Table 2.3 Usual staging of chronic left-sided heart failure due to endocardiosis.

Stage Definition Treatment
I Murmur present (Grade I-Il) but no fatigue, dyspnoea or coughing No therapy usually advised - but dietary intake of sodium should be controlled, and obesity corrected
II Dog comfortable at rest but cough present, may have delayed return to normal heart rate following exercise, and may have respiratory sounds Exercise should be restricted.
Dietary control over sodium intake and excessive body weight
Xanthine derivatives or diuretics
III Laboured respiration and poor exercise tolerance, in addition to coughing Minimise exercise
Digitalisation may be necessary and vosodilators may be helpful
IV Decompensated congestive heart failure with dyspnoea, orthopnoea and coughing even at rest Cage rest, diuresis and sedation if excitable
Digitalisation if tachycardia or cardiomyopathy
Vasodilator therapy
Antidysrhythmic drugs if necessary