The THCKCS guide to Heart Care
As many cavalier owners will know, the breed is prone to several serious health conditions, one of which is MVD; mitral valve disease. It’s said that this polygenetic disease affects the cavalier breed 20 x more than any other canine breed.
Current statistics show that MVD affects over 50% of all Cavalier King Charles Spaniels by age 5 years and nearly all Cavaliers by age 10. Cavaliers should be screened for heart murmurs annually from the age of one.
What is mitral valve disease (MVD)
Also referred to as degenerative valve disease, MVD involves the degeneration of the heart valve separating the two chambers on the left side of the heart. As a chronic progressive disease, it will worsen over time.
The heart has four valves, one of these being the mitral valve. The purpose of the valves is to control the flow of blood around the heart each time it beats. When the heart beats, the valves allow blood to pass through and then close to stop any blood from leaking back into the initial chamber. MVD causes the valve between the left atrium and left ventricle to thicken, resulting in the valve not being able to close properly and blood leaking back through as a result. This leak is heard as a heart murmur.
The knock-on effect is that greater pressure is put on the heart to work harder and pump blood around the body. The heart also enlarges due to the need to pump harder to compensate for the loss caused by the initial backflow (‘regurgitation’). The heart may be able to cope with this over a long period; however, at a certain point, the pressure becomes so high that blood accumulates in the blood vessels of the lungs causing fluid to leak into the lungs – the result is congestive heart failure.
How severe is MVD?
We already know that MVD is a chronic and progressive disease, with the worsening effects outlined above, but that doesn’t mean that all dogs with the disease go on to develop heart failure. The various stages of the condition have been classified as below:
STAGE A – Breeds prone to MVD with no current symptoms or murmur
STAGE B1 – A murmur is present but there are no symptoms and no evidence of heart changes on imaging
STAGE B2 – A murmur is present with signs of enlarged heart but no heart failure
STAGE C – Showing signs of heart failure such as coughing, breathing problems, exercise intolerance, or collapse.
Symptoms to look out for
Symptoms of MVD may not display easily and in some cases, affected dogs can live their entire lives without showing any signs of the disease. The main symptom for diagnosing MVD is the presence of a heart murmur – this will only be picked up during a routine examination by your vet who can listen to your dog’s heart.
There may be other signs that could indicate the onset of MVD, including:
coughing (after lying down or sleeping, and often worse at night)
slowing down on walks or displaying low energy in general
breathing quicker than usual, with breathlessness and/or panting
weight loss
fainting or collapsing.
If in any doubt, it is always best to get your dog seen by a vet. Upon detection of a heart murmur, further tests may be required to confirm the diagnosis. It is also recommended to take your dog to your veterinarian for annual heart screens.
Our recommended steps to boost
Diet
Recent studies have shown deficiencies of taurine and carnitine may contribute to the development of heart disease in dogs and so a diet rich in these amino acids is crucial.
As such, we recommend feeding a raw diet which is full of protein and therefore the amino acids that can help to contribute to heart health.
See the below graphs for meats rich in these amino acids;
As you can see the highest levels of these two crucial amino acids are found in meat and organs.
Where a raw diet cannot be fed, a freeze-dried or cooked diet would be the next best thing however it’s important to remember that the cooking process will slightly deplete the nutrient value of the food. Freeze drying does not have this issue but it can be more expensive than most other formats of food.
Inflammatory foods such as starchy carbohydrates, grains and legumes which are lectin rich should be avoided wherever possible. This is because MVD is an inflammatory disease and therefore it’s paramount to feed foods that reduce inflammation and are not pro-inflammatory. Carbohydrates should be fed in the form of fresh fruit and vegetables.
You can read more about feeding a fresh diet here and alternatives to raw (usa) here aswell as our alternatives to raw (U.K.) here.
