HYPERTROPHY AND DILATATION OF THE HEART 91 



prominent symptom of hypertrophy with dilatation is the 

 extension of cardiac dulness, which in dogs may reach as far 

 back as the last rib, or even to the false ribs. 



Dyspnea, palpitation, disturbances in the circulation, 

 dizziness, etc., are resulting symptoms. A prominent sign 

 is the throbbing of the heart, which often shakes the whole 

 body and may be seen quite a distance from the animal. 

 The heart sounds are usually irregular, the first sound loud, 

 metallic and sometimes vibrating; the second sound very 

 weak and often imperceptible. The slightest exertion will 

 produce a very rapid heart action. The pulse is weak. A 

 venous pulse is common in old dogs. Ultimately, due to 

 insufficient heart action, general cyanosis, ascites, hydro- 

 thorax, etc., develop. 



Diagnosis. Care should be taken not to confuse hyper- 

 trophy and dilatation with diseases of the lungs, and other 

 affections of the heart. The increase in the area of cardiac 

 dulness, the abnormally loud, systolic sound, arhythmic 

 pulse, and tendency for ascites and edemas are all charac- 

 teristic of dilatation of the heart. A hard, full pulse with 

 increased areas of dulness points to hypertrophy of the heart. 



These conditions usually can be distinguished from val- 

 vular defects by the absence of the characteristic bruits. 



Prognosis. Favorable in simple hypertrophy of the heart. 

 Unfavorable in dilatation of the heart, except in the very 

 acute cases. 



Treatment. Absolute rest and quiet should always be 

 insisted upon. It is important to remove the causes of these 

 conditions if possible. 



(a) In hypertrophy of the heart with hyperkinesis, seda- 

 tives such as potassium iodid (dogs 0.2-0.8; cats 0.05-0.10) 

 to act as a general sedative may be used for one or two doses. 



(6) In hypertrophy complicated by dilatation, with a 

 weak, feeble heart action, cardiac tonics and stimulants are 

 indicated. Digitalis fluidextract (dogs 0.1-0.3, cats half 

 the quantity) is probably the most important drug for this 

 condition. These doses may be repeated as often as neces- 

 sary. Good, nutritious food should be allowed at all times. 

 General stimulants are to be used when necessary. 



