What we do
Quality care needs state-of-the-art portable ultrasound machines. We also use digital electrocardiography (ECG) and Holter monitors (lightweight digital ECG recorders) to allow assessment of heart rate and rhythm in the clinic as well as during rest or exercise at home. Many horses need an ECG recorded during exercise.
Some patients require critical care and hospitalisation and some require interventional techniques such as a pacemaker. However, over 95% of our cases can be seen as daycare outpatients
Investigations in Cats and Dogs
Murmur investigations typically involve 2D, M-Mode and Doppler echocardiography. In some cases, blood pressure measurement, ECG and thoracic radiography (chest X-Rays) may also be required. These investigations are usually performed with the patient conscious, however a light sedation may be useful for the more detailed measurements in anxious or restless patients. The majority of cases that we see just need a scan and extra tests aren’t done to meet some protocol. It is important to focus on what is needed to give a good outcome for each patient.
We also see many dogs that collapse and investigating these cases usually involve echocardiography, Holter ECG monitoring and blood tests. A video of these events is really helpful where possible.
Investigation of coughing/breathlessness can be more complicated. Often the pragmatic way is to exclude/attribute the problem to cardiac disease before considering additional tests such as thoracic radiography or CT scanning and bronchoscopy under general anaesthesia. A full respiratory workup is expensive and requires general anaesthesia in many cases. Mark is happy to assess a history and decide if we should do an echocardiogram first or if the case requires a hospital-based full respiratory investigation.
Equine Investigations
Investigations of poor performance, heart murmurs or arrhythmia can be arranged at veterinary facilities or at your client’s yard. The majority of equine cases seen are when a heart murmur is identified in the course of other assessments – many are from pre-purchase examinations. A full clinical examination is usually followed by echocardiography +/- exercise ECG. These require considerable experience to allow for the issues of age, breed and athletic use, safety and performance, insurance, and resale. Mark has performed around 600-800 echocardiograms per annum for decades and is a firm believer that cardiology speciality training is essential to ensure that these scans are accurate.
Cardiology CPD
CPD sessions are bespoke on a private or group basis. A day with a practice can be very productive – for example one session with beginners, a lunch and learn for example on the use of proBNP or treatment issues, and a scanning session with more experienced vets. Sometimes these are supported/subsidised by commercial companies.
Expert Witness and Cardiology Consultant
I have acted as an Expert witness in legal disputes and insurance cases. I have also acted as a consultant to ultrasound companies and pharma companies and been an investigator in some of the seminal drug trials of the last 20 years.