Comparison of Doppler ultrasonic sphygmomanometry, oscillometry and high-definition oscillometry for non-invasive blood pressure measurement in conscious cats.

OBJECTIVES: Systemic arterial hypertension is a common occurrence and can have serious adverse consequences in cats. Therefore, measuring blood pressure is very important. There are many indirect blood pressure measurement devices available. This study compared Doppler, oscillometric (petMAP Graphic II, SunTech Vet20, the Cardell Insight-X0000) and high-definition oscillometry devices for the non-invasive measurement of blood pressure in conscious cats. METHODS: In this prospective study, blood pressure was measured in 32 cats using the different devices according to the recommendations of the American College of Veterinary Internal Medicine Consensus Statement. Blood pressures (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP]), time to complete measurements, number of attempts needed, coefficient of variation (CV) between the blood pressure measurements of the different devices, ease of completing measurements and apparent stress level of the cat were assessed. RESULTS: There was a significant difference between devices in the time taken to obtain blood pressure readings and the number of attempts necessary to obtain six reliable measurements. The CV of the Doppler device was significantly smaller than that of the rest of the devices, but there were no other differences between the devices. The mean SBP, DBP and MAP measured by the petMAP device were significantly higher than the measurements from the other devices. The perceived ease of measurement was not significantly different between the various machines. The perceived level of stress of measurement with the Doppler device was significantly higher compared with the other devices but did not lead to an increased SBP. CONCLUSIONS AND RELEVANCE: Using a Doppler device to measure blood pressure in conscious cats is fast, relatively easy and gives reliable results. A disadvantage is that the Doppler device can only measure SBP, while oscillometric devices also provide DBP and MAP. However, in veterinary medicine, systolic hypertension is considered the most relevant.

Understanding the barriers to blood pressure assessment in cats.

OBJECTIVES: A questionnaire was designed to survey veterinarians and veterinary nurses/technicians on blood pressure (BP) assessment in cats, including ocular examination, encompassing current methodology, indications, uptake and barriers. METHODS: An online questionnaire was produced and promoted to more than 2000 veterinary professionals, of whom 545 answered all questions and 85 answered most questions. RESULTS: Of the participants, 572 (90.8%) were based in the UK and almost all (n = 613, 97.3%) had access to a BP monitor. Of those that had a monitor, most (n = 550, 88.4%) participants had access to a Doppler monitor; 367 (59.0%) participants had access to multiparameter monitors; fewer (n = 202, 32.5%) had access to oscillometric BP monitors. Where applicable, Doppler monitors were most commonly chosen for conscious cat measurements (n = 337, 72.2%) due to the greater 'trust' and 'reliability' of these compared with oscillometric machines. Conscious BP measurement typically involved two members of staff (n = 391, 62.9%). Only 156 (29.1%) participants recommended BP assessment at least several times a week in their interactions with cat owners. BP assessment was routinely recommended in cats with ocular target organ damage (n = 365, 87.7%), chronic kidney disease (n = 346, 78.6%), proteinuria (n = 255, 63.0%) and hyperthyroidism (n = 266, 60.9%). Common equipment-related barriers included 'cuff frustration' and difficulties hearing the pulse signal for Doppler users (72.2% and 71.6%, respectively), and oscillometric machines failing to give a reading at least some of the time (52.8%). Situational hypertension concerns affected many (n = 507, 92.0%), as did lack of time to do the procedure (n = 402, 73.0%). Significant owner barriers included difficulties persuading the owner to bring their cat in for BP checks (n = 475, 86.2%) and concerns over costs (n = 445, 80.8%). Most participants had access to a direct ophthalmoscope (n = 527, 96.5%); however, 399 (73.1%) reported that they struggled to interpret ocular findings. CONCLUSIONS AND RELEVANCE: Significant barriers exist to successful BP assessment in cats. Education and support of clinics should focus on improving confidence with equipment and eye examination.

Agreement Between Tongue-Based Oscillometric and Invasive Blood Pressure in Anesthetized Dogs of Various Weights.

