Studies that differentiated respiratory signs caused by primary respiratory tract disease from those caused by congestive heart failure using NT-proBNP did not include a group with cough as the sole clinical sign and most dogs showed at least one and usually several other respiratory abnormalities (stridor, stertor, cough, increased panting, tachypnea, increased respiratory effort, and obvious respiratory distress) (40, 42). The gene discussed is NPPB; the disease is congestive heart failure.