Omega 3’s
Omega 3 is one of the most powerful supplements you can add to your dog’s diet. Countless studies have shown that omega-3 fatty acids have far-reaching positive effects on the health of dogs. Among others, they can contribute to the brain development of puppies, strengthen the immune system of dogs, reduce inflammation, increase the ability to fight cancer and benefit heart health. Some studies indicate omega 3’s have positive effects on myocardial energy metabolism, endothelial function, heart rate and blood pressure, and immune function.
The best sources of omega-3 come from feeding EPA & DHA and by feeding fresh fish. Where this cannot be done - check out or omega 3 guide and article linked here to find the best omega 3 supplements for your dogs.
Be careful not to feed too many omega 6’s as these are also pro-inflammatory when they are not balanced correctly with omega 3’s.
Antioxidants
Because MVD is an inflammatory disease -
It’s recommended you feed antioxidant-rich foods which help to protect cells from damage which is caused by reactive oxygen species (ROS) and therefore free radicals. Both of these are unstable molecules which cause damage to cell structures. Inflammation within the body can lead to an increase in ROS. These ROS damage the surrounding tissues. At low levels, ROS is a signalling molecule for cells, however, when in high quantities it can lead to the progression of inflammatory diseases.
Research studying the impact of supplementing the diet with antioxidant-rich vitamins (like vitamin C, beta-carotene, vitamin E and selenium) has come up short, but diets high in antioxidant-rich foods have been linked to a reduced risk of developing heart disease. As a result, current national guidelines on the prevention of cardiovascular disease recommend choosing foods rich in antioxidants versus taking supplements. Below is a list of the best food sources of important antioxidant nutrients.
Vitamin C
Berries, dark green vegetables, red and yellow peppers, tomatoes and tomato juice, pineapple, cantaloupe, mangos, papaya and guava.
Vitamin E
Eggs, salmon & dark leafy green vegetables.
Selenium
Chicken, eggs, dairy products, garlic, salmon, wheat germ, and most vegetables.
Beta Carotene
Variety of dark orange, red, yellow and green vegetables and fruits such as broccoli, kale, spinach, sweet potatoes, carrots, red and yellow peppers, apricots, cantaloupe and mangos.
Other foods may be available
We recommend using four-leaf rovers whole food supplements for easy supplementation where feeding these foods isn’t possible.;
Red rover - antioxidants in a tub!
Green rover - organic broccoli sprouts and fermented greens
Herbs
Dandelions;
Dandelions have been used in herbal medicine throughout history to reduce inflammation and relieve pain. That’s because they have polyphenols that are powerful anti-inflammatories. They also have alkaloids, flavonoids and terpenoids that have value as anti-inflammatories. Dandelions are also
full of antioxidants which can help fight free radicals found in the body that may lead to some chronic health conditions such as cancer or diabetes. A great natural anti-inflammatory, liver tonic and diuretic. Dandelion root is most helpful for digestive and liver support, while the leaves have stronger diuretic properties meaning that they help remove excess fluid from the body. This is particularly useful for animals with heart disease. When the heart pumps blood less effectively (for many reasons), excess plasma from blood vessels will seep out into the lungs.
If you are looking to support a pet with heart disease, then a combination of Hawthorne berries and Dandelion Leaf may be beneficial, such as the product Heart Care made by Amber Naturals.
If you are using homegrown dandelion, always ensure it has been grown organically and without pesticides. Ensure it is prepared correctly before feeding.
If you would like to give Dandelion on its own, here are some other doses that may be useful:
Infusions and teas: 5-30grams per cup of water. Give 1/8 cup of tea per 10kgs of body weight twice a day
Leaf (Usually in 25% ethanol): 1:2 or 1:3 ratio; Give 0.5 ml per 10kgs of weight twice a day
Root or whole plant (Usually in 25 – 70% ethanol) 1:2 – 1:3 ratios; Give 0.5cc per 10kgs of body weight twice a day
Hawthorn;
Hawthorn is best known as one of the safest herbs for the heart.
It is commonly used as a cardiac tonic, as it increases blood circulation by dilating and relaxing the blood vessels, and enhances the transport of nutrients and oxygen throughout the body. Like dandelion, it’s also a great source of antioxidants.
