025. Ultrasonographic features of gastropathy in dogs with acute kidney injury and acute-on-chronic kidney injury. Animals. 15(18):2666. https://doi.org/10.3390/ani15182666 | PMid:41007911 PMCid:PMC12466630
Rahbar Saadat Y, Barzegari A, Saadatian Z, Montazersaheb S, Zununi Vahed S. 2025. Gut microbiota and kidney aging: insights into current research. Nutrition and Metabolism. 22(1):133. https://doi.org/10.1186/s12986-025-01032-w | PMid:41199352 PMCid:PMC12593916
Savira F, Magaye R, Liew D, Reid C, Kelly DJ, Kompa AR, Sangaralingham SJ, Burnett Jr JC, Kaye D, Wang BH. 2020. Cardiorenal syndrome: multi-organ dysfunction involving the heart, kidney and vasculature. British Journal of Pharmacology. 177:2906-2922. https://doi.org/10.1111/bph.15065 | PMid:32250449 PMCid:PMC7280015
Summers S, Quimby J. 2024. Insights into the gut-kidney axis and implications for chronic kidney disease management in cats and dogs. The Veterinary Journal. 306:106181. https://doi.org/10.1016/j.tvjl.2024.106181 | PMid:38897377
Wang M, Guo Y, Zhao W. 2019. Gastrointestinal disorders in chronic kidney disease. Longhua Chinese Medicine. 2:11. https://doi.org/10.21037/lcm.2019.07.01
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