88 DISEASES OF THE HEART 



longer period than in the dog. The respirations are acceler- 

 ated, the dyspnea similar to that of pneumonia, a disease with 

 which it is sometimes confused in making a diagnosis. 



In the later stages of the condition, circulatory disturbances 

 are quite prominent. These are manifested by cyanosis, 

 venous pulse, edema of the lungs, etc. In the septic form a 

 hemorrhagic diathesis appears with hemorrhages from the 

 membranes, bloody urine, etc. As general symptoms, 

 depression, weakness, etc., come on rapidly, the animal often 

 shows complete prostration. 



Diagnosis. Acute endocarditis is quite difficult to recog- 

 nize as the symptoms are similar to other diseases of the heart. 

 It may be confused with any acute febrile disease having a 

 sudden onset (septicemia, inflammation of the brain, pneu- 

 monia, etc.). A careful examination of the heart is always 

 necessary for a diagnosis. It is often very difficult, and in 

 some cases quite impossible to distinguish between acute 

 endocarditis and myocarditis, with which it is very closely 

 associated. Between the two forms of endocarditis it is 

 almost impossible to differentiate. In the ulcerous form the 

 onset is more rapid than in the verrucose, and sometimes the 

 primary seat of infection can be located. 



Prognosis. The prognosis is unfavorable, especially in the 

 ulcerous form. Complete recovery is rare. The valves are 

 usually left permanently impaired resulting in valvular 

 insufficiency. 



The course of the disease varies. It is sometimes very 

 acute, ending in death in a few hours or days (endocarditis 

 ulcerosa). Or the condition may last for several days or 

 weeks, eventually developing into the chronic form (endo- 

 carditis valvularis verrucosa) . 



Treatment. The animals should be kept in an absolutely 

 quiet place avoiding all excitement or movement. 



In the early stages (in dogs especially) cold compresses 

 should be applied over the region of the heart (ice-bag or 

 cold water compress). These should be changed as often 

 as necessary. 



Regulate the action of the heart by the u.se of digitalis, or 

 if the heart is very weak, it should be stimulated by the use 



