This is an adult onset disease with a clinical presentation that may be as subtle as a gradual development of exercise
intolerance and weight loss. However, more commonly the early signs of the disease are overlooked and the disease is
not diagnosed until congestive heart failure develops and the patient presents with coughing, respiratory distress and occasionally, ascites. It would appear that the early stages of DCM are difficult to diagnose unless a clinician maintains a high level of suspicion for dogs that are of an at risk breed and annual screening is performed.