Non-invasive blood pressure measurement in dogs and cats

Bloodpressure measurements are of interest for todays veterinary practice. It can be used for screening of incoming patients, the emergency case, the intensive care patient and sedated animal. Furthermore, like in human medicine, blood pressure can be influenced by several diseases. The most reliable method of arterial blood pressure measurement is the direct or invasive method. Only the non-invasive methods doppler and oscillometric methods are used in veterinary medicine. The article describes the method of measurement, and provides a review of the literature. The oscillometric method especially in dogs. Both methods measure a lower bloodpressure if compared with an invasive method. The difference in bloodpressure is for the oscillometric method in cats greater then in dogs and appears to increase at higher blood pressures. Keeping these facts in focus, and if one is able to work in a quiet environment, repeat the measurements and maintain a critical attitude, blood pressure measurements can be performed in veterinary practice.     

Diurnal variations of blood pressure in cats

Blood pressure (BP) was analyzed invasively using the telemetry system in unanesthetized, unrestrained healthy adult mongrel cats. After surgical implantation of a telemetry transmitter, BP was transiently elevated due to the invasive nature of the surgery, but it was gradually decreased. BP was largely stabilized seven to ten days postsurgery. Once BP was settled, systolic, diastolic and mean BPs(2) were obtained at 5-min intervals in individual cats. Hourly averages of these BP values revealed a diurnal variation with two peaks at 8:00 and 19:00. We also found that BP was significantly higher when cats were active compared to when they were sleeping or at rest (p<0.05). The average 24-hr BP in 20 healthy cats was 118.4+/-11.0 (systolic), 78.0+/-8.7 (diastolic) and 94.8+/-9.5 mmHg (mean) by the telemetry system.     

Epidemiological study of blood pressure in domestic cats

Blood pressure was measured indirectly in 203 cats using an oscillometric technique in conjunction with a tail cuff. Systolic blood pressure was found to be log normally distributed across the population, while diastolic pressure was log log normally distributed Blood pressure was found to rise with age (systolic, diastolic, mean arterial and pulse pressure were significantly higher in animals aged 11 years or over than in animals aged under 11 years) but this rise did not parallel an increase in plasma urea or creatinine. Cats with clinical renal disease did however have higher blood pressures than normal cats, as did cats with ocular change consistent with hypertensive retinopathy.     

One-step method for catheterising the jugular vein of cats to enable repeated blood sampling

A one-step method for catheterising the jugular vein of cats for taking multiple blood samples was developed, with the aid of radiography, to determine an appropriate internal catheter length for adult cats. The effects of multiple blood sampling and heparin flushes on the cats' haematocrit and blood total solids were also assessed. Seven healthy adult cats were used. A total of 128 of 132 (97 per cent) blood samples were collected successfully through a 19 G, 30.5 cm catheter introduced as a central venous catheter and maintained in place during two periods of 48 hours. The haematocrit and total solids were significantly decreased in all the cats, but no clinically significant blood loss or coagulation disorders were observed.     

Response of cats to familiar and unfamiliar human contact using continuous direct arterial blood pressure measurement

Continuous direct measurement of feline arterial blood pressure (ABP) was carried out via a modified method with percutaneous, ultrasound guided catheterization of the common carotid artery. In 21 healthy, conscious cats the ABP was measured during rest, alertness and activity. Furthermore, the ABP response to being petted by familiar and unfamiliar persons was assessed.Linear mixed modelling revealed that the mean blood pressure (MBP) in resting cats (114.6 mmHg) was lower (P < 0.001) than in alert cats (122.7 mmHg), which was lower (P < 0.001) than that of active cats (136.8 mmHg). The MBP during petting by a familiar person (144.7 mmHg) tended to be higher (P = 0.065) than that during petting by an unfamiliar person (139.4 mmHg). The MBP of active cats was lower (P = 0.003) than MBP of cats petted by a familiar person, but not different from MBP of cats petted by an unfamiliar person. The MBP returned to resting values between 16 and 20 min after the familiar person had left, whereas resting values were reached between 11 and 15 min after the unfamiliar person had left. The complications of the described method were limited considering the potential risks of continuous direct ABP measurement.In conclusion, the described technique enables accurate measurement of feline ABP, which is influenced by the cat’s activity level and the familiarity of persons.     

