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During the second phase of dilated cardiomyopathy, clinical signs begin to appear. These clinical signs may include, exercise intolerance and congestive heart failure. This is usually manifested as respiratory distress and or coughing and weakness. The unhealthy heart muscle can also lead to electrical instability and irregular heart rhythms, also known as arrhythmias. Arrhythmias can then lead to syncope and even sudden death. To diagnose a dog with dilated cardiomyopathy, your dog’s cardiologist may look for arrhythmias and/or decreased cardiac pump function by using one or more of these test; electrocardiography, echocardiography, or a holter monitor. All of which check for arrhythmias, decreased cardiac pump function on routine evaluation or diagnostic screening. If any of the previously listed are found, a cardiologist must rule out the following to properly diagnose the dog; structural heart diseases, toxic cardiomyopathies, nutritional‐associated cardiomyopathies, and myocarditis. All of which mimic symptoms of dilated