Temperature, pulse rate, respiratory rate, and blood pressure are the 4 vital signs that are often measured in veterinary patients and serve as the primary objective measurements of the physical examination. Normal values frequently reassure the clinician of the general health of the patient, whereas abnormalities of these variables lead clinicians down various diagnostic pathways.
A critical factor in this analysis and decision-making process is whether elevations in these vital signs are clinically important or whether they are merely artifacts caused by the patient being in a medical setting. In human medicine, a patient's blood pressure is higher at the doctor's office than at his or her home, a phenomenon known as the white-coat effect.1 A 2008 study found that 60.3% of 224 human patients attending a lipid screening clinic experienced the white coat effect when their blood pressure was measured by a doctor during a clinic visit.2
Whether an analgous effect also exists in companion animals has been studied, but to a much lesser extent than in humans. In cats, a significant increase in blood pressure was demonstrated in research colony cats when comparing a 24-hour radiotelemetric implant measurement in the colony environment with the blood pressure measured in a simulated veterinary clinic.3 Additional studies have found significant differences in pulse rate, respiratory rate, and indirectly measured blood pressure in cats when measurements made in the home were compared with those obtained in a veterinary hospital.3–5 In dogs, Kallet et al6 found that there was a significant increase in pulse rates measured at the clinic versus at home and a higher, albeit not significantly increased, blood pressure at the clinic versus at home. Another study7 found no significant increase in blood pressure in dogs in the hospital, compared with at home, when measured by use of the Doppler technique and the right cranial tibial artery. Unlike for blood pressure and pulse rate, a search of the literature did not yield any studies evaluating differences in temperature and respiratory rate in dogs in a home environment versus a veterinary hospital.
The purpose of the study reported here was to compare values for the 4 major vital signs (temperature, pulse rate, respiratory rate, and blood pressure) for healthy dogs in their home environment and at a veterinary hospital. Our hypothesis was that the measurements taken in the hospital environment would be significantly higher than those taken in the home environment.
Vicks V966 Comfortflex with Insight, Kaz Inc, Hudson, NY.
Parks Medial Electronics Inc, Aloha, Ore.
Prism, version 6, GraphPad Software Inc, San Diego, Calif.
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