This study aimed to evaluate the agreement between oscillometric blood pressure (OBP) measured from the tongue and invasive blood pressure (IBP) measured from the dorsal pedal artery in anesthetized dogs of various body weights. Forty-five client-owned dogs undergoing general anesthesia for surgery or imaging scan were included; weights ranged from 2.5 to 42.6 kg. Agreement between paired IBP and OBP during normotension was verified with reference standards used in small animals and humans. The data were stratified by body weight (≤5 kg versus >5 kg). In the >5 kg group (n = 29), the bias ± standard deviation for mean (2.1 ± 7.9 mm Hg) and diastolic pressure (-2.7 ± 7.9 mm Hg) exhibited reliability that met human standards (<5 ± 8 mm Hg). However, in the ≤5 kg group (n = 16), the bias ± standard deviation met only veterinary standards (≤10 ± 15 mm Hg) for mean (3.1 ± 10.2 mm Hg) and diastolic pressure (-2.5 ± 12.6 mm Hg). Agreement for systolic pressure did not meet either standard for both groups. This study demonstrates that tongue-based OBP is a close estimate of mean/diastolic blood pressure in anesthetized dogs (>5 kg) during normotension by small-animal and human criteria.

'The Mercury Challenge': feline systolic blood pressure in primary care practice - a European survey.

OBJECTIVES: The aim of this study was to collect data from a substantial number of older cats having their systolic blood pressure (SBP) measured in a variety of clinical practices, to describe the findings and assess variables that affected the duration of assessment and the values obtained. METHODS: An international (European-based) multicentre convenience sample survey of cats ⩾7 years of age attending veterinary clinics and having SBP measured as part of their clinical assessment. Information gathered included details of the cat, concomitant disease(s) or therapies, SBP results, device used, time taken to assess SBP and the demeanor of the cat. RESULTS: Useable data were available from 8884 cats aged 7-26 years, from 811 clinics across 16 countries. The device used to measure SBP was Doppler in 47.4% and oscillometry in 48.5%. The demeanor of the cat was reported to be calm in 45.7%, anxious in 41.9% and nervous in 8.9%; and the duration of assessment was reported to be <5 mins in 50.4%, 5-10 minutes in 41.7% and >10 mins in 7.9%. Concomitant chronic kidney disease (CKD) was reported in 21.8%, hyperthyroidism in 12.0% or both in 3.1%. The median SBP was 150 mmHg (range 80-310), with 18.6% classified as hypertensive (SBP 160-179 mmHg) and 21.1% as severely hypertensive (SBP ⩾180 mmHg). The measured SBP was significantly affected by the cat's demeanor, duration of SBP assessment, presence of CKD and/or hyperthyroidism, the cat's sex and age, and the presence of concomitant therapy. The duration of SBP assessment was significantly affected by the cat's demeanor. CONCLUSIONS AND RELEVANCE: In veterinary clinics, SBP can be measured in most cats within a short period of time using either Doppler or oscillometric equipment. The presence of CKD or hyperthyroidism was associated with significantly higher SBP values, and anxious or nervous cats had higher SBP values and took longer to obtain SBP assessments.

Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats.

OBJECTIVES: This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. METHODS: Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer's guidelines. Doppler and oscillometric devices were used alternately as the first device. RESULTS: Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A (P <0.001) and B (P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A (P = 0.002) and B (P <0.001). Both modes' MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (-14.94 mmHg), with a smaller bias and narrower LOA. CONCLUSIONS AND RELEVANCE: The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.

Pressão arterial sistólica em cães anestesiados: concordância entre mensurações por dois métodos não invasivos / Systolic blood pressure in anesthetized dogs: agreement between measurements by two noninvasive monitors