Systolic blood pressure in cats with diabetes mellitus

OBJECTIVE: To determine the prevalence of systemic hypertension in cats with diabetes mellitus and establish ranges for echocardiographic variables in diabetic cats. DESIGN: Prospective study. ANIMALS: 14 cats with diabetes mellitus and 19 healthy control cats. PROCEDURE: Systolic blood pressure was measured indirectly with a noninvasive Doppler technique. Ophthalmic and echocardiographic examinations were performed, and urine protein concentration was measured. Cats were considered to have hypertension if they had systolic blood pressure > 180 mm Hg and at least 1 other clinical abnormality typically associated with hypertension (eg, hypertensive retinopathy, left ventricular hypertrophy, or proteinuria). RESULTS: None of the diabetic or control cats had systolic blood pressure > 180 mm Hg. One diabetic cat had left ventricular hypertrophy, but systolic blood pressure was 174 mm Hg. None of the cats had evidence of hypertensive retinopathy or proteinuria. Mean values for echocardiographic variables for the diabetic cats were not significantly different from published values for healthy cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that hypertension does not occur or occurs in only a small percentage of cats with diabetes mellitus.     

Autologous blood collection and transfusion in cats undergoing partial craniectomy

OBJECTIVE: To describe the procedure for autologous blood donation and associated complications in cats undergoing partial craniectomy for mass removal. DESIGN: Prospective case series. ANIMALS: 15 cats with intracranial mass confirmed by computed tomographic scan, no evidence of renal failure, and PCV > or = 22%. PROCEDURE: One unit (60 ml) of blood was collected and stored 7 to 17 days before surgery and transfused during the perioperative period if needed. The PCV was measured before donation, before surgery, during surgery, and after surgery to assess effect of donation on PCV before surgery and effect of transfusion on PCV after surgery. Cats were evaluated for donation complications, iatrogenic anemia, and adverse reactions associated with administration of autologous blood. RESULTS: Complications associated with phlebotomy were not detected. Fifteen cats underwent partial craniectomy 7 to 17 days after blood donation; all had histologic confirmation of meningioma by examination of tissue obtained at surgery. Eleven cats received autologous blood transfusions. None of the cats received allogeneic blood transfusions. Transfusion reactions were not observed. Subclinical iatrogenic anemia was detected in 3 cats. Two cats were considered to have received excessive transfusion, and 3 cats received inadequate transfusion. All cats undergoing partial craniectomy were discharged from the hospital and were alive > 6 months after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Autologous blood donation before surgery was considered safe for cats undergoing partial craniectomy for resection of meningioma. The only complication observed was iatrogenic anemia. The procedure contributed to blood conservation in our hospital.     

Reliability of using reagent test strips to estimate blood urea nitrogen concentration in dogs and cats

OBJECTIVE: To evaluate the clinical accuracy of reagent test strips used to estimate BUN concentration in dogs and cats. DESIGN: Prospective study. ANIMALS: 116 dogs and 58 cats. PROCEDURE: Blood samples were collected at the time of admission to the hospital. Estimates of BUN concentration obtained with reagent test strips (category 1 [5 to 15 mg/dL], 2 (15 to 26 mg/dL], 3 [30 to 40 mg/dL], or 4 [50 to 80 mg/dL]) were compared with SUN concentrations measured with an automated analyzer. For dogs, category 1 and 2 test strip results were considered a negative result (nonazotemic) and category 3 and 4 test strip results were considered a positive result (azotemic). For cats, category 1, 2, and 3 test strip results were considered a negative result (nonazotemic) and category 4 test strip results were considered a positive result (azotemic). RESULTS: On the basis of SUN concentration, 40 of the 174 (23%) animals (20 dogs and 20 cats) were classified as azotemic. One dog and 2 cats had false-negative test strip results, and 1 dog had a false-positive result. Sensitivity and specificity were 95% (20/21) and 99% (94/95), respectively, for dogs and 87% (13/15) and 100% (43/43), respectively, for cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that reagent test strips are a reliable method for rapidly estimating BUN concentrations in dogs and cats. Because test strip results are only semiquantitative and there remains a potential for misclassification, especially in cats, urea nitrogen concentration should ultimately be verified by means of standard chemistry techniques.     

