Two-minute warning: A new protocol for early detection of feline heart disease you can do in your own practice

2019-9-16 iStock-147708531 Cat FCU - blog.jpg

Two minutes could be all it takes to save a cat’s life.

That’s how long it takes to administer a new screening technique to detect cardiac issues in cats who aren’t showing any outward signs of heart disease.

Researchers at the Cummings School of Veterinary Medicine at Tufts University recently developed a focused cardiac ultrasound (FCU) protocol for use by veterinarians in general practice. The team published their study in the Journal of Veterinary Internal Medicine. They write that their new protocol will increase the detection of occult heart disease in asymptomatic cats compared with routine physical examination.

John E. Rush, DVM, MS, DACVECC, DACVIM, corresponding author of the study, told NEWStat, “There’s a FCU done in an ER setting by emergency veterinarians (essentially a simplified echocardiogram—or echo—that can be performed by noncardiologists with a minimum of training), which is different than the one we propose for veterinarians in general practice.”

The researchers took that FCU protocol performed in ERs and simplified it even more to see if primary practice veterinarians, using equipment already available in a practice, could use it to screen and determine if an asymptomatic cat needed a more in-depth evaluation.

Rush, a veterinary cardiologist at the Cummings School, said, “The one we propose for general practice is a limited exam, looking at just a few cardiac structures, done on an ultrasound machine that might not be a high-end machine, done by a primary care veterinarian, taking maybe only two minutes, making no specific measurements, intended to cost only a small amount of [money, and] intended to answer the question ‘should this cat go to a cardiologist to get a more complete exam.’”

If the answer to that question is “yes, this cat should go to a cardiologist for a more complete exam,” the primary care veterinarian should refer the cat to a specialist, and that “more complete exam” would include a full echocardiogram. “The full echo might take 15 to 30 minutes, looking at all cardiac structures on a high-quality and expensive machine, done by a cardiologists or someone with extensive formal training in cardiology, making lots of measurements.”

That full echo would cost more than the proposed FCU protocol due to the time and equipment required, the measurements obtained, and the expertise of the person doing the exam, Rush said. He explained that the complete echo is intended to answer such questions as whether a cat should receive medications for cardiac disease, when to recheck the results, what is the patient’s prognosis, and are there any other tests that should be done based on the results of the full echo.

To test their theory, the researchers taught 22 general practice veterinarians, none of whom had any prior formal cardiac ultrasound training, to perform FCUs on about 300 cats, none of whom had shown any clinical signs of heart disease.

Even with limited training, the veterinarians were 93% successful at diagnosing cats with moderate heart disease and 100% successful at diagnosing severe heart disease.

Two minutes. Your own hospital. And no referral needed.

Photo credit: © iStock/aspenrock

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