Nutritional Supplements for Cardiac Patients
Nutrition for Cardiac Patients
- Diet in the cardiac patient can slow disease progression, minimize medication requirements, and in some cases, cure the underlying disease.
- Diet choices should be made based on the individual patient, type and extent of the heart disease, other health concerns, and what the patient will eat.
- Diet changes should be done over an extended period (approximately 1 month) to avoid GI upset.
- Diet changes should be avoided for about 2 weeks after starting or changing medications and until the patient is eating well.
- Consultations with a veterinary nutritionist are available with the help of your primary care veterinarian at: http://vetnutrition.tufts.edu
SODIUM and DIETS
Salt (sodium chloride) restriction is important to decrease the retention of water and help control blood pressure.
For more information about sodium content of various foods, please visit:
- Dog: http://vetmed.tufts.edu/wp-content/uploads/low-sodium-diet-list-dogs-oct-2018.pdf
- Cat: http://vetmed.tufts.edu/wp-content/uploads/low-sodium-diet-list-cats-oct-2018.pdf
- Treats: http://vetmed.tufts.edu/wp-content/uploads/low-salt-treats-for-dogs-2015.pdf
CVCA recommends avoiding kidney diets unless your pet has kidney disease that warrants protein restriction.
OMEGA-3 FATTY ACIDS (FISH OILS)
- Commercial diets generally do not achieve the high levels of EPA and DHA that are recommended.
- Dogs with heart failure have been shown to be deficient in EPA and DHA.
- Commercial fish oil supplements vary widely in the amount of EPA and DHA they contain.
- A common formulation is a 1 gram capsule containing 180 mg EPA and 120 mg DHA. At this concentration, the recommended dose is 1 capsule per 10 lbs. of body weight.
- Avoid cod liver oil, flax, flaxseed oil, and products containing added vitamins A and D (vitamin E should be included as an antioxidant).
- For more information about fish oils, please visit: http://vet.tufts.edu/heartsmart/diet/important-nutrients-for-pets-with-heart-disease/
- Reputable brands include Welactin and Nordic Naturals. Your primary care veterinarian may have additional brand recommendations.
- Beneficial cardiovascular effects shown in humans and dogs.
- Improved energy metabolism in heart muscle cells.
- Anti-inflammatory (heart failure is known to be an inflammatory disease).
- Reduced potential for arrhythmias and sudden death.
- Combats cardiac cachexia (the loss of lean body mass related to advanced heart disease).
- May extend the lifespan of cardiac patients.
- L-carnitine is an essential amino acid responsible for the production of energy within the heart.
- Carnitine deficiency has been reported in humans and dogs with dilated cardiomyopathy.
- Two studies in Boxer dogs and Doberman Pinschers with documented heart muscle carnitine deficiency showed improved heart muscle function with L-carnitine supplementation.
- Supplementation is safe, but can be pricey in larger dogs. The powdered form is less expensive and should be mixed with food.
- The L-form of carnitine must be used, as dogs do not convert regular carnitine to the L-form used by the heart.
- The reported doses for dogs is 50 mg per kg of body weight three times daily or approximately
- 750 mg three times daily for small-medium dogs (20-40lbs)
- 1500 mg three times daily large dogs (50-80lbs)
- 2000 mg three times daily for giant dogs (90+lbs)
- Taurine is an amino acid found in high concentrations in the heart. It is necessary for normal heart function.
- Measurement of whole blood and plasma taurine levels can be helpful in determining if patients require supplementation.
- Cats have a limited ability to produce taurine, so it must be provided in their diet.
- Taurine deficiency can cause dilated cardiomyopathy (DCM). With supplementation, cats with nutritionally-related DCM may recover normal heart size and function.
- Dogs readily make taurine from other amino acids, so they should be able to maintain normal blood levels despite their diet.
- Despite this, several studies have shown that dogs can develop taurine-deficient DCM and may respond to supplementation.
- American cocker spaniels are affected by a particular form of DCM in which both L-carnitine and taurine supplemented together have been shown to improve heart function.
COENZYME Q10 (Co-Q10)
- Co-Q10 is an antioxidant and also supports energy metabolism.
- It is used for coronary artery disease in humans and there are some studies showing benefits in patients with heart muscle dysfunction.
- There are no veterinary studies to support or refute the use of Co-Q10 in dogs and cats.
- Co-Q10 is most effective when given in an oil based emulsion and is very sensitive to UV light, so oil solution in amber colored capsules are best.
- The inflammation in heart disease can result in weight loss from decreased appetite and increased energy utilization. Dietary therapy in cases of weight loss should focus on palatability and providing adequate calories.
- Other dogs with heart disease suffer from obesity. Obesity contributes to the symptoms of congestive heart failure including breathing difficulty, coughing, and exercise intolerance. If your pet is overweight, please work with your veterinarian on a controlled weight loss plan.
There are many nutritional supplements with claims of cardiovascular benefits. While some of these benefits may be true, these natural substances may have interaction with the medications prescribed by your veterinarian. Often these natural or herbal therapies have pharmaceutical properties that may alter the blood pressure, heart rate, fluid volume or other cardiovascular parameters so please use them with caution after consultation with CVCA and your veterinarian.