The oscillometric monitor is a noninvasive method used for measuring blood pressure in dogs and cats. Despite widely used, there is a large variability in the accuracy of oscillometric monitors, which may also be influenced by the location of the blood pressure cuff. The Doppler ultrasound is another non-invasive method that was shown to measure blood pressure with good accuracy and precision in small animals. The present study aimed to determine the agreement between systolic arterial pressure (SAP) measured by the Prolife P12 oscillometric monitor with 2 cuff locations and the Doppler ultrasound in anesthetized dogs. Dogs scheduled for routine anesthetic procedures were included in the study, which was carried out in 2 phases. In Phase 1, SAP values measured by the Doppler were compared with those measured by the Prolife P12 monitor with the cuff placed at the thoracic limb for both methods. In Phase 2, SAP values measured by the Doppler were compared with those measured by the Prolife P12 monitor, with the cuff placed at the thoracic limb for the Doppler and at the base of the tail for the P12. The cuff width corresponded to approximately 40% of limb or tail circumference. On all occasions, 3 consecutive measurements of SAP were recorded, followed by a single measurement of SAP by the P12, and then other 3 measurements were performed with the Doppler. The arithmetic mean of the 6 SAP measurements with the Doppler was compared with the SAP value measured by the P12 monitor (paired measurements). Agreement between SAP values measured by the Doppler and the P12 monitor was analyzed by the Bland Altman method for calculation of the bias (Doppler - P12) and standard deviation (SD) of the bias. The percentages of differences between the methods with an error ≤ 10 mmHg and ≤ 20 mmHg and Pearson's correlation coefficients were also calculated. Results were compared with the criteria from the American College of Veterinary Internal Medicine (ACVIM) for validation of noninvasive blood pressure methods. A total of 33 dogs were included in Phase 1 and 15 were included in Phase 2. During Phases 1 and 2, 179 and 87 paired measurements were recorded, respectively. Most of the measurements were recorded during normotension (SAP = 90-130 mmHg): 113/179 in Phase 1 and 52/87 in Phase 2. The bias (± SD) for Phases 1 and 2 were -2.7 ± 14.1 mmHg and 7.2 ± 25.8 mmHg. The percentages of differences ≤ 10 mmHg and ≤ 20 mmHg were: Phase 1, 61% and 83%; Phase 2, 41% and 70%. Correlation coefficients were 0.81 and 0.67 for Phases 1 and 2, respectively. According to the ACVIM criteria, maximum values accepted for bias are 10 ± 15 mmHg, the percentages of differences ≤ 10 mmHg and ≤ 20 mmHg should be ≥ 50% and ≥ 80%, respectively, and the correlation coefficient should be ≥ 0.9. When the blood pressure cuff was placed at the thoracic limb, SAP values measured by the P12 monitor met most of the ACVIM criteria, demonstrating good agreement with SAP values measured by the Doppler. The only requirement not met was the correlation coefficient which was 0.81 whereas the recommended is ≥ 0.9. Conversely, when the cuff was placed at the base of the tail, SAP values measured by the P12 monitor did not meet most of the ACVIM criteria indicating that, in anesthetized dogs, SAP measurements with the P12 monitor should be performed with the cuff placed at the thoracic limb. One limitation of this study was that most measurements fell in the normotensive range and the results should not be extrapolated for hypotensive and hypertensive conditions. In conclusion, the Prolife P12 oscillometric monitor demonstrated good agreement with SAP values measured by the Doppler and provides acceptable values in normotensive anesthetized dogs.(AU)

Hypertensive ocular disease in cats: A guide to fundic lesions to facilitate early diagnosis.

PRACTICAL RELEVANCE: Systemic hypertension is common in older cats and can result in damage to organs with a rich arteriolar supply such as the eyes, kidneys, myocardium and brain. Hypertensive disease in these organs is known as target organ damage (TOD). Disease in the eye resulting from hypertension is the most easily identifiable form of TOD and can often be the reason the cat is presented to the veterinarian. Routine blood pressure measurement and fundic examination allows cats with hypertensive ocular lesions to be detected early in the course of the disease, when the lesions have the best chance of responding to treatment. CLINICAL CHALLENGES: Detecting early evidence of TOD in the fundus requires a veterinarian to be competent in recognising lesions associated with mild hypertensive disease, as well as the more easily recognised advanced lesions that frequently result in impaired vision and blindness. AUDIENCE: This review is written for all veterinarians who treat cats. It provides information and images to facilitate and guide veterinarians performing fundoscopy in cats, in particular in those over 7 years of age, with the aim of diagnosing hypertensive ocular lesions when they are present. EQUIPMENT: The clinical manifestations of hypertensive ocular disease can be detected non-invasively with inexpensive equipment. A summary of the equipment available for general practitioners to perform fundoscopy is provided. EVIDENCE BASE: This is a comprehensive review of the literature on hypertensive ocular disease in cats. The author has also included images of hypertensive ocular lesions taken in general practice to highlight the variety of lesions that can be detected.

Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions.

