Exercise testing informs diagnosis, prognosis, treatment of canine heart disease

An open narrative review by Grégoire Bugeaud et al. brings exercise testing and training into sharper focus for dogs with congestive heart failure (CHF), offering tools veterinarians and owners can use to improve diagnosis, prognosis, and everyday care. Physical exercise is a well‑established supportive therapy in human cardiology, but its use in veterinary cardiology, particularly in dogs with congestive heart failure, remains underexplored.

The review was conducted in accordance with the guidelines for narrative reviews as recommended by the journal Animals. The objective was to identify, analyze, and summarize the current scientific evidence on the use of physical exercise as a diagnostic, prognostic, and therapeutic tool in the management of canine congestive heart failure. The aim of this narrative review is to discuss the main published studies on physical exercise in dogs, both for diagnostic and prognostic assessment and as a therapeutic strategy (exercise training) to slow the progression of CHF, thereby contributing to a better understanding of this highly prevalent condition in routine veterinary practice.

At the clinical level the review highlights two tested, practical methods for assessing dogs’ functional capacity. Two main exercise tests have been evaluated: the 6 min walk test, which offers “a simple and practical way to assess functional capacity, and treadmill‑based protocols, including stepwise or workload tests, which can be paired with biomarkers to monitor therapeutic responses.” Both are described as submaximal tests that can help spot declining performance, track response to treatment, and add objective data when clinicians assess severity and prognosis.

On the treatment side, exercise training appears to offer real benefit but with limits. “While exercise training does not reverse myocardial damage, it appears to slow disease progression by modulating sympathetic activity, preserving [...]” The review reports that “an improvement in the functional class of heart failure and quality of life due to physical exercise has been observed, a key point for owners.” It also flags safety concerns: “Even though there are risks associated with this complementary therapy (syncope or risk of exacerbating symptoms of cardiac pathologies), the risk‑benefit balance seems to clearly favor the use of exercise when used in a controlled manner in stable patients.”

The authors note that evidence of utility has been gathered, but more work is needed: “Evidence of the utility of physical exercise as a testing method or as a complementary treatment has been gathered in this review. However, to further develop the clinical practice of exercise, additional studies need to be conducted to develop standardized testing methods, clarify the impact of exercise training programs on all classes [...]” That gap means clinicians should apply tests and training cautiously and document responses.

Practical takeaway for owners and clinicians: use 6‑minute walk tests or treadmill protocols as objective checks, consider pairing treadmill testing with biomarkers where available, and introduce exercise training only under veterinary supervision for stable patients. For active dog owners who monitor performance, these tools can turn vague concerns into measurable trends that guide care and keep tails wagging longer.

Article details: Exercise Testing and Physical Activity in Dogs: From Health to Heart Disease, Grégoire Bugeaud et al., Animals (Basel). 2025 Nov 19;15(22):3336. DOI: 10.3390/ani15223336. PMID: 41302044. PMCID: PMC12649190. Affiliations: Veterinary Medicine, EUVG‑Vasco da Gama University School, Avenida José R. Sousa Fernandes 197, 3020‑210 Coimbra, Portugal; CIVG‑Vasco da Gama Research Center, Avenida José R. Sousa Fernandes 197, 3020‑210 Coimbra, Portugal; School of Agriculture, Santarém Polytechnic University, Quinta do Galinheiro‑S. Pedro, 2001‑904 Santarém, Portugal.