Most of our patients are referred for evaluation of symptoms of heart or lung disease including cough, shortness of breath or difficulty breathing, exercise intolerance, collapse, or abdominal swelling. Many referred patients do not have symptoms of heart disease but have a heart murmur, extra heart sound, or irregular heart rhythm detected by their family veterinarian that needs further investigation. Some patients are referred for evaluation of their cardiopulmonary status before an anesthetic procedure is performed. Following an initial examination a number of steps can be taken. The cardiopulmonary referral services we offer include:

Echocardiography (including Color Flow Doppler)

An echocardiogram is an ultrasound of the heart. This non-invasive test is performed to look inside the heart where we can watch the heart pump and relax, and detect heart chamber and wall enlargements. Doppler (including color-flow) refers to the most advanced type of ultrasound that allows us to determine the direction and speed of blood flow in the heart and great vessels. This knowledge allows us to detect abnormal blood flow across leaky heart valves or valves that do not open well, as well as estimate pressures inside the heart.

Pets are examined on a specially designed table with a state-of-the-art, cardiac-dedicated ultrasound machine with color flow and spectral Doppler (Vivid 7 Expert by GE). This is the same machine you would be evaluated with at your hospital. Your pet will be placed on their side while the Cardiologist moves a transducer (a "wand") from underneath the table across a small shaved area on your pet. Please note that shaving can be avoided in show dogs or other pets with special needs.

Electrocardiograms (ECG, EKG)

An electrocardiogram (ECG, EKG) is an evaluation of the electrical activity of an animal's heart. This allows us to determine if your pet's heart rate, heart rhythm, and conduction of the electrical impulses through the heart are normal. Our machine (HP Pagewriter XLi) allows on screen monitoring and high quality tracings.

Blood Pressure (Doppler)

Blood pressure can be very important in the management of heart and kidney disease in pets. Detection of high blood pressure can prevent development of sudden blindness, worsening kidney and heart disease, and stroke. Monitoring of blood pressure is critical to the most efficacious and safest dosing of some important cardiac medications.

Holter Monitors and Event Monitors

A Holter Monitor is a 24-hour ECG recorder that monitors your pet's normal daily activity in his or her home environment. This test is performed to look for intermittent rhythm disturbances that may be causing weakness, collapse (fainting), or be a risk for sudden death. This test may also be performed to monitor the treatment response to medications prescribed for irregular heart rhythms.

The Holter monitor is placed in a backpack-like wrap that is very comfortable for most dogs.

Event monitors are very similar to Holtor monitors. Event monitors can be worn for up to 30 days to determine if collapse or weakness episodes are due to an abnormal heart rhythm.

Pacemaker Implantation

A pacemaker is used to keep the heart beating regularly at a normal heart rate. Pacemakers are used to prevent sudden death and collapse in animals with severe slow heart rhythm problems. Today's pacemakers are small (about half the size of a deck of cards) and are inserted under the skin in the neck region. The pacemaker lead is advanced through a blood vessel in the neck down into the heart.

Cardiac Catheterization and Balloon Dilation

Some congenital heart defects can be improved by procedures involving passing catheters (balloon dilation catheters) down into the heart from a blood vessel in the neck. These are minimally invasive procedures that avoid chest surgery.

Radiology

Radiographs (X-rays) are taken to get a general impression of heart size and shape, to evaluate the lungs for airway disease or congestive heart failure fluid, and to look at the blood vessels in the lungs. Our Radiology Department takes high quality radiographs that are all reviewed by the Cardiologist and MedVet's board-certified radiologist, Dr. Jon Shiroma.

Emergency Transfers

If the emergency doctor from CVES has recommended that your pet be evaluated by the Cardiology Department, your pet will be transferred to either Dr. Linda Lehmkuhl or Dr. Eva Sikorska. You will be asked to leave a deposit to transfer care to the Cardiology Department. This deposit will be used to continue nursing care and medical treatment, and to begin diagnostics recommended by the cardiologist.