Small Animal Cardiac Ultrasound for Non-Veterinarians

Topics included in this course

Pre-reading (delivered 2 weeks before start of course)

  • Mammalian cardiac anatomy and physiology
  • Patient preparation

Week 1

  • Obtaining the right parasternal long-axis view (PLAX) in dogs and cats
  • Identifying the key elements in the normal right parasternal long-axis view
  • Judging systolic function by eye from the PLAX view
  • Colour box placement.

Week 2

  • Obtaining the right parasternal short-axis view (PSAX) at the papillary muscle level
  • Judging systolic function by eye from the PSAX view
  • Taking measurements of left ventricular diameter and wall thickness in the PLAX and PSAX views
  • Examples of normal and abnormal, with a particular focus on hypertrophic cardiomyopathy in cats and dilated cardiomyopathy in dogs

Week 3

  • M-mode measurements in the PLAX and PSAX views
  • PSAX at aortic valve level
  • LA:Ao ratio in the PSAX view

Week 4

Putting it altogether: the complete examination from the parasternal approach, to include:

  • Examination protocol to follow
  • How to report your findings

 

On-going support will be provided within a closed Facebook group. The only people present in the group will be qualified echocardiographers and your fellow course attendees, present and future.

 

Who should take this course?

The purpose of this course is to equip experienced users of ultrasound with the knowledge and support they require to be able to confidently perform a basic cardiac ultrasound examination in partnership with a veterinarian. It is recommended that you secure the support of a local veterinarian – at least in principle – before undertaking this course.

It is important to stress to any veterinarian you intend to work with that your role would be that of a veterinary ultrasound technician. You would use your knowledge and equipment to screen for overt cardiac pathology, providing them with the images and measurements they require to make a diagnosis, plan treatment or refer to a specialist. This course will not make you a sonographer or qualify you in any way: it is only with the cooperation and trust of a vet that you will be able to use these skills. From a practical perspective, you will very much need the assistance of at least one vet nurse for holding the patient, and some animals may even need light sedation for their examination.

This course will be led by Catherine Stowell, with the support of a Consultant Cardiologist and Professor of Cardiology. Catherine is an accredited echocardiographer with a Masters degree in Medical Ultrasound from Imperial College, London. She runs a weekly veterinary echo clinic in partnership with a local veterinary practice, which takes cardiology referrals from a number of surrounding practices.

Prerequisites for this course:

  • 2+ years of working with animals
  • Have attended level 1 ultrasound training from an AUA-approved training provider and have at least 12 months of scanning experience or have completed level 2 ultrasound training delivered by a qualified sonographer or you are a qualified vet nurse.
  • An ultrasound machine with a microconvex and/or high frequency phased array probe.
  • Cut-out cardiac table [hold fire on this – these are expensive and we’re working on getting a discount for our course attendees].
  • Cooperative canine or feline volunteers to practice on. These would preferably be your own pets. They will need to be shaved, so you must either be able to do this yourself, or know a groomer or vet nurse who can do this for you.

Disclaimers:

  • You will require a high-end (preferably Colour Doppler) ultrasound machine to take full advantage of this course. Entry level machines may struggle with image resolution and the high frame rates required in veterinary cardiac imaging. There is no requirement to use a particular make or model of ultrasound machine, but it is important to be aware of the ways in which you may be limited should you choose to undertake this course without the correct equipment. At the very least, a microconvex probe is required. If you only have an ultrasound machine equipped with a large convex probe, you will not be able to obtain any of the images required for this course. The ideal probe for cardiac ultrasound is a high frequency phased array probe, due to its small footprint and ability to fit between rib spaces. If you need guidance on ultrasound equipment, please contact us for help before making an expensive purchase which might not be suitable.
  • This course will not qualify or accredit you to diagnose cardiac disease in animals. This is a veterinary procedure and there is no exemption to this for anybody (this includes your course tutor!). The purpose of this course is to equip you with the knowledge to screen for overt, common cardiac disease in small animals (such as dilated cardiomyopathy, systolic dysfunction, hypertrophic cardiomyopathy, severe congenital pulmonary and aortic stenosis, severe mitral valve disease), and can only be used in partnership with a veterinarian. Before undertaking this course, you will be required to sign a statement acknowledging that you must never attempt to diagnose disease, advise anybody on the cardiac health of their pet, or provide a cardiac scanning service without the knowledge and oversight of a veterinarian. Your role is to provide a report directly to the veterinarian only. It is up to the vet to make a diagnosis based on your images and measurements.