Heart (cardiovascular) disease is any condition of the heart or blood vessels. Heart diseases can be congenital (present from birth) or acquired (occur later in life) and many diseases are heritable, meaning that they are passed on from generation to generation. Cardiology is the branch of medicine that focuses on the management and treatment of diseases of the heart and blood vessels.
How to determine if your pet has heart disease?
Symptoms of heart disease in animals can take many forms including activity or exercise intolerance, shortness of breath or difficulty breathing, restlessness during sleep, coughing, and/or fainting. Often, heart diseases may be present in animals without the presence of clinical signs and animals will not outwardly demonstrate symptoms until disease is advanced. Heart disease is often detected by primary-care veterinarians through regular physical examination prior to the onset of clinical signs. Common findings to suggest the presence of heart disease include abnormal heart sounds (heart murmurs), abnormally fast, slow, or irregular heart rhythms, abnormal arterial or venous pulses, or abnormal color of the mucous membranes.
What can be done if your pet has heart disease?
The primary goal of the cardiology service is to determine the underlying type of cardiac disease present through the use of diagnostics and to discuss the various treatment options that are available. At VCA Northwest Veterinary Specialists we offer a variety of diagnostics including:
- Electrocardiography (ECG): Study of the electrical rhythm of the heart
- Echocardiography: Ultrasound study of the heart
- Thoracic Radiography: X-ray study of the heart and lungs
- 24-hour ambulatory ECG (Holter) monitoring: Extended monitoring of heart rate and rhythm for 24-48 hours
Options for management of diagnosed disease may range from monitoring to preventative medications to medications to alleviate symptoms. We are also excited to be the first veterinary facility in Portland to offer interventional cardiology. Interventional cardiology involves the passage of catheters into the heart via peripheral vessels in order to diagnose and correct cardiac disorders. Commonly, these procedures are used in the correction or palliation of congenital heart disease and also in significant arrhythmias leading to clinical signs. This exciting option for treatment of heart disease is performed using fluoroscopy, or moving radiographs, which allow us to visualize the catheters in the heart as they are manipulated. The interventional procedures available at VCA Northwest Veterinary Specialists include:
- Balloon dilation of congenital valve stenosis: A procedure used to increase the width of narrowing or abnormally formed valves
- Catheter-Based closure of patent ductus arteriosus: A procedure to correct a common congenital heart defect in which a connection remains between the pulmonary artery and aorta
- Pacemaker implantation: A procedure required to correct arrythmias leading to slow heart rates
When is the cardiology service available?
The cardiology service at VCA Northwest Veterinary Specialists is available to provide cardiology care to dogs, cats and other animals with heart, vascular, and lung disease Monday through Thursday by appointment. We are also available to the Emergency and Critical Care Service Friday through Sunday for consultation.
Frequently Asked Questions
- What Additional Training Does A Board Certified Veterinary Cardiologist Have?
A veterinarian who has been awarded this specialty status by the ACVIM will list the initials, 'DACVIM (Cardiology),' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVIM (cardiology). The word 'Diplomate' typically means the specialist has achieved the following:
• Obtained a traditional veterinary degree (three to four years of college plus four years of veterinary school).
• Complete a one year internship and an additional two to three years of advanced training, including a residency at an approved program where the doctor will have trained with some of the best experts in the field and obtained hands on experience. As part of their training program, veterinary cardiologists receive extensive training in a variety of diagnostic imaging techniques, including veterinary echocardiography and angiography.
• Following this training, the aspiring veterinary cardiologist must pass a series of examinations covering all aspects of general internal medicine and veterinary cardiology.
After completing and passing all of these rigorous requirements, the veterinarian is then recognized by peers as a board certified specialist in veterinary cardiology, and will list the credentials, 'DVM, DACVIM (Cardiology),' after his or her name. When your pet needs the care of a veterinary cardiologist, years of intensive training and additional education will be focused on helping him or her to recover from his or her problem or enjoy the highest quality of life possible.
- Why Does My Pet Need A Veterinary Cardiologist?
Just as your own primary care physician may feel the need to refer you to the care of a specialist from time to time, your general practitioner veterinarian may feel your pet needs a veterinary cardiologist to help diagnose or treat a problem. While your general practitioner veterinarian can handle many aspects of your pet's care, just as in human medicine, there is sometimes a need for the attention of a specialist. You can be assured that a veterinarian who knows when to refer you and your pet for more specialized
diagnostic work or treatment is one that is caring and committed to ensuring that your pet receives the highest standard of medical care for his or her condition. While in some cases, your veterinarian may be able to simply consult with a specialist about your pet's care, in other cases it is necessary to actually refer you and your pet to the specialist for more advanced diagnostics and treatment. Board certified veterinary cardiologists also have access to specialized diagnostic or treatment tools that a general practitioner veterinarian may not have.
- What Is Canine and Feline Congestive Heart Failure (CHF) ?
Canine or Feline Heart disease refers to a condition where there is an abnormality of the pet's heart. Canine and Feline Heart failure exists when the heart is no longer able to meet the circulatory needs of the body. Symptoms of canine and feline heart failure include cough, edema, and rapid breathing. Symptoms of heart failure may be more pronounced in active pets as they are more likely to place a demand on their cardiovascular systems whereas the problem may go undetected in more sedentary pets.