Response of cats to familiar and unfamiliar human contact using continuous direct arterial blood pressure measurement

Continuous direct measurement of feline arterial blood pressure (ABP) was carried out via a modified method with percutaneous, ultrasound guided catheterization of the common carotid artery. In 21 healthy, conscious cats the ABP was measured during rest, alertness and activity. Furthermore, the ABP response to being petted by familiar and unfamiliar persons was assessed.Linear mixed modelling revealed that the mean blood pressure (MBP) in resting cats (114.6 mmHg) was lower (P < 0.001) than in alert cats (122.7 mmHg), which was lower (P < 0.001) than that of active cats (136.8 mmHg). The MBP during petting by a familiar person (144.7 mmHg) tended to be higher (P = 0.065) than that during petting by an unfamiliar person (139.4 mmHg). The MBP of active cats was lower (P = 0.003) than MBP of cats petted by a familiar person, but not different from MBP of cats petted by an unfamiliar person. The MBP returned to resting values between 16 and 20 min after the familiar person had left, whereas resting values were reached between 11 and 15 min after the unfamiliar person had left. The complications of the described method were limited considering the potential risks of continuous direct ABP measurement.In conclusion, the described technique enables accurate measurement of feline ABP, which is influenced by the cat’s activity level and the familiarity of persons.     

Observations on blood coagulation after snakebite in dogs and cats

Blood samples from 13 cases of snakebite, 6 in dogs and 7 in cats, were tested for activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrin/fibrinogen degradation products (FDP). Four cases were tested for fibrinogen concentration. Based on the results of a commercially available ELISA test, 9 cases were caused by tiger snakes (Notechis scutatus) and 1 case by a brown snake (Pseudonaja textilis). Three other cases had clinical signs and increased creatine phosphokinase values which suggested tiger snake envenomation. Although the period post-envenomation varied, results indicated a marked prolongation of the APTT and PT in 5 of 6 dogs. Three of these 5 dogs also had increased FDP values and 3 (of 3 examined) were hypofibrinogenaemic. Clinical manifestations of this coagulopathy were: haematoma formation after venepuncture (3 cases), gingival petechiae (1 case) and hyphaema (1 case). In contrast, there was minimal or no prolongation of the APTT and PT values, and no increase in FDP, in all 7 cats. Furthermore, no cat exhibited clinical signs of a coagulopathy.     

Use of the Cell-Dyn 3500 to predict leukemic cell lineage in peripheral blood of dogs and cats

Background— Morphology and cytochemistry are the foundation for classification of leukemias in dogs and cats. Advances in automated hematology instrumentation, immunophenotyping, cytogenetics, and molecular biology are significantly improving our ability to recognize and classify spontaneous myeloproliferative and lymphoproliferative disorders. Objective— The purpose of this study was to assess the utility of flow cytometry‐based light scatter patterns provided by the Cell‐Dyn 3500 (CD3500) automated hematology analyzer to predict the lineage of leukemic cells in peripheral blood of dogs and cats. Methods— Leukemic cells from 15 dogs and 6 cats were provisionally classified using an algorithm based on the CD3500 CBC output data and were subsequently phenotyped by enzyme cytochemistry, immunocytochemistry, indirect flow cytometry, and analysis of antigen receptor gene rearrangement. Results— The algorithm led to correct predictions regarding the ontogeny of the leukemic cells (erythroid/megakaryocytic potential, myeloid leukemia, monocytic leukemia, chronic granulocytic leukemia, lymphoid leukemia) in 19/21 animals. Mismatches in the WBC impedance count and the WBC optical count in conjunction with microscopic assessment of blasts in the blood were useful for predicting myeloproliferative disorders with erythroid or megakaryocytic potential. The leukocyte light scatter patterns enabled distinction among myeloid leukemias (represented by acute myelomonocytic leukemia, acute monocytic leukemia, chronic granulocytic leukemia) and lymphocytic leukemias (including acute and chronic lymphocytic leukemias). One case of acute lymphocytic leukemia was misidentified as chronic lymphocytic leukemia. Conclusions— Algorithmic analyses can be applied to data generated by the CD3500 to predict the ontogeny of leukemic cells in the peripheral blood of dogs and cats. This rapid and quantitative technique may be used to improve diagnostic decisions, expand therapeutic choices, and increase prognostic accuracy.