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Hello I am Dr. Greg McDonald, I am a veterinarian in Southern California. I own McDonald Animal Hospital in Santa Barbara. I want to talk a little bit about congestive heart failure in dogs. This is a very common problem in some of the toy breeds, the smaller breeds, especially the poodles can wind up getting congestive heart failure. What happens is that the heart muscle starts to get enlarged, and it is usually due to a congenital problems. Once the heart muscle begins to enlarge then we start having the valves start to leak. And when the valves are not pushing the blood forward into the bloodstream every beat then it starts to back up, which causes them to have congestion. The congestion winds up getting into the lungs, and so they have fluid on their lungs. And what we first see at home is an animal that is starting to go into congestive heart failure will cough in the evenings. Usually when they are quiet. The reason that they cough is because the trachea is getting pushed up against the spine, because the heart is getting bigger. And also we also see exercise intolerance where these dogs are getting very lethargic, and they can't keep up anymore. If the owners are very astute, and pay attention they can lift the lip up and look and see that the animal is actually getting a little cyanotic instead of having nice pink gums they turn a little blue. So it is important to try and find out why your dog might be coughing at night. Your veterinarian will want to take some x-rays, possibly an ultrasound, and then get your dog on some medication to make the heart beat better, and to get rid of excess fluid on the lungs. This is a little dog that is in congestive heart failure, and it is an x-ray of the chest. You can see here that this heart is much bigger than what you would normally expect. There is a lot more sternal contact. You can see that the heart is getting pushed up this way, which is causing the trachea to be flat up against the spine. You can see the spine going along here, and a normal dog the trachea should come down, and stop about here. So this heart is getting bigger, it is pushing up on the trachea, and making this dog cough. You can also start to see some fluid build up in the lungs in this area. There is much more dense tissue right here that you are going to actually see on the x-rays, and that is because the heart is not beating properly causing congestion in the lungs. This is a dog looking down from above. We call this a VD projection, an x-ray of the heart. And you can see right here is the diaphragm, and this is the dog's head right up here, and this is a heart that is enlarged. In a normal dog the heart would not be quite that big it would be this shape. This also is what we call a basketball shaped heart it is much rounder than it should be. And again you see more of the heart pushing out towards the chest wall over here. And this is not a real traumatically enlarged heart, but you can tell the heart is enlarged, and this dog is in congestive heart failure.