OBJECTIVE: To determine agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses undergoing elective surgery. STUDY DESIGN: Prospective balanced incomplete block design. ANIMALS: A total of 18 client-owned horses. METHODS: Invasive blood pressure (IBP) was measured simultaneously in one of the following three combinations: 1) transverse facial and facial artery; 2) transverse facial and metatarsal artery; and 3) facial and metatarsal artery. The agreement in blood pressure measured for each combination was performed in six horses. At each sample time, systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were measured concurrently in each artery, and the mean of three consecutive measurements was recorded. The position of horse, heart rate and use of dobutamine were also recorded. Bland-Altman analysis was used to assess agreement between sites. RESULTS: A total of 54 paired measurements were obtained, with 18 paired measurements from each combination. All paired measurements showed poor and haphazard (nonsystematic) agreement. The widest limit of agreement was 51 mmHg for SAP measured in the facial artery and metatarsal artery, with a bias of -11 mmHg. The smallest limit of agreement was 16 mmHg for MAP measured in the transverse facial and metatarsal artery, with a bias of 1 mmHg. CONCLUSIONS AND CLINICAL RELEVANCE: There was poor and haphazard agreement for SAP, MAP and DAP measured in each pair of peripheral arteries in this study. These results show that blood pressure measured in different peripheral arteries cannot be used interchangeably. This has implications for studies that use IBP as an outcome variable and studies determining agreement between noninvasive blood pressure and IBP measurements in horses under general anaesthesia.

Effects of sedation with dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure and heart rate in healthy cats.

Objectives Sedative agents are occasionally used to enable echocardiographic examination when screening cats for heart disease, such as hypertrophic cardiomyopathy (HCM). Owing to their haemodynamic effects, sedative agents may alter echocardiographic measurements. The aim of the study was to evaluate the effects of the sedative combination dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure (BP) and heart rate (HR) in healthy cats. Methods Fifty healthy, client-owned cats were prospectively recruited and included after physical examination. Cats were sedated intramuscularly with dexmedetomidine and buprenorphine, according to body weight. Blood pressure and HR measurements, echocardiographic and Doppler examinations were performed prior to sedation and repeated once cats had achieved acceptable sedation. Results Left ventricular internal diameter at end-diastole and systole, right ventricular internal diameter at end-diastole, left atrium (LA), pulmonary artery (PA) deceleration time, and systolic, diastolic and mean arterial blood pressure increased after sedation ( P ⩽0.022). Aortic and PA maximum velocity, fractional shortening, PA acceleration/deceleration time and HR decreased after sedation ( P <0.0001). Interventricular septum at end-diastole and systole, left ventricular posterior wall at end-diastole and systole, aortic diameter (Ao), left atrial/aortic diameter (LA/Ao) and pulmonic acceleration time did not change. Conclusions and relevance Blood pressure increased and HR decreased post-sedation. While wall thickness and LA/Ao were not affected by sedation, indices of LA and left ventricular size increased. Further studies are needed using cats with HCM to assess the effect of this sedative combination on HCM screening results.

Radial vs coccygeal artery Doppler blood pressure measurement in conscious cats.

Objectives The aims of the study were to compare the results of systolic blood pressure (SBP) measurements at the radial and coccygeal artery by Doppler ultrasonography and to assess the impact of gender, age, body weight, body condition score (BCS) and stress score on disagreements. Methods Eighty cats were included in this prospective, block randomised crossover trial. Blood pressure measurements were performed at home, during hospitalisation or in a local animal shelter by a single trained observer according to the latest ISFM consensus guidelines. Statistical analysis included Spearman's correlation and ANOVA. Results Measurement or site order had no effect on blood pressure measurements ( P = 0.157, P = 0.965). Correlation of radial and coccygeal SBP was moderate (rsp = 0.519, P <0.001) and measurements at the tail were by mean 18.7 ± 37 mmHg higher. The differences between the measuring sites were neither correlated with age (rsp = 0.044, P = 0.710) nor with body weight (rsp = 0.122, P = 0.337). A significant effect of BCS ( P = 0.016), but not gender ( P = 0.246) or stress score ( P = 0.424) was identified. Of the 25 cats with a coccygeal SBP ⩾170 mmHg, 14 (56%) were categorised as mildly hypertensive or normotensive when measurements were performed at the forelimb. Conclusions and relevance Choice of the measuring site, coccygeal vs radial artery, has a significant impact on Doppler ultrasonographic SBP results. In many cats, these discrepancies are huge and would certainly affect treatment decisions. Possible explanations include cone-shaped tails, especially in obese cats, leading to distal gapping or slippage of cylindrical cuffs and peripheral pulse pressure amplification. Further studies are urgently needed to clarify whether the discordances are artefacts or have a pathological background.

