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Seek veterinary attention promptly if your dog shows: Breathlessness or obvious difficulty breathing without exertion A sudden collapse or episode of fainting A heart murmur detected at routine examination Progressive exercise intolerance over several weeks A soft cough combined with reduced energy in a breed known to be at risk of cardiomyopathy Related Videos Causes of Carnitine Deficiency in Dogs The underlying causes of carnitine deficiency in dogs vary between individuals: Genetic predisposition: In breeds such as Boxers and American Cocker Spaniels, a genetic tendency to have lower plasma carnitine levels has been documented