Echocardiography (heart ultrasound)
Heart ultrasound with assessment of blood flow (Doppler) — the basic examination for diagnosing heart disease in dogs and cats. No sedation, painless, with the result and plan discussed on the same day.
What it involves
Echocardiography is an ultrasound examination of the heart in real time. On the screen we see how the valves work, how thick the walls of the ventricles are, how strongly the heart contracts and whether its chambers are enlarged. Doppler mode shows the direction and speed of blood flow, so we can see blood flowing back through a leaking valve or a narrowing in the outflow tract.
From the measurements (size of the left atrium, wall thickness, fractional shortening) we determine not only the type of disease but its stage, and it is the stage that decides whether a drug needs to be started now or whether a re-check is enough. When a dog has a murmur, it answers the question of whether the valve is diseased and how severely. In a cat it detects thickening of the heart muscle and clots in the atrium before an embolism occurs.
The examination is painless, takes 20–40 minutes and does not require sedation. The animal lies on its side on a special table with a cut-out through which we place the probe against the chest. It is usually enough to dampen the coat there, and in long-haired dogs we sometimes clip a small patch.
When it is used
For any heart murmur, suspected heart failure (cough, breathlessness, an enlarged heart on X-ray), fainting, arrhythmia, before anaesthesia in patients at risk, and as a follow-up test in animals that are already being treated. In cats of breeds predisposed to HCM it is also done as a preventive measure, even without symptoms.
We also perform it in puppies and kittens with a suspected congenital defect, to establish whether the defect needs treatment.
Indications: symptoms that should prompt a visit
- A vet has heard a heart murmur in my dog or cat.
- On the chest X-ray the heart looks enlarged.
- A dog coughs, tires easily or has fainted.
- A cat is booked for anaesthesia and is a Maine Coon, Ragdoll, British Shorthair or Sphynx.
- A queen or bitch in a breeding programme needs a heart examination before breeding.
- I want to check whether the heart drugs are working and whether the doses are right.
Conditions for which we use it in particular
Diagnostics beforehand
The echo needs no preparation or preliminary tests; it is preceded by listening to the heart and history-taking. Depending on the findings we add an ECG (arrhythmias), blood pressure measurement (a cat with thickened walls may have secondary hypertension), a chest X-ray (pulmonary oedema, fluid) and blood tests, especially assessment of the kidneys and, in cats, the thyroid, because both affect the picture of the heart.
How it proceeds
We lay the animal on its side on the echocardiography table, and the owner can stay beside it. We scan from the right and left sides of the chest in several standard views, taking measurements and saving the images in the records. We do not use sedation; only in exceptionally stressed cats do we consider mild calming, after discussing it with the owner.
We discuss the result straight away in front of the screen and issue a report with the measurements, the diagnosis and recommendations. The referring vet receives a copy of the report (STD-06).
Aftercare
After the examination the animal can return to normal activity straight away. If a disease is diagnosed, we agree a plan: drugs, counting breaths at home and a date for a follow-up echo, usually every 6–12 months in the stages without symptoms and more often after a change of treatment.
Frequently asked questions
Does a heart ultrasound hurt or require anaesthesia?
No. The examination is painless and done without sedation; the animal lies on its side, and we work calmly and without force.
Does the coat need to be shaved?
In most patients it is enough to dampen the coat and use gel. In dogs with a dense coat we clip a small window on both sides of the chest.
How often should the echo be repeated?
It depends on the disease: for mild valve disease every 6–12 months, and sooner after drugs are started. We write the date on the result.
Is an echo enough for a diagnosis, or is an X-ray needed as well?
The echo assesses the heart; the X-ray assesses the lungs and whether the heart is already affecting breathing. With a cough or breathlessness both are usually needed.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Do you have questions about echocardiography?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.