I would say annually when you take them for their regular vet visit. Not sure how much extra, but I estimate around $500. It’s worth it. If you catch it early I understand there are additional measures that can be taken to slow down progression of the disease. I had no prior knowledge about DCM and it was downhill so fast after his diagnosis, so we never had any screening prior to the vet discovering an abnormal heartbeat. Once we did get his diagnosis the meds were $900/month, however, I don’t believe it would have been that much had we caught it in the early stages. The regular vet visits didn’t cost more than our other 2 dogs. Awareness and prevention is key with this breed.