VALVULAR INSUFFICIENCY AND STENOSIS 81 



frequent occurrence in the dog. It is often accompanied by 

 dilatation or hypertrophy of- the heart. Pulse rapid and 

 irregular; systolic bruit and increase of the diastolic sound on 

 auscultation; dyspnea; cyanosis; general weakness; dropsical 

 conditions (ascites, etc.) . A careful examination is necessary 

 to make a differential diagnosis. 



The direct effect of aortic insufficiency is the regurgitation 

 of blood from the artery into the ventricle, causing a disten- 

 tion of the cavity and a reduction of blood pressure in the 

 artery. The amount returning varies with the size of the 

 opening. This regurgitation eventually leads to dilatation 

 and finally hypertrophy. In this way the valve defect is 

 compensated for, and as with each ventricular contraction a 

 larger amount of blood is forced into the arterial system, the 

 regurgitation of a certain amount for a time during diastole 

 does not interfere with the nutrition or with the general 

 circulation. 



The condition is characterized clinically by: A full pulse; 

 strong heart beat; dyspnea; dropsical conditions (ascites, 

 etc.) ; cough from congestion and edema of the lungs; increased 

 area of dulness in the cardiac region; diastolic bruit, etc. 



Insufficiencies of other valves are impossible to recognize 

 during life in these animals. 



Diagnosis.— The faulty heart action is not difficult to 

 recognize, but to determine the location of the lesion is very 

 difficult in small animals. In some cases, however, by care- 

 fully observing the symptoms and using the phonendoscope 

 a differentiation is possible. 



Prognosis.— Complete recovery cannot be expected even 

 in mild cases of insufficiency, therefore the prognosis is 

 unfavorable. However, the condition may exist for a long 

 time in individual cases without producing any serious 

 symptoms provided adequate compensation exists. 



Treatment. — (a) During the stage of compensation no 

 medical treatment is indicated. Keep the animal quiet as 

 possible, avoid all undue excitement and exercise, and give 

 nutritious food to maintain the general condition. 



(b) Stage of broken compensation, when the symptoms 

 of weakness, edema, palpitation, etc., appear, heart tonics 

 6 



