• 1. Paige CF Abbott JA, Elvinger F, et al. Prevalence of cardiomyopathy in apparently healthy cats. J Am Vet Med Assoc 2009; 234:13981403.

    • Search Google Scholar
    • Export Citation
  • 2. Wagner T, Fuentes VL, Payne JR, et al. Comparison of auscultatory and echocardiographic findings in healthy adult cats. J Vet Cardiol 2010; 12:171182.

    • Search Google Scholar
    • Export Citation
  • 3. Schober KE, Maerz I, Ludewig E, et al. Diagnostic accuracy of electrocardiography and thoracic radiography in the assessment of left atrial size in cats: comparison with transthoracic 2-dimensional echocardiography J Vet Intern Med 2007; 21:709718.

    • Search Google Scholar
    • Export Citation
  • 4. Rush JE, Freeman LM, Fenollosa NK, et al. Population and survival characteristics of cats with hypertrophic cardiomyopathy: 260 cases (1990–1999). J Am Vet Med Assoc 2002; 220:202207.

    • Search Google Scholar
    • Export Citation
  • 5. Benigni L, Morgan N, Lamb CR. Radiographic appearance of cardiogenic pulmonary oedema in 23 cats. J Small Anim Pract 2009; 50:914.

  • 6. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure. Part II: causal mechanisms and treatment. Circulation 2002; 105:15031508.

    • Search Google Scholar
    • Export Citation
  • 7. Nakayama H, Nakayama T, Hamlin RL. Correlation of cardiac enlargement as assessed by vertebral heart size and echocardiographic and electrocardiographic findings in dogs with evolving cardiomegaly due to rapid ventricular pacing. J Vet Intern Med 2001; 15:217221.

    • Search Google Scholar
    • Export Citation
  • 8. Litster AL, Buchanan JW. Vertebral scale system to measure heart size in radiographs of cats. J Am Vet Med Assoc 2000; 216:210214.

  • 9. Ghadiri A, Avizeh R, Rasekh A, et al. Radiographic measurement of vertebral heart size in healthy stray cats. J Feline Med Surg 2008; 10:6165.

    • Search Google Scholar
    • Export Citation
  • 10. Buchanan JW, Bucheler J. Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc 1995; 206:194199.

  • 11. Buchanan JW. Vertebral scale system to measure heart size in radiographs. Vet Clin North Am Small Anim Pract 2000; 30:379393.

  • 12. Sleeper MM, Buchanan JW. Vertebral scale system to measure heart size in growing puppies. J Am Vet Med Assoc 2001; 219:5759.

  • 13. Marin LM, Brown J, McBrien C, et al. Vertebral heart size in retired racing Greyhounds. Vet Radiol Ultrasound 2007; 48:332334.

  • 14. Bavegems V, Van Caelenberg A, Duchateau L, et al. Vertebral heart size ranges specific for Whippets. Vet Radiol Ultrasound 2005; 46:400403.

    • Search Google Scholar
    • Export Citation
  • 15. Kraetschmer S, Ludwig K, Meneses F, et al. Vertebral heart scale in the Beagle dog. J Small Anim Pract 2008; 49:240243.

  • 16. Lamb CR, Wikeley H, Boswood A, et al. Use of breed-specific ranges for the vertebral heart scale as an aid to the radiographic diagnosis of cardiac disease in dogs. Vet Rec 2001; 148:707711.

    • Search Google Scholar
    • Export Citation
  • 17. Harada M, Koie H, Iwaki S, et al. Establishment of vertebral heart scale in the growth period of the Japanese macaque (Macaca fuscata). J Vet Med Sci 2010; 72:503505.

    • Search Google Scholar
    • Export Citation
  • 18. Onuma M, Ono S, Ishida T, et al. Radiographic measurement of cardiac size in 27 rabbits. J Vet Med Sci 2010; 72:529531.

  • 19. Stepien RL, Benson KG, Forrest LJ. Radiographic measurement of cardiac size in normal ferrets. Vet Radiol Ultrasound 1999; 40:606610.

    • Search Google Scholar
    • Export Citation
  • 20. Lamb CR, Tyler M, Boswood A, et al. Assessment of the value of the vertebral heart scale in the radiographic diagnosis of cardiac disease in dogs. Vet Rec 2000; 146:687690.

