Therapeutic Strategies and Clinical Management in the Treatment of Heart Failure in Cats

Q: What is the clinical evidence from this study?

Study design: Review. Population: Congestive heart failure in cats (feline cardiomyopathies). Intervention: Therapeutic management of feline CHF (oxygen therapy, thoracentesis, furosemide, torsemide, pimobendan, clopidogrel).

Q: What does this research mean for the field?

Pleural effusion in cats with congestive heart failure is associated with shorter median survival compared to isolated pulmonary edema (155 days vs. 234 days) and earlier progression to diuretic refractoriness. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Carolina Castellões Ladeiras; Gabrielly Mesquita de Jesus; Leticia Sarmento Baptista; Larissa da Silva Coleone; Nathalia Bezerra de Carvalho; Beatriz Fernandes de Araujo; Maria Otília Carvalho; Carolina Junqueira Simões Ramires; Laís Helena Paulo Silveira

doi:10.47172/ijhmreview.v12i3.683

October 26, 2026International Journal of Health Management ReviewOpen Access

Therapeutic Strategies and Clinical Management in the Treatment of Heart Failure in Cats

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Why the study?

The therapeutic management of cats with congestive heart failure is challenging due to the need for hemodynamic and respiratory stabilization, the risk of progression to refractory conditions, and complex cardiorenal interactions.

Key Points

Analyze scientific evidence regarding therapeutic strategies and clinical management of congestive heart failure in feline patients.
Narrative review conducted using a search of the PubMed database with the search terms "Heart Failure" and "Cats".
Emergency management prioritizes oxygen therapy, sedation with butorphanol (0.2 mg/kg IV or IM), rapid thoracentesis for pleural effusion, and parenteral furosemide (2 to 6 mg/kg IV or IM, or continuous infusion).
Cats presenting with pleural effusion had a significantly shorter median survival compared to those with isolated pulmonary edema (155 days vs. 234 days) and progressed earlier to refractory failure.
Chronic therapy relies on oral furosemide (1 to 2 mg/kg every 8–12 h), torsemide (0.1 to 0.3 mg/kg/day) for refractory cases, clopidogrel (18.75 mg/cat PO every 24 h) for thromboprophylaxis, and renal axis monitoring.

Structured PICO

P

Population

Feline patients with congestive heart failure secondary to cardiomyopathies, evaluated through a narrative review of literature published over a 5-year period.

I

Intervention

Emergency stabilization (oxygen therapy, sedation with butorphanol 0.2 mg/kg IV or IM, thoracentesis for massive pleural effusion, furosemide 2 to 6 mg/kg IV, IM, or continuous infusion) and chronic management (oral furosemide 1 to 2 mg/kg every 8-12 hours, torsemide 0.1 to 0.3 mg/kg/day for refractory Stage D cases, individualized pimobendan, atenolol, taurine 250 mg PO every 12 hours in DCM, antithrombotic prophylaxis with clopidogrel 18.75 mg/cat PO every 24 hours +/- rivaroxaban, and enteral free water or hypotonic parenteral fluids for cardiorenal management)

O

Outcome

Hemodynamic and respiratory stabilization (target resting respiratory rate < 30 bpm), control of thromboembolic and cardiorenal complications, quality of life, and survival

This veterinary narrative review synthesizes evidence-based strategies for managing feline congestive heart failure, emphasizing acute respiratory stabilization via oxygen, thoracentesis, and furosemide, alongside chronic individualized diuresis, thromboprophylaxis, and careful cardiorenal monitoring.

Limitations

Narrative literature review design without quantitative meta-analysis
Search restricted to a single database (PubMed)
Language restriction to studies published in full text in English or Portuguese
Timeframe restricted to articles published in the last five years

Implication

Therapeutic evidence for feline CHF remains sparse; leaves open optimal protocols pending prospective trials.

Abstract

Congestive heart failure (CHF) in cats is a major clinical manifestation of cardiomyopathies and may progress to pulmonary edema, pleural effusion, and thromboembolic complications. The therapeutic management of these patients poses a challenge due to the need for hemodynamic and respiratory stabilization, the risk of progression to refractory conditions, and the complex interaction between cardiac and renal functions. This study aimed to analyze the scientific evidence regarding therapeutic strategies and the clinical management of CHF in cats. To this end, a narrative review was conducted using a search of the PubMed database with the search terms “Heart Failure” and “Cats.” The literature highlights the importance of emergency stabilization through oxygen therapy, thoracentesis for pleural effusion, and judicious administration of diuretics. In long-term follow-up and the management of cardiorenal syndrome, emphasis is placed on individualized diuretic therapy, control of complications, and continuous monitoring of renal function, with the goal of improving patients’ quality of life and survival.

Discussion

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Cite This Study

Ladeiras et al. (2026) conducted a review in Congestive heart failure in cats (feline cardiomyopathies). Therapeutic management of feline CHF (oxygen therapy, thoracentesis, furosemide, torsemide, pimobendan, clopidogrel) was evaluated.

synapsesocial.com/papers/6ae2e2c361f440a81e6596cc https://doi.org/10.47172/ijhmreview.v12i3.683

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Therapeutic Strategies and Clinical Management in the Treatment of Heart Failure in Cats

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Therapeutic Strategies and Clinical Management in the Treatment of Heart Failure in Cats

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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