Effect of Body Position, Exercise, and Sedation on Estimation of Pulmonary Artery Pressure in Dogs with Degenerative Atrioventricular Valve Disease.

BACKGROUND: Severity of pulmonary hypertension (PH) in dogs is related to clinical signs and prognosis. HYPOTHESIS/OBJECTIVES: We hypothesized that Doppler echocardiographic (DE) indices of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) are influenced by independent factors that create clinically important variability of DE-based estimates of PH in dogs. ANIMALS: Thirty-eight client owned dogs with naturally acquired degenerative atrioventricular valve disease and tricuspid regurgitation (TR). METHODS: Dogs were prospectively enrolled, and target variables were acquired during 4 echocardiographic study periods (lateral recumbency, standing, lateral recumbency after a 6-minute walk test [6MWT], and lateral recumbency after sedation with butorphanol 0.25 mg/kg IM). Statistical methods included repeated measures ANOVA, mixed model analysis, and Chi-squared test of association. RESULTS: There was a significant increase in peak TR flow velocity (TRFV; P < 0.01) after sedation in 78% of dogs, with TRFV increasing by >0.4 m/s in 42% of dogs, independent of stroke volume. A significant effect of study period on DE-estimated PVR was not found (P = 0.15). There were negligible effects of sonographer, body position, and 6MWT on echocardiographic variables of PH. Clinically relevant cyclic variation of TRFV was found. There was an association between estimation of right atrial pressure based on subjective assessment and estimation based on cranial vena cava collapsibility (P = 0.03). CONCLUSIONS AND CLINICAL IMPORTANCE: The increase in TRFV observed with sedation could change assessment of PH severity and impact prognostication and interpretation of treatment response. Further studies with invasive validation are needed.

Comparison of arterial blood pressure measurements obtained invasively or oscillometrically using a Datex S/5 Compact monitor in anaesthetised adult horses.

OBJECTIVE: To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 40 healthy adult horses. METHODS: Horses were anaesthetised with various anaesthetic protocols (based on clinical requirements). Depending on positioning, cannulation of the facial or lateral metatarsal artery was performed for IBP measurement. The cannula was connected via a transducer to the monitor. An appropriately sized NIBP cuff was placed around the tail base and connected to the same monitor. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial blood pressures were continuously recorded from the invasive system, and at 3 minute intervals from the oscillometric system, throughout the surgical procedure using a Datex iCollect program. An appropriate arithmetic correction factor was applied to the oscillometric results where the cuff was not level with the heart. Assessment of the degree of agreement between invasive and noninvasive readings at each time point was performed using a modified Bland-Altman analysis. RESULTS: While in many horses there was relatively close correlation between the values obtained over time, there was substantial variability in individual animals which resulted in wide Bland-Altman limits of agreement. The oscillometric device over-reads by approximately 32, 23 and 22 mmHg, and under-reads by 26, 17 and 19 mmHg for SAP, MAP and DAP, respectively, compared with the IBP values. However, using the mean difference and standard deviation, the device conforms to American College of Veterinary Internal Medicine (ACVIM) standards. CONCLUSIONS AND CLINICAL RELEVANCE: Oscillometric blood pressure measurement using the Datex Ohmeda S/5 Compact multiparameter monitor conforms to ACVIM standards when the NIBP cuff is placed on the tail. However, because of the wide variability in measurements, we cannot recommend this technique to guide therapy in anaesthetised adult horses.

ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats.

Practical relevance: Feline hypertension is a common disease in older cats that is frequently diagnosed in association with other diseases such as chronic kidney disease and hyperthyroidism (so-called secondary hypertension), although some cases of apparent primary hypertension are also reported. The clinical consequences of hypertension can be severe, related to 'target organ damage' (eye, heart and vasculature, brain and kidneys), and early diagnosis followed by appropriate therapeutic management should help reduce the morbidity associated with this condition. Clinical challenges: Despite being a common disease, routine blood pressure (BP) monitoring is generally performed infrequently, probably leading to underdiagnosis of feline hypertension in clinical practice. There is a need to: (i) ensure BP is measured as accurately as possible with a reproducible technique; (ii) identify and monitor patients at risk of developing hypertension; (iii) establish appropriate criteria for therapeutic intervention; and (iv) establish appropriate therapeutic targets. Based on current data, amlodipine besylate is the treatment of choice to manage feline hypertension and is effective in the majority of cats, but the dose needed to successfully manage hypertension varies between individuals. Some cats require long-term adjuvant therapy and, occasionally, additional therapy is necessary for emergency management of hypertensive crises. Evidence base: These Guidelines from the International Society of Feline Medicine (ISFM) are based on a comprehensive review of the currently available literature, and are aimed at providing practical recommendations to address the challenges of feline hypertension for veterinarians. There are many areas where more data is required which, in the future, will serve to confirm or modify some of the recommendations in these Guidelines.