    • Search Google Scholar
    • Export Citation
  • 21. Guglielmini C, Diana A, Pietra M, et al. Use of the vertebral heart score in coughing dogs with chronic degenerative mitral valve disease. J Vet Med Sci 2009; 71:913.

    • Search Google Scholar
    • Export Citation
  • 22. Litster A, Atkins C, Atwell R, et al. Radiographic cardiac size in cats and dogs with heartworm disease compared with reference values using the vertebral heart scale method: 53 cases. J Vet Cardiol 2005; 7:3340.

    • Search Google Scholar
    • Export Citation
  • 23. Lamb CR, Tyler M, Boswood A, et al. Assessment of the value of the vertebral heart scale in the radiographic diagnosis of cardiac disease in dogs. Vet Rec 2000; 146:687690.

    • Search Google Scholar
    • Export Citation
  • 24. Takemura N, Toda N, Miyagawa Y, et al. Evaluation of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in dogs with mitral valve insufficiency. J Vet Med Sci 2009; 71:925929.

    • Search Google Scholar
    • Export Citation
  • 25. Abbott JA, MacLean HN. Two-dimensional echocardiographic assessment of the feline left atrium. J Vet Intern Med 2006; 20:111119.

  • 26. Campbell EE, Kittleson MD. The effect of hydration status on the echocardiographic measurements of normal cats. J Vet Intern Med 2007; 21:10081015.

    • Search Google Scholar
    • Export Citation
  • 27. Hansson K, Haggstrom J, Kvart C, et al. Interobserver variability of vertebral heart size measurements in dogs with normal and enlarged hearts. Vet Radiol Ultrasound 2005; 46:122130.

    • Search Google Scholar
    • Export Citation
  • 28. Eerasin L, Sturgess CP, Cannon MJ, et al. Feline idiopathic cardiomyopathy: a retrospective study of 106 cats (1994–2001). J Fel Med Surg 2003; 5:151159.

    • Search Google Scholar
    • Export Citation
  • 29. Greco A, Meomartino L, Raiano V, et al. Effect of left vs. right recumbency on the vertebral heart score in normal dogs. Vet Radiol Ultrasound 2008; 49:454455.

    • Search Google Scholar
    • Export Citation

Advertisement

Use of the vertebral heart scale for differentiation of cardiac and noncardiac causes of respiratory distress in cats: 67 cases (2002–2003)

Meg M. Sleeper VMD, DACVIM1, Risa Roland DVM, DACVIM2, and Kenneth J. Drobatz DVM, MSCE, DACVECC, DACVIM3
View More View Less
  • 1 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 2 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 3 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Abstract

Objective—To assess the effectiveness of the vertebral heart scale (VHS) system to differentiate congestive heart failure from other causes of dyspnea in cats.

Design—Retrospective case series.

Animals—67 cats with acute respiratory distress.

Procedures—Medical records of client-owned cats evaluated on an emergency basis because of acute respiratory distress during a 1-year period were reviewed. For study inclusion, cats must have undergone evaluation with echocardiography and thoracic radiography within 12 hours after hospital admission. The VHS was calculated for each cat by 2 investigators. Signalment, physical examination, and echocardiographic findings were reviewed for each patient.

Results—There was 83% agreement overall between the 2 investigators in assessment of cardiomegaly in cats with dyspnea (κ = 0.49). The VHS cutpoints were the same for both observers in terms of optimizing sensitivity and specificity. A VHS of > 8.0 vertebrae was the best cutpoint when screening for heart disease, whereas a VHS of > 9.3 vertebrae was very specific for the presence of heart disease. Measurements between 8.0 and 9.3 vertebrae suggested the cause of dyspnea was equivocal (ie, secondary to congestive heart failure or respiratory disease), in which case echocardiography would be most useful in providing additional diagnostic information.

Conclusions and Clinical Relevance—Results suggested that the VHS system may be a useful tool to help differentiate cardiac from noncardiac causes of respiratory distress in cats in an emergency situation when an echocardiogram is not available or is not plausible in an unstable patient.

Contributor Notes

Dr. Roland's present address is Metropolitan Veterinary Associates, 2626 Van Buren Ave, Norristown, PA 19403.

Address correspondence to Dr. Sleeper (sleeper@vet.upenn.edu).