Cardiac Examination
Cardiac physical exam includes:
- Auscultation (listening) to the heart to evaluate for heart murmurs, arrhythmias (irregular rhythm), or abnormal heart sounds. An abnormal valve can often be identified based on the location of a murmur on the chest.
- Palpation (feeling) of the heartbeat.
- Auscultation (listening) to the lungs
- Assessment of circulation, including femoral pulse quality, jugular pulsation, and mucous membrane color/refill time.
Electrocardiogram
An electrocardiogram measures the electrical activity of the heart and allows accurate determination of both heart rate and rhythm. Any abnormal rhythm (arrhythmia or dysrhythmia) can be detected and further evaluated. SFVS uses a GE MAC 5000, MAC 1200 and a Solar 8000 for in house ECG testing/monitoring.
Echocardiogram (ultrasound, sonogram, sometimes referred to as a Doppler):
An echocardiogram uses soundwaves to evaluate the:
- heart chamber size, wall thickness, and cardiac function
- appearance and function of the 4 cardiac valves
- blood flow across the valves
- presence of cardiac tumors or fluid around the heart.
- Elevated blood pressure in the lungs (pulmonary artery hypertension)
- This is the diagnostic test that yields the most information about underlying heart disease type and severity.
SFVS uses a GE VIVID 7 in the Bonita office and an Acuson Cypress in the Sarasota office.
Doppler Blood Pressure
This test uses Doppler technology to assess the afterload or resistance to blood flowing out of the heart.
High blood pressure (systemic hypertension) can occur in older animals or in animals with diabetes, kidney, adrenal or thyroid disease.
Systemic hypertension can have a significant impact on underlying heart or kidney disease, and can cause blindness in some animals. SFVS uses a Parks Doppler Model 811-B for blood pressure monitoring.
Thoracic Radiography
Radiographs of the chest are used to evaluate:
- the size and shape of the heart
- the lungs for fluid (from congestive heart failure or other causes), infection/inflammation, or masses
- the chest cavity surrounding the heart and lungs
- the trachea
- thoracic skeleton for evidence or deformity or trauma
Laboratory Services
Laboratory testing is used to assess:
- overall metabolic function and screen for underlying disease.
- the response or effects of commonly used cardiac medications.
- SFVS has a full in house laboratory as well as use of an outside laboratory for more advanced testing.
Oxygen Therapy
This is commonly used in critically ill patients, particularly those with congestive heart failure, pulmonary disease or severe pulmonary artery hypertension.
Methods of oxygen delivery include:
- flow by or supplemental oxygen: holding an oxygen supply up to the patients nose/mouth using a tube or mask
- nasal oxygen: delivered through a tube directly into the nasal passage
- oxygen chamber: a highly concentrated oxygen chamber or cage that the animal is placed inside of.
All of the above options are used for patients requiring oxygen therapy at SFVS.
Holter Monitor
A Holter monitor is a 24 hour ambulatory electrocardiogram used for arrhythmia detection. This is useful for identifying new arrhythmias as well as evaluating for response to treatment with antiarrhythmic medication. It is also used to screen for arrhythmias in certain at-risk breeds (Doberman, Boxer). Electrodes are placed on both sides of the chest and attached to a recording device. The entire monitor is secured using a combination of tape and a vest or jacket and is typically well tolerated by the animal.
Acute and chronic heart failure therapy
All of the testing modalities mentioned above are utilized for the diagnosis, treatment, and monitoring of patients with cardiac and/or respiratory disease with the goal of keeping disease controlled and maintaining a good quality of life for all of our patients.
Fluid removal
Patients with various types of heart disease can accumulate fluid within body cavities. These cavities include the pericardial sac (sac around the heart), chest, or abdomen. This fluid can significantly compromise circulation, energy level, ability to breathe or rest comfortably and can be fatal in some cases if not removed quickly. Fluid can be removed from these cavities (a procedure called centesis) offering near immediate relief for the patient. Fluid can also accumulate in the lungs and skin, but fluid in these locations can only be removed with medication.
Some animals need to be sedated for fluid removal, but anesthesia is rarely necessary. The procedure is done with sterile technique to avoid introducing an infection. The fluid that is removed is analyzed to further identify the underlying disease process. There are risks associated with fluid removal which are fully discussed prior to performing the procedure. Most animals respond very well and often feel significantly better immediately.