Surgical implantation and functional assessment of an invasive telemetric system to measure autonomic responses in domestic pigs.

The first aim of this study was to establish a surgical procedure to implant a new telemetric device for the continuous recording of electrocardiogram (ECG) and blood pressure (BP) in freely moving pigs. A second aim was the functional assessment of cardiovascular parameters, including heart rate variability (HRV) and blood pressure variability (BPV), so that these data could be used as the basis for the objective evaluation of autonomic activity and balance in different behavioural contexts. Eleven domestic pigs (German Landrace) underwent surgery for the placement of a telemetric device. At day 15 after surgery, 512 consecutive inter-beat intervals and pressure waves were analysed using different detection methods (automatic and manually corrected) while the animals were resting or feeding, respectively. HRV and BPV were calculated. Incomplete datasets were found in four pigs due to missing ECG or BP signals. Technical and surgical issues concerning catheterisation and detachment of the negative ECG lead were continuously improved. In the remaining pigs, excellent signal quality (manually corrected data of 1%) was obtained during resting and acceptable signal quality (<10%) was obtained during feeding. Automatic triggering was sufficiently reliable to eliminate errors in BP recordings during active behaviour, but this was not the case for ECG recordings. Sympathetic arousal with accompanying vagal withdrawal during feeding was documented. The established surgical implantation and functional assessment of the telemetric system with the reliable registration of cardiovascular parameters in freely moving pigs could serve as a basis for future studies of autonomic regulation in context of stress and animal welfare.

Influence of the observer's level of experience on systolic and diastolic arterial blood pressure measurements using Doppler ultrasonography in healthy conscious cats.

The objective of this study was to determine the influence of the observer's level of experience on within- and between-day variability, and the percentage of successful systolic (SAP) and diastolic arterial blood pressure (DAP) measurements obtained by Doppler ultrasonography (DU) in awake cats. For this purpose, six healthy conscious cats were used and four observers with different levels of training performed 144 SAP and DAP measurements on 4 days using DU. Measurements were recorded five consecutive times, and mean values were used for statistical analysis. Only the two most skilled observers - a PhD student in cardiology and a Dipl ECVIM-CA (cardiology) - had within- and between-day coefficients of variation (CVs) for SAP ⩽16% (13-16%). Conversely, the two less experienced observers - a fifth-year student and an assistant - had high between-day CVs (61% and 73%). For DAP, only the most experienced observer (Dipl ECVIM-CA) succeeded in 100% of the attempts, with within- and between-day CVs of 11% and 4%, respectively. Conversely, DAP could not be measured by the other three observers in 8%, 19% and 56% of attempts (from the highest to the lowest level of experience); therefore, the corresponding CV values could not be calculated. In conclusion, SAP may be assessed using DU in healthy awake cats with good repeatability and reproducibility by a well-trained observer. Measurement of DAP is more difficult than of SAP, and needs a longer training period, which represents one of the limitations of DU in cats.

A study of measurement of noninvasive blood pressure with the oscillometric device, Sentinel, in isoflurane-anaesthetized horses.

