Rapid Cardiac Assessment at Primary Care – Sharing by Internal medicine veterinarian Dr. I-Ju Ho

Cardiac assessment is one of the examinations an Internal medicine veterinarian needs to do every day.

In the past, the cardiac assessment and treatment of pets have often been seen as difficult work and something that can only be done by cardiologists. With the trend of increasing improvements in medical standards and the quality of healthcare, the medical needs of aged pets have also increased significantly. The majority of pets kept in Taiwan are small dog breeds. These kinds of pets are actually at high risk for cardiac disease, and thus initial cardiac assessment has become an essential check-up.  As a veterinarian in a primary care hospital, Dr. Ho mentions that cardiac assessments have already become the most frequently required examination in both general medicine and surgery in Dr. Dolittle Animal Hospital.

Although the ECG examination is difficult in terms of operation, it provides valuable and irreplaceable insights. 

Clinically speaking, Dr. Ho emphasizes that not only cardiac assessment is important. She says: “Internal medicine veterinarians just like putting together a complex puzzle. They always have to perform several examinations to get a complete picture of the disease.” However, since Internal medicine veterinarians have limited time and human resources, they often have no choice but to give up conducting some of these diagnostic tests. Cardiac assessments often cannot be implemented as it requires medical specialty knowledge and high-level manpower. Take the ECG, one of the cardiac assessments, as an example. “It is really troublesome, but it also provides important information. In human medicine, it is already a common routine examination, but it is not the case for veterinary medicine.” Dr.Ho bemoans that in veterinary training education, ECG interpretation learning is not comprehensive hence primary care practitioners feel unfamiliar with it and not frequently implement this ECG examination in their clinical routine.

However, ECG examination is very important to cardiac assessment. It can provide a lot of information about the preliminary cardiac condition. For example, when the ECG findings are abnormal, it represents an abnormal cardiac function. It helps clinicians infer the following diseases: Heart rate or conduction problems (arrhythmia, conduction block), changes in myocardial current (atrium and ventricular hypertrophy or enlargement, pericarditis), abnormal electrolyte metabolism, etc. On the other hand, it is also widely used in other cases that need monitoring, including heart rate monitoring, testing after taking drugs, etc. To conclude, it can help veterinarians find the right direction for clinical diagnosis or treatment. Dr. Ho suggests that even if it is not possible to perform high-level cardiac assessments, preliminary ECG examinations can actually provide valuable insights at a fast speed at a lower cost – something necessary for primary care veterinarians.

The sharing of Cardiobird: It’s essential to have a fast and convenient examination!

As Dr. Ho mentions, in Dr. Dolittle Animal Hospital, regardless of the medical and surgical examinations, cardiac-related assessments will definitely be carried out. Fast, affordable, accurate, and convenient methods are critical. Unlike traditional cardiac assessment, CardioBird is a rapid cardiac assessment dedicated to serving veterinarians. It only takes a few minutes to collect the ECG data, which is then analyzed and processed by both an AI and the cardiologist team, providing a single lead (Lead II) in a short time. The interpretation results of the ECG report directly help veterinarians jump through the most difficult part: the challenges for ECG interpretation. Cardioband report provides information on the cause, heart rhythm, heart axis, atrioventricular conduction block, atrial enlargement, or hypertrophy at one time. The diagnosis and treatment advice is very helpful to Dr. Ho in the first-line consultation.

Clinically speaking, she says that CardioBird can be widely used in general routine examinations, including health checks, especially for aged pets and those prone to heart disease. In terms of preanesthesia check, since ECG is a very important assessment for cardiac function, it is included in the routine examination and generally accepted by the pet owner. If there are cost considerations, Dr. Ho suggests that ASA classification can also be used to communicate with pet owners. Basically, when the pets’ condition is ASA grade 2 or higher, she will strongly recommend an ECG examination before being anesthetized.  In the case of cardiac disease tracking, CardioBird examinations should be performed before and after medication to provide a reference for medication and treatment adjustment.

Additionally, Dr. Ho shares that ECG can also provide very useful information not only for cardiac disease-related cases but also for the diagnosis of other diseases with the reason of numerous diseases are also related to abnormal heart rhythms. One example she gives is gastric dilatation torsion (GDV). In fact, severe atrial fibrillation (Afib) can be seen on the ECG as an indication of urgency level. Atrial fibrillation is a condition that needs attention. Dr. Ho remembers there was an emergency case: When the pet was brought into the hospital, it was already in a very bad condition. After the catheter was urgently applied, the pet was found to be in critical condition. The traditional assessment method was not suitable in such an urgent case, so the CardioBird rapid cardiac assessment was performed by data collection in 30 seconds and the professional team provided the interpretation report. The primary care veterinarians make use of the time to focus on stabilizing the pet’s condition. After CardioBird’s report was returned, Dr. Ho adjusted the medication according to the report recommendations from the cardiologists, and she was also able to win golden time in handling urgent cases. Dr. Ho emphasizes: “If you only do X-rays and echocardiography and ignore the ECG test beforehand, you will never find Afib! If the animal’s condition is unstable, it is not recommended to do X-ray and echocardiography directly since it will increase the burden on animals. Fortunately, CardioBird rapid cardiac assessment exists.”

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