When it comes to hawthorn supplements for dogs, there is a fair amount of research on the subject. Hawthorn is among the most studied plants in western herbal medicine and that provides many benefits when it comes to seeking information. Placebo-controlled studies in humans have revealed success in treatments from leaves, flowers and berries of the hawthorn plant.
Whilst you can feed the berries, we recommend using a dandelion and hawthorn tincture such as;
Only Natural Pet (USA/CANADA)
Dandelion (Taraxacum officinale) Roots and Leaves Alcohol-Free Tincture
Hawthorn (Crataegus oxyacantha) Flowers and Leaves Alcohol-Free Tincture
Reminder to always choose alcohol-free or at most low alcohol tinctures!
Supplements;
One Great heart all rounder supplement is the heart packages from Five Leaf Pet Botanicals. Specifically we recommend their heart care pack one;
1 x Canine Heart Formula
1 x Hawthorne
1 x Dog Greens
1 x Carnitine + Taurine
1 x Canine Heart Health Handbook
Cardiac Supplements;
Ferapets cardiac support - (Also suitable for daily preventative coq10 dose)
Taurine 250 mg
L-Carnitine 200 mg
Coenzyme Q10 50 mg
Organic Hawthorne Berry 50 mg
Vitamin E (D-Alpha Tocopherol) 10 IU
Inactive Ingredients
Salmon Flavor
Silica (from bamboo)
Vegan capsule (Cellulose, Water)
Thornevet heart health powder/chews
Ingredients;
L-Carnitine (L-Carnitine Tartrate) 140mg
Taurine 140mg
Hawthorn extract (flowering tops) (Crataegus laevigata) 70mg
Eleuthero extract (root)(Eleutherococcus senticosus) 70mg
d-Alpha Tocopheryl (Vitamin E) (70 IU) 58mg
Quercetin Phytosome 50mg
Arjuna extract (bark) (Terminalia arjuna) 35mg
Coenzyme Q10 20mg
Iron (II) Bisglycinate 1.5mg
Magnesium (Albion® DiMagnesium Malate) 500mcg
Potassium (Tripotassium Citrate) 100mcg
COQ10;
This is a nutrient produced naturally in the body. A powerful antioxidant, it protects the brain, heart and muscles. “CoQ10 is in virtually all cells in the body,” Peart says. “It’s mostly concentrated in the mitochondria or the ‘powerhouse’ of the cell.
That means it’s involved in energy production and powers biochemical reactions. In addition, CoQ10 has anti-inflammatory properties.
Certain foods you feed to dogs also contain CoQ10, including:
Oily fish such as salmon, mackerel and sardines.
Eggs.
Chicken.
Organ meats, like livers, hearts or brains.
When veterinary cardiologists studied the impact of using CoQ10 on dogs with heart disease, the results showed that CoQ10 may protect heart muscle cells from injury through its antioxidant action.
Studies and research recommend starting breeds predisposed to MVD on Coq10 at age 2 at a daily dose of 30mg and upping to 200mg once a day upon diagnosis of MVD.
Dr Judy Morgan advises that some supplements, such as CoQ10, may defer the onset of mitral valve disease although there is no scientific proof they do so. She recommends 100 mg twice daily for dogs under 13 and 8 to 10 mg per pound of body weight twice daily for larger breeds prone to heart disease.
In Dr Khalsa’s book, Natural Dog, she states the following guidelines for feeding;
“A small dog would take 30 milligrams once a day; a large dog would take 30 to 100 mg once a day. The dose should be doubled in cases of very advanced heart failure.”
Many Coq10 supplements contain harmful inactive ingredients - we recommend where possible to use a supplement with 0 inactive ingredients but we have found this hard to find as the years go on. So sometimes it can be a case of finding a Coq10 with the least amount of harmful excipients.
Learn more about finding healthy supplements here.
Preventative dosage for the USA
Now 30mg COQ10 - Other Ingredients: Rice Flour and Hypromellose (cellulose capsule).
