Physical ExaminationA heartworm infected dog with moderate disease may appear to be perfectly ordinary upon physical examination. Severely affected dogs, however, may reveal signs of right-sided heart collapse. Labored breathing or crackles can be heard from the lungs due to vascular ailments and elevated stress. A history of coughing and inability to exercise are among the first detectable abnormalities. Tachycardia (rapid heartbeat), ascites (fluid in the abdomen) and hepatomegaly (enlarged liver) signal right-sided congestive heart failure. Hemoptysis (blood in the sputum) occasionally occurs and signals severe clots and complications within the lungs. Anorexia (loss of appetite), cachexia (severe weight loss), syncope (fainting) jaundice or yellow bile pigmentation within the skin and mucus membranes may seem in severely affected dogs. Occasionally, heartworms are reported in abnormal locations such as the eyes, abdominal cavity, cerebral artery and spinal cord. Clinical signs and disease experienced in such infections depend largely upon the location of the worms. The main response to the presence of heartworms in dogs, however, occurs in the lungs and heart.Radiology (X-ray)Radiographic abnormalities develop early in the course of the disease. X-rays of the lungs and heart are the best resources available to assess the intensity of the disease and also to create a prognosis. Typical changes detected are enlargement of the following structures: pulmonary arteries at the lobes (especially the lower lobes) of the lung, main pulmonary artery, and right side of the heart. Blunting and thickening, usually along with tortuosity (abnormal twists or turns), of pulmonary blood vessels, can be noted. Inflammation can be found in the lung tissue, particularly the tissue which surrounds the pulmonary blood vessels.
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