Changes

* Mid-systolic click, associated with mitral prolapse. In many dogs, clicks are a precursor to mitral regurgitation.

* Mid-systolic click, associated with mitral prolapse. In many dogs, clicks are a precursor to mitral regurgitation.

Primary respiratory disease, such as chronic bronchitis, is also common in older small breed dogs. It is important to distinguish between the patient with clinically significant respiratory disease and incidental DMVD from the patient with clinically significant DMVD.  

Primary respiratory disease, such as chronic bronchitis, is also common in older small breed dogs. It is important to distinguish between the patient with clinically significant respiratory disease and incidental DMVD from the patient with clinically significant DMVD. Respiratory sinus arrhythmia, indicating vagal influence on heart rate and rhythm, is usually not present in severe cardiac disease. In contrast, sinus arrhythmia is usually preserved or accentuated when respiratory disease is the cause of clinical signs.

 

 

Signs depend on stage of disease, but may include coughing, syncope, weight loss, pale or cyanotic mucus membranes and prolonged capillary refill time. If left sided heart failure is present then signs will also include exercise intolerance, weakness, dyspnoea, inappetance and lethargy. If right sided heart failure is present then signs including hepatomegaly, jugular pulses & distension, pleural effusion, ascites and peripheral oedema (pulmonary crackles) will occur.  

 

There may be resting tachycardia, pale mucous membranes, prolonged capillary refill time (CRT) and jugular filling time, cool extremities, loss of sinus arrhythmia and new cardiac arrhythmias e.g. [[Atrial Fibrillation|atrial fibrillation]] or [[Supraventricular Premature Complexes|atrial premature complexes]].

== Diagnosis ==

== Diagnosis ==