The severity of pet heart failure is often staged, using the following guideline:
Asymptomatic: Heart disease may be detectable in the pet but there are no outward signs. A cardiac murmur or arrhythmia may be present.
Mild to moderate heart failure: Clinical signs of heart failure are in evidence at rest or with mild exercise.
Advanced heart failure: Critical clinical signs, such as respiratory distress, ascites (fluid in the body cavity), and profound exercise intolerance, are in evidence. With each advancing stage, the prognosis worsens and the need for treatment of the dog or cat increases.
- What is Chronic Valve Disease?
Chronic Value Disease (CVD), or endocardiosis, is a group of diseases characterized by degeneration and fibrosis of the heart's mitral and/or tricuspid valves. It most commonly affects the mitral valve in dogs, cats, and horses. It is less common in cats, but occurs more commonly in the smaller dog breeds, particularly the miniature poodle, Shetland sheepdog, dachshund, and cocker spaniel.
- What is Dilated Cardiomyopathy?
While valve disease is the more common heart ailment in smaller breeds of dogs, larger breeds are more prone to suffer from dilated cardiomyopathy. Dilated cardiomyopathy involves the dilation and thinning of the heart's chambers, which can lead to lowered heart function and, eventually, congestive heart failure.
- What Is Hypertrophic Cardiomyopathy?
The most common heart disease in cats, hypertrophic cardiomyopathy (HCM) is a heart muscle disease in which the walls of the heart, specifically the left ventricle, become abnormally thickened. As the disease progresses, it alters the structure of the heart and impairs its function. It is a potentially serious
disease that is found in cats of all ages. A cat that seems healthy can suddenly become very ill or even die. There currently is no cure, although there are medications veterinarians and veterinary cardiologists can prescribe to help alleviate the symptoms.
- What Is A Canine or Feline Heart Murmur?
A heart murmur is a sound caused by turbulence in the cat or dog's blood flow. Murmurs can occur if valves in the heart are leaking, either due to congenital problems or age related changes. Pet heart murmurs are graded according to severity. Mild murmurs, especially in older dogs, may not require treatment.
- What Is Pericardial Effusion?
This is a buildup of fluid in the membranous sac surrounding the pet's heart. This can be caused by various types of heart tumors although, in many cases, no apparent cause can be found. If a large amount of fluid is present, it can compress the heart and prevent it from working properly. Heart sounds will be muffled and, on x-rays, the heart may appear balloon-like due to the presence of the fluid.
- Heartworm Disease: When Prevention Fails
Veterinary cardiologists are often called upon when a pet is suffering from a suspected heartworm infection. Although there are excellent preventive medications on the market, veterinarians still see cases of this dreaded disease either due to owners forgetting to administer the preventive medication or not realizing that their pet is at risk in a particular region or time of year. The good news is that, at least for dogs, treatment options have improved. There are drugs that can be administered to remove the worms. Cases of heartworm infection in cats, although comparatively more rare, are more difficult to deal with. When a heartworm infection is detected in cats, the treatment is typically limited to close monitoring of the cat and supportive care until the worms die off. In rare cases, surgical removal of the worms may be recommended.
- The Veterinary Cardiology Exam: What to Expect
The veterinary cardiologist will start with a complete physical exam. Canine or feline heart murmurs can often be heard and detected with a simple stethoscope. The veterinary cardiologist will also check your pet's pulse rate, the color of the mucous membranes, as well as examine him or her for any physical evidence of fluid buildup in the abdomen or extremities. Other diagnostic tests that are useful when attempting to pinpoint or rule out heart disease include:
Chest X-Rays: These pictures allow the veterinary cardiologist to assess your pet's heart and lungs and also provide information that can help tell the doctor whether or not your pet is suffering from congestive heart failure.
Veterinary Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart and can tell whether heartbeats are normal or not. An ECG has a recognizable pattern showing the 'peaks and valleys' of the heart's activity. Each point on the tracing depicts how well each specific part of the heart is doing its job. An ECG can provide valuable information about a suspected arrhythmia.
Cardiac Ultrasound (Echocardiogram): This test allows the visual examination of the interior of the heart, its valves, and its surrounding structures via ultrasonography. It is a sophisticated diagnostic tool which, when combined with other components of a complete cardiac workup'"history, physical examination, cardiac and pulmonary auscultation, ECG, x-rays, and other pertinent tests'"can provide veterinary cardiologists with a complete diagnostic picture of your pet's illness and help outline a treatment course for him or her.
Doppler Echocardiography: A more advanced form of ultrasonography, this sophisticated technology can enhance the diagnostic information gained from standard two-dimensional ultrasounds. In short, sound waves are bounced off of moving red blood cells in order to determine the movement and force of blood flow within the heart. There are three types of Doppler ultrasound: continuous wave, pulsed wave, and color flow. Each type is helpful in diagnosing and/or assessing the severity of different types of heart problems.
Holter Monitor: This is a 24-hour continuous ECG recording that can provide information about heart activity while the pet is at home and engaged in normal activities. The pet wears the monitor in a specially fitted vest.
Blood Pressure Monitoring: Your pet's blood pressure can be checked and monitored in much the same way as is done in people.
Services Offered in Cardiology
- Electrocardiography (ECG)
- Holter monitoring
- In-house STAT laboratory
- Digital radiography
- Doppler ultrasound studies
- Continuous ECG monitoring and telemetry
- Central venous pressure monitoring