This 8 year/old pekingese presented with loss of appetite and ascites. Historically she had been diagnosed with a heart murmur. Lab work showed decreased sodium and globulins and thoracic x-rays showed a tall heart with an increased vertebral heart score of 11.5 and distention/loss of detail in her abdomen from fluid accumulation. Her lung sounds were normal. Abdominal ultrasound revealed ascites with venous congestion. No compression of the caudal vena cava at the diaphragm was noticed during the respiratory cycle and the rest of the abdomen appeared normal. An echocardiogram was performed and diagnosed moderate pulmonary arterial hypertension, severe tricuspid regurgitation, moderate pulmonic insufficiency, right atrial enlargement and right ventricular hypertrophy. The left atria was enlarged and moderate mitral valve regurgitation was present. The left ventricle had increased fractional shortening and was well compensated. An abdominocentesis was performed, removing 500 mls of pink-tinged serous fluid, and recommendations were made to initiate treatment with pimobendan, enalapril, furoseomide, spironolactone and sildenafil. With a good initial response and proper treatment for pulmonary hypertension and right-sided congestive heart failure, this patient’s average life expectancy is 200 days. Without treatment we would expect this to decrease to days to just a few weeks.