Ferapets cardiac support - (Also suitable for daily preventative coq10 dose) Ingredients: Taurine 250 mg, L-Carnitine 200 mg, Coenzyme Q10 50 mg, Organic Hawthorne Berry 50 mg, Vitamin E (D-Alpha Tocopherol) 10 IU Inactive Ingredients: Salmon Flavor, Silica (from bamboo) Vegan capsule (Cellulose, Water)
The treatment dosage for the USA
Purely holistic 100mg - ingredients; Organic Oilve Oil, Gelatin, Purified Water, Sunflower Lecithin, Glycerin. Contains <1% of the following: Iron Oxide Color.
Jarrow formula 100mg - Other Ingredients: Capsule - Microcrystalline cellulose, (hydroxypropylmethylcellulose, water), magnesium stearate (vegetable source) and silicon dioxide.
The preventative dosage Europe
Viridian 30mg COQ10 (only suitable for dogs cleared of MCADD) - Ingredients; MCT (Medium Chain Tryglycerides from coconut oil)100mgCo-Q10, (Ubiquinone)30mgIn a base of Alfalfa and Spirulina and Bilberry Plant cellulose capsule/.
Terranova COQ10 30mg - ingredients; Stabilised Rice Bran 350mg, Acai Berry [Euterpe oleracea] (fresh freeze dried – ORGANIC) 50mg, Sea Buckthorn Berry/Leaf [Hippophae rhamnoides] (fresh freeze dried) 50mg, Artichoke Leaf [Cynara scolymus] (fresh freeze dried) 25mg, CoQ10 (coenzyme Q10 – as ubiquinone) 30mg, Larch Tree Arabinogalactan [Larix occidentalis] 5.5mg.
Treatment dosage Europe
Viridian CoQ10 200mg (only suitable for dogs cleared of MCADD)Ingredients; MCT (Medium Chain Tryglycerides from coconut oil)100mgCo-Q10, (Ubiquinone)30mgIn a base of Alfalfa and Spirulina and Bilberry Plant cellulose capsule/.
Terranova COQ10 100mg - ingredients: Stabilised Rice Bran 350mg, Acai Berry [Euterpe oleracea] (fresh freeze dried – ORGANIC) 50mg, Sea Buckthorn Berry/Leaf [Hippophae rhamnoides] (fresh freeze dried) 50mg, Artichoke Leaf [Cynara scolymus] (fresh freeze dried) 25mg, CoQ10 (coenzyme Q10 – as ubiquinone) 30mg, Larch Tree Arabinogalactan [Larix occidentalis] 5.5mg.
It’s important to note that in the current climate we are finding that supplement formulations are changing rapidly due to supply chain and production issues and therefore some supplements that we may have recommended may have had their ingredients list changed to contain undesirables. For this reason, we encourage members to read our supplement guide linked here for you able to learn more about what ingredients should be avoided at all costs.
As always, we hope this guide combined with our additional resources linked below will contribute to helping you make an informed decision regarding the best preventative care for your dog's heart health.
Sources;
https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-019-2169-1
Recent studies have shown deficiencies of taurine and carnitine may contribute to the development of heart disease in dogs.
https://pubmed.ncbi.nlm.nih.gov/20673293/ - omega 3 and heart disease
J.A. Duke, The Green Pharmacy Herbal Handbook: Your Comprehensive Reference to the Best Herbs for Healing (Rodale Books, 2000).
https://www.hindawi.com/journals/ecam/2013/149363/
R. Kidd, Dr Kidd's Guide to Herbal Dog Care (Storey Publishing, 2000).
Coq10 for dogs: https://he01.tci-thaijo.org/index.php/tjvm/article/download/146580/108066/392102
M.L. Wulff-Tilford and G.L. Tilford, Herbs for Pets (Bowtie Press, 1999).
https://www.whole-dog-journal.com/health/heart-disease/coq10-for-heart-health-in-dogs/?amp=1
https://drjudymorgan.com/blogs/blog/benefits-of-coq10-for-heart-disease