Gordon D.

Peddle, VMD,
DACVIM (Cardiology)
Director of the Cardiology Section,
AERA Internal Medicine Department

Dilated Cardiomyopathy in Dogs

Understandingdilatedcardiomyopathy(DCM)
Dilatedcardiomyopathyofunknowncause
(idiopathic)isadiseasecharacterizedby
weakeninganddecreasedpumpfunctionofthe
heartmusclewithsecondaryheartchamber
dilation.ThecauseofDCMisnotclearbutmay
involvegeneticmutationsof
structural/functionalheartproteins.

DCMisgenerallydividedinto
twophases:

1) Anoccultphase,duringwhich
timediseaseispresentbutdogs
remainasymptomatic.This
phasecanlastmonthstoyears.
2) Anovertclinicalphase,when
clinicalsignsdevelop.

BreedsatincreasedriskofdevelopingDCMinclude:

Doberman Pinscher
Great Dane
Irish Wolfhound
Scottish Deerhound
Boxer
Large breed dogs, in general
American Cocker Spaniel (associated with nutritional deficiency)
Portuguese Water Dog (juvenile form)

Consequencesandclinicalsigns

Weakeningoftheheartmuscleactivatesmechanismsforsodiumandfluid
retentionwithinthebodythatcauseheartenlargement(dilation)andcirculatory
congestion.Thiscanleadtoexerciseintoleranceandcongestive heart failure(for
moreinformationaboutcongestiveheartfailureseeoureducationalbrochure
Heart disease and congestive heart failure),usuallymanifestedasrespiratory
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distressand/orcoughingandweakness.Thediseasedheartmusclecanalsolead
toelectricalinstabilityandabnormalheartrhythms,orarrhythmias.Arrhythmias
canleadtosyncope(fainting)andevensuddendeath.

Diagnosis

DiagnosisofDCMindogsintheoccult
phaseisusuallyviadetectionof
arrhythmiasand/ordecreasedcardiac
pumpfunctiononroutineevaluationor
diagnosticscreening.Diagnosisof
DCMindogsduringtheclinicalphase
ismadewhenclinicalsignsappear
causedbyarrhythmiasordecreased
cardiacpumpfunctionintheabsence
ofanyotherunderlyingcause(certain
conditionsthatcanmimicDCMincludeotherstructuralheartdiseases,toxic
cardiomyopathies,nutritionalassociatedcardiomyopathies,andmyocarditis).
ThetestsneededbyyourdogscardiologisttodiagnoseDCMmayinclude:

Electrocardiography(EKG)
Echocardiography(cardiacultrasound),or
Holtermonitor(24hourambulatoryelectrocardiography)

Treatment

Treatmentfortheunderlyingheartmusclediseaseisnotcurrentlyavailable,but
treatmentofclinicalsignscanbeinstitutedandoftenimprovepatientqualityof
life.Congestiveheartfailurecanbetreatedwithmedicationsthatreduce
circulatorycongestionandimproveheartfunction.Treatmentofclinicalsigns
associatedwitharrhythmiascanbeachievedviaantiarrhythmicmedications.

Prognosis

PrognosisfordogsintheoccultphaseofDCMisguarded,asclinicalsignsare
expectedtodevelopeventuallybutthisphasemaylastformonthstoyears.Serial
reexaminationbyyourdogscardiologistisrecommendedevery6monthsduring
thisphasetomonitordiseaseprogression.Prognosisfordogsintheclinicalphase
ofDCMisguardedtopoor,withsurvivalgenerallybetween58monthsfromthe
timeofdiagnosis(slightlylessinDobermanPinschers),buttreatmentisoften
effectiveatalleviatingclinicalsignsandimprovingqualityoflife.

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