OBJECTIVE: To assess accuracy of noninvasive blood pressure (NIBP) measured by oscillometric device Sentinel compared to invasive blood pressure (IBP) in anaesthetized horses undergoing surgery. To assess if differences between the NIBP measured by the Sentinel and IBP are associated with recumbency, cuff placement, weight of the horse or acepromazine premedication and to describe usefulness of the Sentinel. STUDY DESIGN: Prospective study examining replicates of simultaneous NIBP and IBP measurements. ANIMALS: Twenty-nine horses. METHODS: Invasive blood pressure was measured via a catheter in the facial artery, transverse facial artery or metatarsal artery. NIBP was measured using appropriate size cuffs placed on one of two metacarpal or metatarsal bones or the tail in random order. With both techniques systolic (SAP), mean (MAP), and diastolic (DAP) arterial blood pressures and heart rates (HR) were recorded. A mixed effects model compared the IBP to the NIBP values and assessed potential effects of catheter placement, localisation of the cuffs in combination with recumbency, weight of the horse or acepromazine premedication. RESULTS: Noninvasive blood pressure yielded higher measurements than IBP. Agreement varied with recumbency and cuff position. Estimated mean differences between the two methods decreased from SAP (lateral recumbency: range -5.3 to -56.0 mmHg; dorsal recumbency: range 0.8 to -20.7 mmHg), to MAP (lateral recumbency: range -1.8 to -19.0 mmHg; dorsal recumbency: range 13.9 to -16.4 mmHg) to DAP (lateral recumbency: range 0.5 to -6.6 mmHg; dorsal recumbency: range 21.0 to -15.5 mmHg). NIBP measurement was approximately two times more variable than IBP measurement. No significant difference between IBP and NIBP due to horse's weight or acepromazine premedication was found. In 227 of 1047 (21.7%) measurements the Sentinel did not deliver a result. CONCLUSION AND CLINICAL RELEVANCE: According to the high variability of NIBP compared to IBP, NIBP measurements as measured by the Sentinel in the manner described here are not considered as an appropriate alternative to IBP to measure blood pressure in anaesthetized horses.

Cardiopulmonary Effects of Laparoscopic Ovariectomy of Variable Duration in Cats.

OBJECTIVE: To evaluate the cardiopulmonary effects of low-pressure (6 mmHg) peritoneal insufflation of varying duration in healthy cats during ovariectomy (OVE). STUDY DESIGN: Prospective, randomized study. ANIMALS: Female cats (n = 24). METHODS: After anesthesia induction, cats had short (Short LAP; n = 8) or long duration (Long LAP; n = 8) laparoscopic ovariectomy, or Open OVE (Open; n = 8) for comparison. Hemodynamic and pulmonary measurements were recorded after induction of anesthesia (T0), 5 minutes after abdominal insufflation had reached 6 mmHg of pressure (T1), after the 2nd ovary had been resected (T2), after abdominal decompression (T3), and at the end of anesthesia, after abdominal closure (T4). Hemodynamic and pulmonary variables were compared between groups. RESULTS: Low-pressure abdominal insufflation caused cardiopulmonary changes in cats. At T1 and T2, Long LAP and Short LAP caused a significant change in PvCO2 and RC when compared with Open. During T3, RC was lower only in Long LAP. At T2, there was decrease in SV, but not CO for Long LAP when compared with Open. CONCLUSIONS: Duration of insufflation was associated with worsening of negative cardiopulmonary effects; however, these effects were reversible and resolved by the end of the procedure.

Avaliação da pressão arterial sistêmica em cães obesos: comparação entre os métodos oscilométrico e doppler ultrassônico / Systemic blood pressure evaluation by oscillometric versus doppler ultrasonographic methods in obese dogs

A obesidade é o problema nutricional que mais acomete os cães e pode causar vários efeitos deletérios a saúde animal. No entanto, o efeito desta condição sobre a pressão arterial sistólica (PAS) em cães obesos é controverso. Os métodos indiretos de mensuração da PAS são os mais comumente utilizados na medicina veterinária para o diagnóstico da hipertensão sistêmica, por serem mais práticos e de fácil acesso. Não foram localizados na literatura estudos que tenham comparado os dois métodos para esta avaliação em cães obesos. Diante do exposto, o objetivo desse estudo foi avaliar a PAS em cães obesos, comparando os métodos indiretos de mensuração da pressão arterial, oscilométrico e doppler ultrassônico, a fim de verificar as diferenças nos valores obtidos, como também o método mais indicado para aferir a PAS em cães nesta condição. Foram avaliados 50 cães, incluindo 25 obesos com escore de condição corporal (ECC) médio de 8,42±0,50 e 25 cães com peso corporal ideal com ECC médio de 4,56±0,51. Os resultados revelaram valores superiores da PAS obtidos pelo método doppler (152±16mmHg) comparados ao oscilométrico (136±11mmHg). A análise de correspondência determinada por análise estatística multivariada demonstrou maior correspondência entre a condição corporal e o método de avaliação da PAS. Esses achados sugerem que o método indireto doppler pode aferir com mais precisão os valores de PAS em cães obesos.(AU)

