6.9 Treatment of congestive heart failure in horses
The prognosis for horses with congestive heart failure (CHF) is poor. They very seldom recover to a point where they are able to perform useful work except when the CHF is due to an arrhythmia, pericardial disease or in some cases myocardial disease. Where, much more commonly, valvular heart disease is the underlying cause, treatment is at best short-term and palliative. However, longtreatment may be justified if the horse has great sentimental or breeding value. Thus, in selected individuals, it may be valid to control the clinical signs using drugs.
The principal categories of drugs used to control signs of CHF in small animals and humans are diuretics, positive inotropes, and vasodilators. However, the choice of these drugs for the equine clinician is very limited. To appreciate the rationale of the use of these drugs it is important to understand the pathophyof CHF (Chapter 2). Horses with CHF should be rested. Box rest with some daily walking in hand is ideal.
6.9.2 Positive inotropes