Kathryn Atkinson, DVM, MS, ACVIM
FREQUENTLY ASKED QUESTIONS:
What is a Board-certified Cardiologist?
In addition to completing four years of veterinary school and undergraduate training, they have completed an internship and residency, which are an additional 3-5 years of training. They must also pass rigorous examinations to achieve certification from the ACVIM (American College of Veterinary Internal Medicine). Being Board certified brings a greater understanding in the area of cardiology.
Is a consultation with my primary veterinarian available prior to my initial exam?
Either Cardiologist is available to consult with your veterinarian, but without an examination it is difficult to provide specific answers regarding your pet.
Why is my veterinarian referring my pet to a Cardiologist?
Our Cardiologists have specific training that allows in-depth knowledge of the cardiac diseases. We also have diagnostic equipment that is not often used by general veterinarians. For example, our ultrasound has Doppler study (see description below) capability.
What is a heart murmur?
A heart murmur is an unusual sound heard during a heartbeat, usually indicating turbulent blood flow. Murmurs range from very faint to very loud, on a scale from 1-6, and can sometimes sound like a whooshing or swishing noise. A heart murmur is not in itself a disease, but it does help to identify if there is primary heart disease. Some heart murmurs are innocent and do not require treatment or lifestyle change. Most often they are caused by disease and/or aging, and the treatment depends on the heart condition causing them. An echocardiogram is often recommended to determine the source of the turbulent blood flow.
What can I expect during the appointment and diagnostic testing?
Our hospital is a new place for your pet and we try and make the experience as stress-free as possible. We work slowly and patiently, to keep your pet calm. If your pet is in a critical condition, such as respiratory distress, we will work to stabilize him/her prior to proceeding with any diagnostic testing. This also helps to ensure the best quality for the test. You will have an initial consultation with the cardiology technician and Cardiologist, and then the diagnostic tests will be performed. We require your pet to lie on his/her side and/or their sternum, and be still for up to 15 minutes, for the diagnostic tests. The echocardiogram is done in a dim, quiet room and most of our patients will fall asleep while we perform this test. We rarely require a light sedation, and you will be contacted prior to this decision. Following the work-up you will meet with the Cardiologist to discuss the results of our findings and recommendations.
How long does the testing take and how soon will we know test results?
Depending on how many diagnostic tests are decided upon, we may ask that you leave your patient here for the majority of the day. If you have time constraints we can work to accommodate your needs. You will discuss this with the doctor during the morning exam. Please bring with you any supportive documentation to the appointment, including any medical records, blood tests, x-rays and medications. The results of the tests we perform will be available for you the same day, with the exception of Holter monitors and laboratory tests. The doctor will show you the echocardiogram, x-rays and/or electrocardiogram done that day, as well as go over discharge and prescription recommendations during the consultation appointment.
What diagnostic tests may be recommended?
Echocardiogram (Echo): This is an ultrasound of the heart, which helps determine how the heart is functioning. It also shows the heart muscle thickness, heart chambers, and valve structure. If a heart murmur has been heard this is the best diagnostic tool for determining the cause of the turbulent blood flow.
Doppler study: This is performed during the echocardiogram. Doppler imaging shows the flow pattern of the blood through the heart and vessels, and measures the velocity. This option is not available on all ultrasounds and our ultrasound machine does support this.
Chest Radiographs (X-Rays): These show the heart in relation to the chest cavity and the lungs and if the heart is enlarged. They also show the condition of the lungs and if congestive heart failure is present. This does not assess heart function.
Electrocardiogram (ECG or EKG): This is a recording of the heart's electrical conduction system. It shows if the heart is in normal rhythm or if there are any arrhythmias, pauses, skipped or abnormal beats. Certain patterns can also show heart enlargement.
Holter Monitor: This is essentially a 24 hour electrocardiogram, which is very important when diagnosing rhythm disturbances and causes of collapse/syncope. It is a lightweight digital device, about the size of a cassette tape, that can be worn by the smallest of patients. We do shave a small patch on either side of the chest for the electrodes to be placed. Your pet can do their normal activities; we just ask that you keep the monitor clean and dry at all times. The monitor records the electrical activity which is analyzed and printed, and then the results are discussed with you.
Can my pet eat, drink water and/or take their medications prior to the exam?
Unless otherwise requested, we advise to give all medications as prescribed and that your pet can eat and drink water as normal.
Is follow-up care with the Cardiologist, or my primary veterinarian?
We usually recommend rechecks here every 6-12 months, but depending on your pet's condition, there may be more frequent rechecks recommended to ensure the best therapy. We will also work with your veterinarian and keep him/her informed about each exam, and discuss with him/her when follow-up care can be performed at their clinic.