Obesity is the most common nutritional problem in dogs and it can cause various harmful effects on animal health. However, the effect of this condition on systolic blood pressure (SBP) in obese dogs is controversial. The indirect method of measuring PAS is the most commonly used in veterinary medicine for the diagnosis of systemic hypertension, because it is more practical and easy to access. There is little scientific information about the comparison of the two non-invasive methods of measurement of blood pressure in obese dogs. Therefore, the objective of this study was to evaluate the SBP in obese dogs by comparing both indirect methods of measuring blood pressure, with oscillometric and doppler vascular in order to verify the differences in blood pressure values, but also the best method to assess the SBP dogs in this body score condition. The study complain blood pressure measurement of 50 dogs, with were divided in obese dogs with mean body condition score (BCS) of 8.42±0.50 (n=25) and dogs with ideal BCS of 4.56±0.51 (n=25). At comparison of blood pressure values, SBP values obtained by doppler method (152±16mmHg) were higher than the oscillometric (136±11mmHg). Correspondence analysis determined by multivariate statistical analysis showed correlation between body condition and the procedure of the SBP. These findings suggest that the indirect method doppler can better reflect the SBP in obese dogs.(AU)

Avaliação e comparação entre métodos de mensuração de pressão arterial sistólica em gatos hígidos anestesiados / Evaluation and comparison between methods of measurement of systolic blood pressure in healthy anesthetized cats

Foram avaliados e comparados, para fins de validação, dois diferentes métodos de mensuração de pressão arterial sistólica (PAS), não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro), em 12 gatos hígidos anestesiados de idade variando entre sete meses e dois anos. Em cada animal, procedeu-se à mensuração simultânea da pressão não invasiva e da invasiva. O método oscilométrico foi comparado, por meio de sete medidas consecutivas, com intervalo de 30 segundos entre elas, com o método invasivo, e, logo em seguida, o método Doppler foi comparado ao método invasivo da mesma maneira. Concluiu-se que o método oscilométrico é estatisticamente igual ao método invasivo, enquanto o Doppler difere de ambos. Entretanto, pela forte correlação positiva entre os métodos Doppler e invasivo, foi possível criar um fator de correção (equação de regressão linear) para se determinar o valor da pressão invasiva, a partir do valor obtido pelo método Doppler. Para obtenção de valores mais fidedignos, recomenda-se a utilização desse fator de correção quando o método Doppler for utilizado para mensuração de PAS em gatos anestesiados.

For validation purposes, two different methods of measurement of systolic blood pressure (SBP), noninvasive or indirect (oscillometric and vascular doppler), direct or invasive (arterial catheterization - the gold standard) were evaluated and compared in 12 healthy anesthetized cats, varying between seven months to two years old. In each animal, we proceeded to the simultaneous noninvasive and invasive measurement of pressure. The oscillometric method was compared by means of seven consecutive measurements with an interval of 30 seconds between them, with the invasive method, and soon after, the doppler method was compared to the invasive method in the same way. It was concluded that the oscillometric method is statistically equal to the invasive method, whereas doppler differs from both. However, due to the strong positive correlation between doppler and invasive methods, it was possible to create a correction factor (linear regression) to determine the value of invasive pressure from the value obtained by the doppler method. To obtain more reliable figures, it is recommended to use this correction factor when the doppler method is used to measure SBP in anesthetized cats.

Comparison of how well conscious cats tolerate blood pressure measurement from the radial and coccygeal arteries.

Hypertension is a common condition of older cats and acquiring clinically relevant and repeatable blood pressure (BP) measurements in conscious cats is important in its diagnosis and management. The most common sites for indirect BP measurement in the cat are the radial artery (RA) and the coccygeal artery (CA) but, to date, there are no published data comparing how conscious cats tolerate BP measurements from these sites. A high-definition oscillometric BP monitor was used to measure BP in 30 cats admitted to a cat-only veterinary clinic for reasons other than hypertension. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were measured using the RA and CA, alternating which site was used first. The number of failed attempts and total time to achieve six measurements was recorded. Measurement of BP using the CA was better tolerated than the RA, resulting in fewer failures and shorter total time required. SAP measurements were slightly higher from the CA compared with the RA, irrespective of which site was used first. There were no significant differences in MAP and DAP. The coccygeal artery appears to be the more appropriate site to use when measuring BP in conscious cats using this oscillometric machine. Further studies are required using alternative BP monitors, including Doppler machines, to establish whether this is a consistent finding. When measuring BP in cats the site used should be recorded and the same site used for all subsequent measurements from the same cat.