The Role of Point-of-Care Ultrasound in Managing Cardiac Emergencies

Retrospective Evaluation of Subpleural Consolidations Using Lung Ultrasound in 634 Dogs and 347 Cats

BACKGROUND

Human literature describes vascular patterns in various types of lung consolidations; however, these changes have not been analyzed in dogs and cats. This retrospective analysis of medical records aimed to describe vascular patterns observed in the airless subpleural lung tissue of dogs and cats and to compare these patterns to various lung consolidations and clinical diagnoses according to parenchymal and vascular criteria described in human literature.

ANIMALS

This study included 347 cats and 634 dogs.

METHODS

This was a retrospective study encompassing medical records obtained between 2018 and 2023. Lung ultrasound was performed in dogs and cats and cases with different sonographically identified airless subpleural lung tissue were selected. Airless subpleural lung tissue was categorized into five types of consolidations: shred, nodule, wedge sign, mass, and tissue sign. Further classification was based on the parenchymal criteria, the presence or absence of bronchograms and the vascular patterns identified within these regions. Bronchograms were classified as air bronchograms (dynamic and/or static), fluid bronchograms, mixed fluid and air bronchograms, and/or absence of bronchograms. Vascular patterns were classified as tree-like, residual, chaotic, "vascular sign", and whether they were continuous with and extended from the chest wall or not.

CONCLUSIONS AND CLINICAL IMPORTANCE

It is possible to identify and characterize airless subpleural lung tissue in cats and dogs based on the parenchymal and vascular characteristics.

Two-dimensional echocardiographic right heart ratios for assessment of right heart size in dogs: Reference intervals and reproducibility

BACKGROUND

Reference intervals for simple body weight-independent measurements of right heart size and function are limited.

OBJECTIVES

Generate reference intervals for measurements of right heart size indexed to the long-axis aortic valve diameter (AoD) or corresponding left heart structure (right heart ratios) and describe the reproducibility of these indices.

ANIMALS

Ninety healthy adult dogs of variable body weight.

METHODS

Prospective study. All dogs underwent an echocardiogram performed by the same operator. Numerous linear 2-dimensional measurements of right heart size and function from different imaging planes were performed. Eight dogs underwent repeated echocardiograms by the same operator on 3 different days, and 3 different operators performed repeated echocardiograms on the same day. Reference intervals were generated using the Clinical Laboratory Standards Institute method. Reproducibility was quantitated using coefficients of variation (CVs) and reproducibility coefficients.

RESULTS

Reference intervals for right heart ratios were generated and allow simple assessments of right heart size and function that do not require a scaling exponent or body weight table. Right heart ratios did not show clinically relevant associations with body weight. All CVs were <22.6%. In general, CVs for right heart measurements indexed to AoD were lower compared with right heart measurements indexed to the corresponding left heart structure.

CONCLUSIONS AND CLINICAL IMPORTANCE

Reference intervals for simple body weight-independent right heart ratios are available to help detect abnormalities of right heart size and function. Reproducibility coefficients might be useful to help identify meaningful changes in right heart size during serial evaluations.

Double Outlet Right Atrium in an American Domestic Shorthair Cat

•DORA should be considered in cases with radiographic evidence of LA enlargement. •TTE can diagnose DORA. •Cats with DORA may remain undiagnosed until adulthood.